The role of upper middle arm circumference in the detection of malnutrition in diabetic children

INTRODUCTION: Type 1 diabetes (T1D) is a chronic disease that requires continuous insulin therapy. The study aimed to screen the prevalence of malnutrition in children with T1D by measuring the mid-upper arm circumference (MUAC) and to compare the Z scores with the body mass index-standard deviation score (BMI-SDS) of Turkish children.
METHODS: In this cross-sectional study, patients who were followed up with the diagnosis of T1D in the Adana City Training and Research Hospital Pediatric Endocrinology Outpatient Clinic and admitted to the follow-up outpatient clinic between June and September 2022 were included in the study.
RESULTS: Of the 94 patients included in the study, 52 (55.3%) were female and 42 (44.7%) were male. While 7 (7.4%) patients had a weight SDS for an age value below -2, seven (7.4%) patients had a height SDS for an age value below -2. According to BMI SDS values, 61 (64%) patients were found to have normal weight, 18 (19.1%) patients had mild malnutrition, and four (4.3%) patients had moderate malnutrition. According to the MUAC Z-score, 52 (55.3%) patients had normal weight, 30 (31.9%) had mild malnutrition, 5 (5.3%) had moderate malnutrition, and 1 (1.1%) had severe malnutrition. It was noteworthy that 18 (60%) of 30 patients with mild malnutrition, according to MUAC-SDS, were in the normal weight group according to BMI-SDS. It was found that there was a strong positive correlation between the BMI (kg/m2) value of the patients and the arm circumference (cm) (r=0.867; p<0.001).
DISCUSSION AND CONCLUSION: In conclusion, the prevalence of malnutrition in children with T1D was at very high rates, at 23.4% according to BMI-SDS values and 38.3% according to MUAC Z-score values. In addition, MUAC is an easy and effective method that can be applied in every case of malnutrition screening if standard percentiles of malnutrition are developed for Turkish children.