Nutrition In SAGE-DM, preventing malnutrition and frailty may be as important as achieving glycaemic control The important role of malnutrition in the elderly, including the presence of diabetes and other chronic diseases, has been confirmed in many studies [224] This condition is common among the elderly and is an important but rarely considered cause of diabetes-related adverse events Recent epidemiological research, including a large meta-analysis of studies and reviews [225], shows malnutrition, or risk of malnutrition, is common among people with diabetes, particularly among older people, those with diabetes duration of over 10 years, multimorbidity, frailty, functional impairment, and those who are hospitalized or institutionalized These results highlight the need for routine nutritional screening and timely nutritional intervention Diabetes-related malnutrition is associated with increased risk of mortality, frailty, sarcopenia, hospitalization, and functional impairment in the clinical course of diabetes in the context of aging It is important to identify signs of malnutrition: unintentional weight loss of 10% over the last 6 months or 5 kg in the last 6 months, BMI 65 and/or who are overweight is brisk walking (to the point of breathlessness) 35 times per week (150 min/week).To prevent frailty and sarcopenia, resistance training and multi-component exercise are recommended [234]
In the UK, intramuscular hydroxocobalamin is the standard formulation due to its longer duration of action compared to cyanocobalamin
Bloating, burping stomach pain etc
This distinction matters because improvement reflects actual healing rather than masked symptoms
