The Mediating Role of Nutritional Status in the Association between Oral Frailty Risk and HbA1c Levels among Elderly Patients with Type 2 Diabetes

Objective To investigate the interactions among nutritional status, oral frailty risk, and glycated hemoglobin (HbA1c) in elderly patients with type 2 diabetes mellitus (T2DM). Methods Elderly T2DM patients who were treated at the Affiliated Hospital of North China University of Science and Technology from August to December 2024 were recruited as the research subjects. A general information questionnaire, the Mini-Nutritional Assessment - Short Form (MNA-SF), and the Oral Frailty Index-8 (OFI-8) were employed for data collection. The HbA1c levels of the patients were collected after admission. The mediating effect of nutritional status on the relationship between oral frailty risk and HbA1c was analyzed. Results In this study, the incidence of high oral frailty risk among elderly T2DM patients was 75.23%. The mean HbA1c level was 7.6 (6.8, 9.5) %, and the total nutritional score was 10 (8, 12) points. Oral frailty risk was positively correlated withHbA1c (r=0.421, p<0.01) and nutritional status (r=0.421, p<0.01). Nutritional status was also positively correlated with HbA1c (r=0.438, p<0.01). Nutritional status served as a mediating variable between oral frailty risk and HbA1c, and the mediating effect accounted for 21.97% of the total effect. Conclusion Nutritional status acts as a mediating variable between oral frailty risk and HbA1c in elderly T2DM patients. This finding implies that medical staff should closely monitor the nutritional and oral health of patients to optimize HbA1c control and minimize the incidence of complications.