Revealing the Association Between Dietary Quality index and Diabetic Foot Ulcer: A Case-Control Study

ObjectiveDiabetic foot ulcers (DFUs) are a serious complication of type 2 diabetes mellitus (T2DM). Diet quality may influence DFU risk; however, evidence remains limited. This study investigated the association between overall diet quality and DFU prevalence.MethodsIn this case-control study, 390 adults with T2DM were enrolled, including 130 patients with clinically confirmed DFUs and 260 controls without DFU. Habitual dietary intake was evaluated using a validated 147-item Food Frequency Questionnaire supplemented with a recall interview. Multivariable logistic regression model was applied to examine the association between overall diet quality and DFU.ResultsMean total overall diet quality scores were significantly lower in participants with DFUs than in controls (56.3 ± 8.2 vs 61.2 ± 8.5; P < 0.001). All diet quality components, variety, adequacy, moderation, and overall balance, were also lower among DFU cases (P < .01). In fully adjusted model, the association between diet quality score and DFU was no statistically significant when analyzed as a continuous variable (OR = 0.90; 95% CI: 0.78-1.03). However, participants in the highest diet quality tertile had significantly lower odds of DFU compared with those in the lowest tertile (OR = 0.71; 95% CI: 0.49-0.99), with a significant dose-response trend observed across tertiles (P for trend = 0.031).ConclusionsDiet quality score was not significantly associated with DFU when modeled as a continuous variable; however, higher diet quality tertiles were associated with lower odds of diabetic foot ulcer, suggesting a potential protective relationship of overall dietary patterns after accounting for major sociodemographic and clinical risk factors.