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

## TL;DR

This study found that a pro-inflammatory diet is linked to a higher risk and severity of diabetic foot ulcers in people with type 2 diabetes.

## Contribution

The study is the first to link the Energy-adjusted Dietary Inflammatory Index to diabetic foot ulcers in a case-control design.

## Key findings

- DFU patients had significantly higher E-DII scores than controls.
- Higher E-DII scores correlated with longer ulcer duration and higher PEDIS scores.
- The highest E-DII tertile was associated with nearly double the odds of DFUs.

## Abstract

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.

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.

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]).

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.