Malnutrition risk is associated with hypoglycemia among general population admitted to internal medicine units. Results from the MENU study

Background/objectives: To examine the association between increased malnutrition risk upon admission, and the incidence of hypoglycemia among adult patients admitted to internal medicine units in Israel. Subjects/methods: This was a cross-sectional study, and included were all adult patients admitted to internal medicine units, regardless of reason for admission. The NRS2002 was used to for nutritional screening. All glucose measurements were obtained using an institutional blood glucose-monitoring system, which consisted of a point of care, automated glucometer, and an interactive database. Patients were categorized as hypoglycemic if they had at least one documented hypoglycemia (= <70 mg/dL) event during the hospitalization period. Blood chemistry measured at admission was also recorded. Results: Included were 876 patients (mean age 70.0 ± 17.3, 50.6% were males). Rate of positive malnutrition screen was 39.7% of the population. A total of 5.4% of the study population had at least one hypoglycemic event during hospitalization. Rate of diabetes mellitus did not differ between patients with or without hypoglycemia. A greater proportion of patients with hypoglycemia were at increased malnutrition risk compared to patients without documented hypoglycemic events (56.8% vs. 38.9%, p = 0.018). Patients who had hypoglycemia had higher NRS2002 scores for pre-hospitalization unintentional weight loss and reduced food consumed. In logistic regression analysis, increased malnutrition risk was associated with hypoglycemia occurrence (OR 1.982, 95% confidence interval 1.056-3.718, p = 0.033). Age, sex, and diabetes mellitus status did not affect the rate of hypoglycemia. Conclusions: Our data suggest increased malnutrition risk as measured by the NRS2002 almost doubled the risk for hypoglycemia during the hospitalization.