Assessing nutritional and hydration status in patients with a diabetic foot ulcer: Agreement between hand-to-hand and hand-to-foot bioimpedance methods.

Statistically significant but small differences were observed between hand-to-foot and hand-to-hand BIA measurements for raw impedance parameters.

• Significant differences found for resistance (P < 0.001), reactance (P = 0.036), and phase angle (P < 0.001)
• Differences were described as 'statistically significant but small'
• Study used one-sample t-tests, Bland-Altman plots, intra-class correlation, and Cohen's d to analyze agreement
• 164 patients with diabetic foot ulcers underwent both HF and HH BIA measurements in this cross-sectional study

Strong agreement was found between hand-to-hand and hand-to-foot BIA methods for derived body composition and hydration metrics.

• Intra-class correlation coefficients exceeded 0.75 for body composition and hydration indices
• Systematic biases observed were described as 'clinically negligible'
• Over- or underestimation was pre-defined as deviation greater than 10% from HF values
• The derived body composition and hydration indices showed 'strong consistency between methods'

Malnutrition was diagnosed in 32.3% of patients with diabetic foot ulcers using GLIM criteria.

• Malnutrition prevalence was 32.3% in the 164-patient cohort
• Malnutrition was diagnosed using the GLIM (Global Leadership Initiative on Malnutrition) criteria
• HH BIA showed 88.7% accuracy in identifying malnourished individuals
• HF BIA showed similar accuracy at 89% for identifying malnourished individuals

Hand-to-hand BIA is a reliable alternative to hand-to-foot BIA for assessing nutritional status in diabetic foot ulcer patients when foot measurements are not feasible.

• HF BIA measurements are often not feasible in this population due to amputations or ulcerated feet
• Assessing fat-free mass (FFM) is described as crucial for diagnosing malnutrition
• Malnutrition is prevalent among people with DFU and is associated with impaired wound healing and increased amputation risk
• The study concluded that 'small systematic biases observed were clinically negligible, supporting the use of HH BIA when HF measurements are unfeasible'