Subscribe Now Subscribe Today
Research Article

Comparison of a Simple Nutrition Screening Tool (SNST) Compared with Subjective Global Assessment (SGA) in Body Mass Index (BMI) Assessments of Type 2 Diabetic Patients Validation of SNST Versus BMI in T2 Diabetes

Banun B.R. Rohimah, S. Sugiarto, Ari A.P. Probandari and Budiyanti B.W. Wiboworini
Facebook Twitter Digg Reddit Linkedin StumbleUpon E-mail

Diabetes is a major health problem and has become a burden to the health care system worldwide. Malnutrition is common among patients with diabetes, both in hospitalized and outpatient clinic settings. Therefore, nutrition screening is needed to detect malnutrition risk. Recently, a new nutrition-screening tool for adult populations has been developed, termed the Simple Nutrition Screening Tool (SNST). SNST has been validated for use in adult hospitalized patients. This study aimed to determine the validity (sensitivity, specificity, Maximum Sum Sensitivity and Specificity [MSSS] and Area Under Curve [AUC]) of SNST and SGA in calculating the body mass index in type 2 diabetic patients. This observational study employed a cross sectional design. A total of 153 type 2 diabetic outpatients from an internal medicine clinic at Dr Moewardi Hospital were recruited using a purposive sampling technique. The independent variables included nutrition-screening interpretation using SNST and SGA, while the dependent variable was body mass index (BMI). Contingency tables and the ROC curve were used to determine the validity of SNST and SGA compared with standards for nutrition and body mass index. There ware significant associations between SNST and BMI (p<0.001) and SGA and BMI (p<0.001). Validation of SNST vs. SGA revealed the following: sensitivity, 88.89% vs. 77.78%; specificity, 81.25% vs. 81.94%; MSSS, 170.14% vs. 159.72% and AUC, 0.851 vs. 0.799. SNST exhibited better validity than SGA predicting the body mass index of type 2 diabetic patients.

Related Articles in ASCI
Similar Articles in this Journal
Search in Google Scholar
View Citation
Report Citation

  How to cite this article:

Banun B.R. Rohimah, S. Sugiarto, Ari A.P. Probandari and Budiyanti B.W. Wiboworini, 2016. Comparison of a Simple Nutrition Screening Tool (SNST) Compared with Subjective Global Assessment (SGA) in Body Mass Index (BMI) Assessments of Type 2 Diabetic Patients Validation of SNST Versus BMI in T2 Diabetes. Pakistan Journal of Nutrition, 15: 412-418.

DOI: 10.3923/pjn.2016.412.418


1:  Adnan, M., T. Mulyati and J.T. Iswoyo, 2013. Hubungan Indeks Massa Tubuh (IMT) dengan kadar gula darah penderita Diabetes Mellitus (DM) tipe 2 rawat jalan di RS tugurejo Semarang. J. Nutr. School Muhammadiyah Univ. Semarang, 2: 18-24.
Direct Link  |  

2:  Almeida, A.I., M. Correia, M. Camilo and P. Ravasco, 2013. Length of stay in surgical patients: Nutritional predictive parameters revisited. Br. J. Nutr., 109: 322-328.
CrossRef  |  Direct Link  |  

3:  Atreja, A. and S. Kalra, 2015. Infection in diabetes. J. Pak. Med. Assoc., 65: 1028-1030.

4:  Campillo, B., J. Richardet and P.N. Bories, 2006. Validation of body mass index for the diagnosis of malnutrition in patients with liver cirrhosis. Gastroenterol. Clin. Biol., 30: 1137-1143.
PubMed  |  Direct Link  |  

5:  Casqueiro, J., J. Casqueiro and C. Alves, 2012. Infections in patients with diabetes mellitus: A review of pathogenesis. Indian J. Endocrinol. Metab., 16: 27-36.
CrossRef  |  Direct Link  |  

6:  Chakravarty, C., B. Hazarika, L. Goswami and S. Ramasubban, 2013. Prevalence of malnutrition in a tertiary care hospital in India. Indian J. Crit. Care Med., 17: 170-173.
CrossRef  |  Direct Link  |  

7:  Debruyne, L.K., K. Pinna and E. Whitney, 2008. Nutrition and Diet Therapy. 7th Edn., Thomson Brooks, USA.

8:  Donath, M.Y. and S.E. Shoelson, 2011. Type 2 diabetes as an inflammatory disease. Nat. Rev. Immunol., 11: 98-107.
CrossRef  |  Direct Link  |  

9:  Gibson, R.S., 2005. Principles of Nutritional Assessment. 2nd Edn., Oxford University Press, New York, ISBN-13: 9780195171693, Pages: 908.

