JUI WANGSZU-YING LEECHIA-TER CHAOJENQ-WEN HUANGKUO-LIONG CHIEN2025-07-012025-07-012025-06https://scholars.lib.ntu.edu.tw/handle/123456789/730443Background: Frailty, characterized by aging-associated physiological reserve decline, leads to functional loss and adverse outcomes. Patients with diabetes mellitus (DM) have a high frailty risk. However, whether frailty assessment results derived from different tools diverge regarding their outcome correlations remains unclear. Objectives: The authors analyzed associations between different frailty assessment results and DM patients’ outcomes Methods: Between 2008 and 2016, adults (age >40 years) with type 2 DM were identified from the National Taiwan University Hospital Integrated Medical Database. The frailty assessment was performed using modified FRAIL scale and frailty index. Cox proportional hazard and Poisson regression analyses were used to determine the relationship between frailty and multiple outcomes after multivariate adjustment. Results: In total, 30,012 patients (mean 64.1 years, 45.4% women) with type 2 DM were included. The 2 frailty assessments were moderately positively correlated (r = 0.49; 95% CI: 0.48-0.49). After a median of 7.1 years (Q1-Q3: 3.9-10.4 years) of follow-up, FRAIL-identified mild and moderate-to-severe frailty did not correlate with a high mortality probability, but frailty index–identified severe and moderate frailty did. However, FRAIL-identified moderate-to-severe frailty correlated with a higher probability of all-cause hospitalization (incidence rate ratio [IRR]: 1.2; 95% CI: 1.09-1.32), intensive care unit admission (IRR: 4.19; 95% CI: 1.69-10.38), and cardiovascular hospitalization (IRR: 1.46; 95% CI: 1.28-1.66), whereas frailty index–identified mild, moderate, and severe frailty increased the probability of all-cause and cardiovascular hospitalizations only. Conclusions: We observed major discrepancies in outcome associations between FRAIL scale and frailty index among DM patients. Carefully selecting tools for measuring DM-associated frailty is important.encardiovascular event(s)chronic kidney diseasediabetes mellitusfrail renal phenotypefrailtyoutcomes[SDGs]SDG2[SDGs]SDG3[SDGs]SDG5journal article10.1016/j.jacasi.2025.02.01440266179