Assessment of Malnutrition and its Determinants among Patients with Type 2 Diabetes seen in Primary Care Settings of Eastern Uttar Pradesh, India

Background Malnutrition is an under-recognized yet clinically significant problem among patients with Type 2 Diabetes Mellitus (T2DM), particularly in low-resource settings. Objective To assess malnutrition among patients with Type 2 Diabetes Mellitus attending primary health care facilities in Gorakhpur, Eastern Uttar Pradesh, and to identify associated determinants. Methods A cross-sectional observational study was conducted among patients with Type 2 Diabetes Mellitus(T2DM) attending three primary health care centres from April, 2024 to December 2024. Data on socio-demographic characteristics, clinical profile, and anthropometric measurements were collected. Patients were evaluated for malnutrition using Malnutrition Universal Screening Tool(MUST), a screening tool to identify adults at risk of malnutrition. Associations between malnutrition risk and explanatory variables were examined using chi-square or Fisher’s exact test, with a p-value < 0.05 considered statistically significant. Results A total of 152 patients with T2DM were included with a near equal ratio of males and females (1.1:1). The mean age of the participants was 53.92 ± 15.02 years with half (50.0%) belonging to lower or lower middle class and majority (80.0%) belonging to rural background. Using the MUST score, 29.6% of the participants were having malnutrition risk with 13.8% having high risk. Rural residence (p = 0.04), lower income (p = 0.01), lower socioeconomic status (p = 0.02), presence of comorbidities (p = 0.003), lower BMI (p < 0.001), absence of abdominal obesity (p = 0.04), and lower mid-upper arm circumference (p = 0.01) were significantly associated with higher malnutrition risk. Conclusion One in every three individuals with type 2 diabetes seen in primary care is at risk of malnutrition. Routine nutritional screening using simple tools such as MUST should be integrated into primary care and outpatient diabetes care, particularly for socioeconomically vulnerable and high-risk groups in order to address this problem.