The regulation of type 2 diabetes with the prognostic nutritional index and the evaluation of the relationship between the microvascular complications of diabetes

Objective: Type 2 Diabetes Mellitus (T2DM) is a low-grade chronic inflammatory systemic disease that is increasingly common worldwide and has become a global problem. In our study, we aimed to evaluate the effect of the prognostic nutritional index (PNI), a current biomarker assessing both nutrition and inflammation, on diabetic regulation and microvascular complications in patients with T2DM. Materials and Methods: Our study included patients diagnosed with T2DM aged between 18-75 years who agreed to participate between July 2023 and March 2024, as well as healthy controls as the control group. Demographic characteristics, the presence of diabetic microvascular complications, and laboratory data of the participants were recorded. The PNI value was calculated using the formula [10 x albumin (g/dl)] + [0.005 x total lymphocyte count (mm³)]. Clinical and laboratory values of the study group and the control group were compared. Results: A total of 129 patients, including 65 T2DM patients and 64 controls, were included in our study. The average duration of diabetes in the T2DM group was 13 years (min-max 1-35 years). Of the participants, 76 (58.9%) were male and 53 (41.1%) were female. The mean age of the T2DM group was 60 years (min-max 33-75 years), while the mean age of the control group was 52.5 years (min-max 20-75 years). Significant differences were found between the groups in terms of laboratory values such as HbA1c, uric acid, potassium, glucose, CRP, albumin, HDL, and PNI. A negative correlation was observed between PNI and CRP, glucose, and HbA1c, while a positive correlation was found between PNI and albumin. According to the ROC curve analysis, PNI values below 56.6 were found to be significant in indicating diabetes with 60.9% sensitivity and 66.2% specificity. Regression analysis showed that for every 1 unit decrease in PNI, the risk of developing diabetes mellitus increased by 1.48 times. Conclusion: Based on the results of our study, we believe that PNI could be used as a parameter to show diabetic regulation in the follow-up of type 2 DM.