10:  Gomez-Candela, C., R.S. Labajos, N. Garcia-Vazquez, M.V. Perez and M.M. Martinez et al., 2013. [Complete process of implantation of a nutritional risk screening system in the University Hospital La Paz, Madrid]. Nutr. Hosp., 28: 2165-2174, (In Spanish).
CrossRef  |  PubMed  |  Direct Link  |  

11:  Gupta, D., P.G. Vashi, C.A. Lammersfeld and D.P. Braun, 2011. Role of nutritional status in predicting the length of stay in cancer: A systematic review of the epidemiological literature. Ann. Nutr. Metab., 59: 96-106.
CrossRef  |  Direct Link  |  

12:  Hajian-Tilaki, K., 2013. Receiver Operating Characteristic (ROC) curve analysis for medical diagnostic test evaluation. Caspian J. Intern. Med., 4: 627-635.
Direct Link  |  

13:  Knapp, S., 2013. Diabetes and infection: Is there a link?-A mini-review. Gerontology, 59: 99-104.
CrossRef  |  Direct Link  |  

14:  Lee, L.C., A.C. Tsai, J.Y. Wang, B.S. Hurng, H.C. Hsu and H.J. Tsai, 2013. Need-based intervention is an effective strategy for improving the nutritional status of older people living in a nursing home: A randomized controlled trial. Int. J. Nurs. Stud., 50: 1580-1588.
CrossRef  |  Direct Link  |  

15:  Mayasari, M., Susetyowati and W. Lestariana, 2014. Simple Nutritional Screening Tool (SNST) has good validity to identify risk of malnutrition on hospitalized elderly patients. Pak. J. Nutr., 13: 573-578.
Direct Link  |  

16:  Moriana, M., M. Civera, A. Artero, J.T. Real, J. Caro, J.F. Ascaso and J.F. Martinez-Valls, 2014. Validity of subjective global assessment as a screening method for hospital malnutrition. Prevalence of malnutrition in a tertiary hospital. Endocrinologia y Nutricion, 61: 184-189.
CrossRef  |  

17:  Mueller, C., C. Compher, D.M. Ellen and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) Board of Directors, 2011. A.S.P.E.N. clinical guidelines: Nutrition screening, assessment and intervention in adults. J. Parenter. Enteral. Nutr., 35: 16-24.
CrossRef  |  Direct Link  |  

18:  Platek, M.E., J.V. Popp, C.S. Possinger, C.A. DeNysschen, P. Horvath and J.K. Brown, 2011. Comparison of the prevalence of malnutrition diagnosis in head and neck, gastrointestinal and lung cancer patients by 3 classification methods. Cancer Nursing, 34: 410-416.
CrossRef  |  Direct Link  |  

19:  Rasmussen, H.H., M. Holst and J. Kondrup, 2010. Measuring nutritional risk in hospitals. Clin. Epidemiol., 2: 209-216.
CrossRef  |  Direct Link  |  

20:  Rochette, L., M. Zeller, Y. Cottin and C. Vergely, 2014. Diabetes, oxidative stress and therapeutic strategies. Biochimica Biophysica Acta (BBA)-Gen. Subj., 1840: 2709-2729.
CrossRef  |  Direct Link  |  

21:  Paris, A.S., J.M. Garcia, C. Gomez-Candela, R. Burgos, A. Martin, P. Matia and Study VIDA Group, 2013. Malnutrition prevalence in hospitalized elderly diabetic patients. Nutr. Hosp., 28: 592-599.
Direct Link  |  

22:  Solmi, M., N. Veronese, A. Favaro, P. Santonastaso, E. Manzato, G. Sergi and C.U. Correll, 2015. Inflammatory cytokines and anorexia nervosa: A meta-analysis of cross-sectional and longitudinal studies. Psychoneuroendocrinology, 51: 237-252.
CrossRef  |  Direct Link  |  

23:  Sugiani, P.P.S., 2011. Status gizi dan status metabolik pasien diabetes melitus rawat jalan di RSUP sanglah denpasar. Jurnal Ilmu Gizi, 2: 49-57.
Direct Link  |  

24:  Sujanitha, V., S. Sivansuthan, P. Selvakaran and P. Parameshwaran, 2015. Overweight, obesity and chronic complications of diabetes mellitus in patients attending diabetic centre, teaching hospital, Jaffna, Sri Lanka. Ceylon Med. J., 60: 94-96.
CrossRef  |  Direct Link  |  

25:  Susetyowati, S., H. Hadi, M. Hakimi and H.A.H. Asdie, 2014. Development, validation and reliability of the Simple Nutrition Screening Tool (SNST) for adult hospital patient in Indonesia. Pak. J. Nutr., 13: 157-163.
CrossRef  |  Direct Link  |  

26:  Da Silva, H.G.V., S.O. Santos, N.O. Silva, F.D. Ribeiro, L.L. Josua and A.S.B. Moreira, 2012. Nutritional assessment associated with length of inpatients' hospital stay. Nutr. Hosp., 27: 542-547.
Direct Link  |  

27:  WHO., 2014. Global Status Report on Noncommunicable Diseases 2014. WHO Press, Geneva, Switzerland, Pages: 298.

28:  WHO., 2014. NCD country profiles 2014. World Health Organization, Washington, DC.

29:  Young, A.M., S. Kidston, M.D. Banks, A.M. Mudge and E.A. Isenring, 2013. Malnutrition screening tools: Comparison against two validated nutrition assessment methods in older medical inpatients. Nutrition, 29: 101-106.
CrossRef  |  Direct Link  |  

30:  Zekry, D., F.R. Herrmann and U.M. Vischer, 2012. The association between the body mass index and 4-year all-cause mortality in older hospitalized patients. J. Gerontol. Ser. A: Biol. Sci. Med. Sci., 68: 705-711.
CrossRef  |  Direct Link  |  

©  2021 Science Alert. All Rights Reserved