Prevalence and risk factors of malnutrition in elderly patients with diabetes mellitus: a meta-analysis and systematic review.

BACKGROUND: The prevalence and risk factors of malnutrition in elderly patients with diabetes are unclear, a knowledge gap that this meta-analysis aimed to explore. METHODS: Studies published in the PubMed, Embase, Web of Science, Medline, EBSCO, CNKI, Wanfang, VIP, and Sinomed databases from 1 January 2010, to 31 December 2024 were searched using the following terms with a combination of subject headings and free text: "diabetes," "malnutrition," "prevalence," "risk factors," "associated factor," and "influencing factor." Age filters (age ≥ 60 years) were applied where available. All retrieved studies were manually screened for age criteria. The term "elderly" was not used as a search term to avoid missing studies that enrolled older adults without mentioning "elderly" in the title or abstract. Cohort studies, case-control studies, and cross-sectional studies meeting the inclusion criteria were analyzed. Meta-analysis was performed using Stata 15.0 software. RESULTS: This meta-analysis included 30 studies involving 12,564 cases from 9 countries (namely China, South Korea, Japan, Thailand, Turkey, Nigeria, Spain, Brazil, and India). Based on 21 studies, the overall prevalence rate of malnutrition in elderly patients with diabetes was 29% (95% confidence interval (CI): 0.19-0.39). The analysis of 20 studies revealed that the prevalence rate of high malnutrition risk was 42% (95% CI: 0.31-0.53). This study identified 14 risk factors for malnutrition in elderly patients with diabetes. CONCLUSION: This meta-analysis improved our understanding of the prevalence and risk factors of malnutrition in elderly patients with diabetes. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251034655, identifier CRD420251034655.