The relationship of frailty with clinical and laboratory parameters according to edmonton, frai̇l and prisma-7 criteria in patients wi̇th geriatric type 2 diabetes mellitus

Purpose: With the increase of the elder population in the world, the term "frailty in older people" is becoming more and more crucial topic. Frailty is an inevitable consequence of aging and it is also a public health problem considering its' preventable or deferred situation. In this study, we aimed to evaluate Edmonton, Frail and Prisma-7 frailty scales and the link between clinic and laboratory parameters in T2DM patients. Material and the Method: Patients were included to this study above 65 years old and diagnosed as type-2 diabetics who applied Bolu İzzet Baysal University Faculty of Medicine Hospital between the dates June 2020 and January 2021. Edmonton, Frail and Prisma-7 frailty scales were conducted to the patients as face-to-face style survey. According to each scale, patients were grouped whether they are frail or not. Their laboratory parameters and anthropometric scales were recorded. The patients or their relatives were followed up after 6 months later than their participation in the study, and the morbidity and mortality conditions that requires hospitalization during this period were recorded. Study parameters were compared between good and poorly controlled patient groups, and between frail and not-frail groups, relative to diabetes control level. Findings: The patients were 34 female and 66 males. There was no significant difference found between gender distribution and frailty (p>0.05). 50 patients had well-controlled; 50 patients had poorly controlled diabetics. Diabetics regulation were not related to the frailty, 6 months' hospitalization, and mortality (each was p>0.05). The percentage of the frailty patients were found as 28% according to the Edmonton, 44% according to the Frail and 19% according to the Prisma-7 scale respectively. Edmonton frailty is found to be correlated to both 6-months mortality (p=0.02) and hospitalization (p=0.005). There was no significant correlation found between Frail frailty and 6 months mortality (p=0.07), however, there were statistically significant difference has been found on hospitalization rates (p=0.009). Although there was no significant difference has been found between Prisma 7 frailty rates and 6 months hospitalization (p=0.06); there were a statistically significant difference has been found between mortality rates (p<0.001). In the groups that are defined as "frailty" according to the Edmonton, Frail and Prisma-7 scales, there were statistically significant lower serum albumin, GFR, hemoglobin and Lipid ratios (p<0.05 for each). Average waist circumferences were measured higher in the the group that are frail according to the Edmonton scale; body mass indexes were statistically significantly higher in the group that are frail according to Frail scale (p=0.04 for both). On the group that are poorly controlled diabetics (p=0.02); and defined as frail according to the Frail scale, the incidence of diabetic peripheric neuropathy was statistically significantly higher (p=0.03). Results: Frailty alone, is not only related to the diabetes that are being well or poorly controlled. Since Edmonton Frailty scale is both correlated to the mortality and hospitalization; it is superior than Prisma-7 and Frail scales. Adequate nutrition, weight control, correction of anemia and preservation of kidney functions could reduce the prevalence of frailty in elder patients with type 2 diabetes. Keywords: edmonton, frail, frailty, geriatric patients, mortality, prisma-7, Type-2 diabetes