LB072 - WAGNER STAGE MAY BE A PREDICTOR OF MALNUTRITION AND SARCOPENIA IN ELDERLY PATIENTS WITH DIABETIC FOOT ULCERS

LB072

WAGNER STAGE MAY BE A PREDICTOR OF MALNUTRITION AND SARCOPENIA IN ELDERLY PATIENTS WITH DIABETIC FOOT ULCERS

D. A. Haspolat¹, A. S. Çakır^2,*, L. DEMİR³, M. Öztürk⁴, N. İnanç¹

¹Nutrition and Dietetics, Nuh Naci Yazgan University, ²Health Management, Kayseri University, ³Hyperbaric and Diving Medicine, ⁴Anatomy, Kayseri City Hospital, Kayseri, Türkiye

Rationale: Diyabetik ayak ülseri, yaşlı diyabetli bireylerde enfeksiyon, morbidite ve amputasyon riskini artıran kronik bir komplikasyondur. Bu grupta sık görülen yetersiz beslenme, enfeksiyon riskini artırarak ülser ilerlemesini şiddetlendirir; Benzer şekilde, sarkopeni yara iyileşmesini bozabilir ve hareket kabiliyetinin azalması nedeniyle lokal basıncı artırabilir. Bu çalışmada diyabetik ayak ülseri olan yaşlı hastalarda Wagner sınıflaması, malnütrisyon riski, sarkopeni ve diyet alımı arasındaki ilişkinin araştırılması amaçlanmıştır.

Methods: The study was conducted with 51 patients over the age of 60 who had diabetic foot ulcers. Ulcer severity was assessed using the Wagner classification; malnutrition was evaluated with the Mini Nutritional Assessment (MNA), and sarcopenia with the SARC-F scale. Handgrip strength was measured using a dynamometer. Relationships between Wagner stage, malnutrition, and sarcopenia were analyzed using ANOVA and Kruskal-Wallis tests, with post-hoc analysis performed to determine significant differences.

Results: Of the participants, 54.9% were classified as Wagner stage 3. As ulcer stage increased, MNA scores decreased—indicating higher malnutrition—and sarcopenia scores increased (p = 0.002; p < 0.001). A significant difference was found between handgrip strength categories and MNA scores (p = 0.019), particularly between individuals with weak and normal grip strength (p = 0.013). A significant relationship was also observed between Wagner stage and grip strength (p = 0.026), suggesting that handgrip strength declines with advancing ulcer severity.

Conclusion: As diabetic foot ulcer severity increases, the risks of malnutrition and sarcopenia rise, while handgrip strength decreases. These findings highlight the importance of evaluating nutritional status and muscle function in the management of diabetic foot ulcers.

References: Dunning, T., Sinclair, A., and Colagiuri, S. (2014). New IDF Guideline for managing type 2 diabetes in older people. Diabetes Research and Clinical Practice 103, 538-540.

Gazzaruso, C., Gallotti, P., Pujia, A., Montalcini, T., Giustina, A., & Coppola, A. (2021). Predictors of healing, ulcer recurrence and persistence, amputation and mortality in type 2 diabetic patients with diabetic foot: a 10-year retrospective cohort study. Endocrine, 71, 59-68.

Guigoz, Y., & Vellas, B. J. (1997). Malnutrition in the elderly: the Mini Nutritional Assessment (MNA). Therapeutische Umschau. Revue Therapeutique, 54(6), 345-350.

Miller, D. K., Malmstrom, T. K., Andresen, E. M., Miller, J. P., Herning, M. M., Schootman, M., & Wolinsky, F. D. (2009). Development and validation of a short portable sarcopenia measure in the African American health project. Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences, 64(3), 388-394.

Disclosure of Interest: None declared