GLIM-defined malnutrition and frailty in older outpatients with diabetes

Diabetes increases the risk of both malnutrition and frailty in older adults. Although the Global Leadership Initiative on Malnutrition (GLIM) criteria have been increasingly adopted, data on its prevalence and association with frailty in diabetic older adults remain limited. We aimed to determine the prevalence of GLIM-defined malnutrition and examine its relationship with frailty among older outpatients with diabetes. In this retrospective study, 391 diabetic older adults who were subjected to comprehensive geriatric assessment (CGA) were included. Malnutrition was diagnosed based on GLIM criteria, and frailty was determined using Fried Frailty Phenotype. Binary logistic regression analysis was conducted to assess factors independently associated with GLIM-defined malnutrition. The mean age was 76.5 ± 6.3 years, 66.8% were female, and 20.5% were frail. GLIM-defined malnutrition was present in 33% of participants. Malnourished individuals were older and demonstrated significantly poorer functional, cognitive, and physical performance. After adjustment for confounders, frailty remained independently associated with GLIM-defined malnutrition (OR 2.405, 95% CI 1.275–4.537, p = 0.007). Lower arm circumference (OR 0.866, 95% CI 0.809–0.927, p < 0.001), higher depressive symptom scores (OR 1.084, 95% CI 1.001–1.174, p = 0.047), and greater medication burden (OR 1.125, 95% CI 1.033–1.225, p = 0.007) were also independently related to GLIM-defined malnutrition. GLIM-defined malnutrition was highly prevalent and independently associated with frailty in diabetic older adults. GLIM-defined malnutrition affects nearly one-third of older adults with diabetes and is strongly associated with frailty. Integrating nutritional and frailty screening into CGA may support more individualized clinical management in this vulnerable population.