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

Objectives: To compare Predictive Index for Osteoporosis (PIO) with Osteoporosis Self-Assessment Tool for Asians (OSTA) as a clinical tool for identifying the risk of osteoporosis in Filipino men 50e69 and Filipino women 50e65 years of age. Methods: This was an analytic study that employed a cross sectional approach that included Filipino men and women seen at the Outpatient Charity Department or at the private clinics and who underwent dual energy X-ray absorptiometry. All subjects completed a structured questionnaire and their weight and height were obtained, from which their PIO and OSTA scores were computed. Results: A total of 81 patients were included in the study. OSTA has an area under the curve of 0.712 which turns out to be significant (P ¼ 0.0004), with a calculated likelihood ratio of 1.64. The receiver operating characteristic (ROC) curve of PIO showed that the optimal cut off is > 0.962 and the calculated likelihood ratio that this patient may have osteoporosis is 1.38. Comparing the sensitivity and specificity, the resulting P value of 0.2728 denotes that the area under the curve of the 2 tools is not significantly different. Conclusions The optimal cut-off point of OSTA and PIO to discriminate high-risk and low-risk patients for osteoporosis were 0.712 and 0.686, respectively, based on ROC analysis. The performance measures of OSTA and PIO did not vary significantly in predicting the risk for osteoporosis in Filipino adults.

Introduction: Polycystic ovarian syndrome (PCOS) has been recognized as a risk factor for metabolic dysfunction. The objective of this study was to determine the association of each PCOS phenotype with the risk for prediabetes and diabetes mellitus (DM). Methods: This was a cross-sectional study by chart review of PCOS patients classified into 4 phenotypes, who consulted at outpatient clinics in Makati Medical Center. Odds ratio using logistic regression was used to determine association between the PCOS phenotype and having prediabetes or DM Type 2. Results: One hundred thirty-four records of eligible females diagnosed with PCOS classified as Phenotype D (52%), Phenotype A (22%), Phenotype C (19%) and Phenotype B (7.5%), were included. Pre-diabetes was diagnosed in 39.6%, and DM type 2 in 7.5% of the women. Univariate association of phenotype and outcome revealed that DM is significantly more common among phenotypes A and D while prediabetes is significantly most common among phenotype D. However, multivariate regression did not show any positive association between phenotypes and risk for prediabetes and DM. Conclusion Phenotypes A and C were significantly negatively associated with the risk of prediabetes or DM type 2. Obesity and abdominal adiposity were aggravating factors that increased metabolic risk.
Prevalence ; Diabetes Mellitus ; Prediabetic State

OBJECTIVE: To  determine  the  prevalence  of  depression  in  Filipino adult patients with type 2 diabetes mellitus (DM) and the risk factors associated in its development.
METHODS: This  is  a  prospective  cross-sectional  study.  Adult  patients (age 19 and above) with type 2 DM being seen at the outpatient department of the Makati Medical Center from  January  to  March  2015  were  included,  taking  into account  the  following:  age,  gender,  marital  status,  body  mass index, waist circumference, blood pressure, duration of  diabetes,  presence  of  other  co-morbid  illnesses,  pill  burden,  insulin  use,  educational  attainment,  employment  status,  family  income,  and  glycemic  status.    They  were  then screened for depression using the standardized PHQ-9 questionnaire. Bivariate analyses through Chi-square Test (for categorical variables) and Analysis of Variance (for interval/ratio variables) were used to determine which among the risk factors are significant for the development of depression.  Significant  risk  factors  were  treated  for  multivariate  and  univariate analyses through ordinal logistic regression.
RESULTS: A  total  of  110  adult  patients  with  type  2  DM  were  enrolled  in  this  study.  There  were  no  drop-outs.  Sixty-nine percent  of  the  patients  had  none  to  minimal  depression,  24% had mild depression, and 7% had moderate depression. None  of  the  patients  had  depression  that  warranted  anti-depressants  or  psychotherapy.   After  step-wise  analysis, increased  BMI,  elevated  diastolic  blood  pressure  and  uncontrolled blood sugar were found to be associated with higher  PHQ-9  scores  while  unemployment  was  associated with decreased PHQ-9 score.
CONCLUSION: The  prevalence  of  depression  among  Filipino type  2  diabetic  patients  is  higher  than  in  non-diabetic  patients. Being obese, having an elevated diastolic blood pressure, and the presence of uncontrolled blood sugar were significant predictors and were associated with an increased likelihood  of  developing  major  depressive  disorder. Being unemployed appears to have the opposite effect.

Human ; Male ; Female ; Aged ; Middle Aged ; Adult ; Blood Glucose ; Diabetes Mellitus, Type 2 ; Depression ; Depressive Disorder, Major ; Insulin ; Body Mass Index ; Waist Circumference ; Psychotherapy

Objective: This study aims to determine whether ultrasound elastography (fibroscan) is more sensitive and specific in detecting fatty liver and fibrosis as compared to ultrasound and elevated serum aminotransferase levels in patients with type 2 diabetes mellitus and metabolic syndrome. Methodology: All elastography results from January to December, 2013 were reviewed. A total of 102 patients met the inclusion/exclusion criteria. The sensitivity and specificity of elastograph, ultrasound, ALT and AST were computed, with fibrosis score as the surrogate gold standard. Results: Elastography was found to be more sensitive compared to ultrasound for patients with diabetes and metabolic syndrome who have high and moderate probability of fibrosis (100% vs 82.5%, p-value = 0.0036 and 96% vs 76.4%, p-value = 0.0036, respectively). The elastograph is also more specific compared to ultrasound (86.49% vs 32.43%, p-value = 0.0000) for detecting fatty liver and fibrosis. Only elastography was found to be significantly associated with the surrogate gold standard used in this study. Conclusion Elastograph (fibroscan) is more sensitive and specific than ultrasound in detecting fatty liver in the presence of severe and moderate probability for fibrosis. Ultrasound, ALT and AST showed no correlation with fibrosis score.
Non-alcoholic Fatty Liver Disease ; Elasticity Imaging Techniques ; Diabetes Mellitus, Type 2 ; Metabolic Syndrome