Abstract
OBJECTIVE: The aim of this study was to determine whether low calf circumference (CC) could predict nutritional risk and the cut-off value of CC in type 2 diabetes (T2D) older patients. We also aimed to evaluate the risk factors for predicting mortality in T2D. METHODS: A total of 296 older patients with T2D were enrolled in this study and followed for 2.5 years at the longest. RESULTS: The CC level was significantly lower in the nutritional risk group than in the non-nutritional risk with T2D group (26.7 ± 4.1 cm vs. 30.2 ± 3.9 cm, P < 0.001). Decreased CC (OR, 6.79; 95% CI, 2.73–16.84; P < 0.001) and a new insulin resistance index of triglyceride glucose (TyG) (OR, 2.14; 95% CI, 1.13–4.07; P = 0.020) were independent risk factors for nutritional risk. The best CC cut-off value for predicting nutritional risk was 27.8 cm. Decreased CC (HR, 2.98; 95% CI, 1.40–6.33; P = 0.005) remained an independent risk factor for mortality. CONCLUSION: Decreased CC could predict not only nutritional risk but also mortality in T2D patients aged over 80 years. CC may be a valuable index to screen out this population in T2D. The prevention strategy for diabetes patients should shifts gradually from the prevention of metabolic disorders to the muscle mass loss. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13098-025-01830-5.