INTRODUCTION: Malnutrition is a state of deficiency of the proper micro and macronutrients to meet daily nutritional requirement. Hospital malnutrition is associated with higher infection, impaired wound healing, and increased morbidity and mortality, especially in patients with type 2 diabetes mellitus (T2DM).

OBJECTIVES: To determine the comprehensive baseline nutrition status of hospitalized patients and the prevalence of malnutrition in patients with T2DM in Makati Medical Center (MMC).

METHODS: A prospective cross-sectional study involving T2DM patients admitted at MMC from October to December 2014. Malnutrition risk and status were assessed with Subjective Global Assessment (SGA) and clinical parameters.

RESULTS: A total of 150 adults with T2DM were assessed with the Comprehensive Nutrition Assessment Form (CNAF) using SGA, Nutritional risk level showed 37% has moderate risk while 63% has high risk for malnutrition. Nutritional status showed that 55% has mild to moderate malnutrition and 45% of patients have severe malnutrition. Factors significantly associated with high nutritional risk for malnutrition were SGA C (P<0.001), abnormal BMIunderweight and obese class2 (P<0.001), lower albumin (P=0.005) and lower total lymphocyte count (P<0.001). Factors associated to nutritional status were: weight change (P=0.004), functional capacity (P=0.017), disease and nutritional requirements (P<0.001), and presence of edema or ascites (P=0.012).

CONCLUSION: Malnutrition is highly prevalent in the acute hospital setting, 37% has moderate risk while 63% has high risk for malnutrition. While 55% has mild to moderate malnutrition and 45% of patients has severe malnutrition. Significant factors associated with malnutrition were SGA C, abnormal BMI, low albumin and low total lymphocyte count. Factors associated with severity of malnutrition were weight change, functional capacity, disease and nutritional requirements and presence of edema or ascites.

Human ; Male ; Female ; Aged ; Middle Aged ; Adult ; Nutrition Assessment ; Nutritional Status ; Diabetes Mellitus, Type 2 ; Ascites ; Body Weight ; Obesity ; Edema ; Wound Healing

Objective: To determine the association between 25-hydroxyvitamin D [25(OH)D] serum concentrations and health-related quality of life (HRQoL) among patients with low vitamin D levels. Methodology: This prospective cohort study included 76 patients (ages 18 to 59; 54 females and 22 males) who had baseline 25(OH)D below 30 ng/ml and were prescribed a Vitamin D supplement for eight weeks. HRQoL was assessed at baseline and after 8 weeks through the Functional Assessment of Non-Life Threatening Conditions (FANLTC) questionnaire. Results: HRQoL of the participants who were Vitamin D deficient and insufficient at baseline were basically the same (p-values >0.05). After supplementation, the personal well-being and overall HRQoL of the participants who were Vitamin D sufficient were significantly higher than those who were Vitamin D deficient or insufficient (p-values < 0.05). Moreover, after supplementation, all the HRQoL subscale scores as well as the total HRQoL scores of the participants were significantly higher than their baseline HRQoL scores (p-values < 0.05). Conclusion The improved HRQoL scores after Vitamin D supplementation showed that there is a significant association between 25(OH)D serum concentrations and HRQoL.
Vitamin D ; Quality of Life

Introduction: Diabetes mellitus (DM) has been associated with increase in incidence of fracture irrespective of bone mineral density (BMD). There is a paucity of local studies on the relationship of DM, osteoporosis, and fracture. This study aims to compare the osteoporosis risk factors of patients with and without DM admitted for fragility fracture. Methods: This is a retrospective cross-sectional analysis of patients 40 years and above admitted for fragility fracture in Makati Medical Center from January 1, 2015 to December 31, 2017. Results: A total of 132 (32%) patients with DM and 285 patients without DM (non-DM) was reviewed. Mean BMI of DM patients was significantly higher (25.16 kg/m2) compared to non-DM patients (23.27 kg/m2) (P=0.0003). Likewise, presence of comorbidity, specifically hypertension, was significantly higher among DM patients (79.55%) as compared to only 61.75% among non-DM patients (P=0.0003). There was no significant difference found between the two groups in terms of age, gender, proportion of multiple fractures, smoking status, alcohol use, history of fracture and average BMD. Fracture sites were the same for the two groups except in fracture involving finger/toe which was significantly higher in DM patients (P=0.0113). Association between BMI and BMD among DM patients indicate a positive linear relationship (Pearson r of 0.4262) where a higher BMI will likely result to a higher BMD. (P=0.0237). The correlation of HbA1C of DM group patients was noted to have a negative linear relationship with BMD with Pearson r=0.4126 (P= 0.0451). Conclusion Among patients admitted for fragility fracture in Makati Medical Center from 2015 to 2017, clinical profile were similar whether in the DM group or non-DM group except for an increase mean BMI and presence of comorbidity among the DM group. There is also a significant difference in the fracture site according to BMI among both groups. A higher BMI was associated with higher BMD only in patients with DM. Poor glycemic control was associated with lower BMD.
Diabetes Mellitus ; Osteoporosis

Objective: To determine general and clinical characteristics associated with the use of inappropriate footwear among Filipino patients with diabetes. Methodology: Adult patients with diabetes were recruited. Comprehensive foot examination was done checking on foot deformities, neuropathies and peripheral arterial disease. Footwear was then examined as to length and width. Appropriateness of footwear to patient’s foot was measured using International Working Group on the Diabetic Foot (IWGDF) criteria. Results: We classified 170 adults with diabetes based on foot ulcer risk classification of IWGDF. In this population, 62% of respondents were at risk for foot ulcer. Flipflops are the primary choice of footwear among 82% and 47% of the respondents for indoor and outdoor footwear respectively. Inappropriate footwear was see in 91% of the patients. Binary logistic regression showed insufficient evidence to determine an association between the use of inappropriate footwear and patient sex, educational attainment, foot care evaluation and examination. Foot ulcer risk classification showed a trend for higher group levels to wear inappropriate footwear. Conclusion Flipflops and sandals are the primary preferences of the participants. Majority (91%) of the participants wear inappropriate footwear. This finding were due to multifactorial causes: preference, climate, economic reasons, and foot ulcer risk category. Educational attainment and foot care education did not improve the statistics of footwear appropriateness.
Diabetes Mellitus ; Foot Ulcer