The association between dietary inflammatory index and diabetic foot ulcers in type 2 diabetes: a case-control study

Background Diabetic foot ulcers (DFUs) are a major complication of type 2 diabetes mellitus (T2DM). This study examined the association between the Energy-adjusted Dietary Inflammatory Index (E-DII) and odds of DFUs. Methods In a case–control study, 100 patients with DFUs and 150 T2DM controls were recruited. Dietary intake was assessed using a validated FFQ, and E-DII scores were calculated. Logistic regression estimated odds of DFUs across E-DII tertiles. Results DFU patients had higher E-DII scores than controls (2.1 vs. 1.5, p < 0.001). E-DII scores were positively correlated with both ulcer duration ( ρ = 0.32, p = 0.002) and PEDIS score ( ρ = 0.45, p < 0.001). Multivariable logistic regression showed that higher E-DII scores were significantly associated with increased DFU risk (OR for highest tertile: 1.94 [1.02–3.67]). Conclusion Our findings suggest that a pro-inflammatory diet, as measured by the E-DII, is associated with an increased odds and severity of DFUs in individuals with T2DM.