Evaluation of the frequency of frailty in patients with TYPE 2 diabetes mellitus and the relationship between frailty and diabetes

Aim: Fragility is a syndrome in the geriatric population and is defined as a state of increased vulnerability to physical or physiological stressors with increasing age and decreased physiological reserve of many organ and system functions. Diabetes has been reported to increase the risk of fragility due to recurrent hyperglycemia, hypoglycemia, insulin resistance, increased oxidative stress and inflammation. The presence of macrovascular complications due to diabetes has been reported to be an important factor that increases fragility. Studies on fragility in patients with diabetes are limited. In our study, diabetes may lead to the occurrence of fragility in patients at an earlier age and in the light of all this information, we aimed to evaluate the fragility rate in diabetics and to investigate the relationship between fragility and diabetes. Methods: 125 patients with T2DM admitted to Abant İzzet Baysal University Medical Faculty Internal Medicine outpatient clinic were included in the study. Demographic characteristics and routine laboratory parameters of the patients included in the study, the information of the assessment using the Fried's Fragility Scale was recorded. Patients were divided into 3 groups in the form of fragile, pre-fragile and non-fragile. Statistical analysis was carried out with the Statistical Package for the Social Sciences program. Comparisons were made between the fragility groups between Anova and the Kruskal-Wallis test. Results: The glucose of the fragile group was 255 [158- 471] mg/dl, the glucose of the pre-fragile group was 204 [84- 536] and the glucose of the non-fragile group was 151 [87-336] mg/dl (p<0.001). HbA1c levels were found to be 11.7% [8.4-14.2] in fragile, 9.5% [6.3-14.2] in pre fragile, and 7.6% [5.9-11.9] in non-fragile (p<0.001). When evaluated in terms of hand muscle strength (kg) was detected 21.8 kg (10.6-73.1) in the fragile group, 24.3 kg (10.3-78.7) in the pre-fragile group, and 36.7 kg (12.4-68,1) in the non-fragile group (p=0.017). Walking speed (sec) was found to be 12 s (7.5-20) in the fragile group, 10 sn (6.6-20) in the pre-fragile group, and 9 sn (7-14) in the non-fragile group (p=0.002). Conclusion: In our study, it was found that most of the patients with T2DM were pre-fragile and patients with diabetes tended to be fragile. It was also found that T2DM patients with impaired glucose regulation were more fragile. As a result, patients with T2DM should be evaluated for fragility at an earlier age and necessary precautions can be taken to prevent mortality and morbidity. Key words: Fragility, Fried Fragility Scale, Type 2 Diabetes Mellitus.