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Retrospective Study
Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Diabetes. Jul 15, 2026; 17(7): 121349
Published online Jul 15, 2026. doi: 10.4239/wjd.121349
Clinical features of malnutrition in hospitalized patients with type 2 diabetes mellitus-related diabetic foot ulcers: A retrospective study
Su-Hua Wang, Ying Luo, Jing-Bo Lai
Su-Hua Wang, Ying Luo, Jing-Bo Lai, Department of Endocrinology, The Affiliated People’s Hospital of Ningbo University, Ningbo 315040, Zhejiang Province, China
Author contributions: Wang SH, Luo Y, and Lai JB performed the data interpretation; Wang SH and Luo Y edited and reviewed the manuscript; Wang SH designed the study; Luo Y performed the data acquisition and analysis; All authors contributed to drafting the manuscript and approved the submitted version.
AI contribution statement: No AI tool was involved in the generation of research data, interpretation of results, or formulation of conclusions.
Institutional review board statement: This study was conducted in accordance with the principles of the Declaration of Helsinki, and ethical approval was obtained from the Ethics Committee of the Affiliated People’s Hospital of Ningbo University (Approval No. 2026-024).
Informed consent statement: Ethical considerations were thoroughly addressed, including obtaining an informed consent waiver due to the anonymous nature of the data.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Data sharing statement: Data supporting the findings of this study are available from the corresponding author upon reasonable request.
Corresponding author: Su-Hua Wang, MD, Academic Fellow, Department of Endocrinology, The Affiliated People’s Hospital of Ningbo University, No. 251 Baizhang East Road, Ningbo 315040, Zhejiang Province, China. wsh3550@126.com
Received: March 23, 2026
Revised: May 8, 2026
Accepted: June 4, 2026
Published online: July 15, 2026
Processing time: 109 Days and 5.7 Hours
Abstract
BACKGROUND

Type 2 diabetes mellitus is a global health challenge that often leads to complications such as diabetic foot ulcers (DFUs). Although malnutrition is a common feature of hospitalized patients with type 2 diabetes mellitus, data on malnourished patients also diagnosed with DFUs are limited.

AIM

To determine the clinical features of malnutrition in this high-risk population.

METHODS

This retrospective study included patients diagnosed with DFUs who were hospitalized between January 2020 and December 2025. We analyzed clinical data derived from electronic medical records, with patients being categorized into malnutrition and non-malnutrition groups based on nutritional status at admission and compared with respect to demographic, clinical, and outcome variables. Univariate and multivariate logistic regression analyses were performed to identify factors of interest, and receiver operating characteristic curves were used to evaluate the predictive value of significant risk factors.

RESULTS

In total, 268 eligible patients were enrolled in this study, of whom 96 and 172 were assigned to the malnutrition and non-malnutrition groups, respectively. Univariate analysis identified significant between-group differences for six factors, namely, age, duration of diabetes, serum albumin, triglycerides, hemoglobin, glycated hemoglobin, and multidrug-resistant organisms (MDROs; P < 0.05). Multivariate analysis revealed that age (> 65 years; P = 0.004), serum albumin (< 36.6 g/L; P = 0.014), hemoglobin (< 111.2 g/L; P < 0.001), glycated hemoglobin (> 7.1%; P < 0.001), and MDROs (P < 0.006) were independent risk factors for malnutrition. Furthermore, compared with the non-malnutrition group, patients in the malnutrition group had a longer mean hospital stay and lower rates of wound healing within 60 days (P < 0.05).

CONCLUSION

To improve the clinical outcomes of malnourished hospitalized patients with DFUs, early intervention should be provided to those with risk factors such as older age, depleted hemoglobin, and MDRO infections.

Keywords: Malnutrition; Diabetic foot ulcer; Type 2 diabetes mellitus; Nutritional risk screening; Clinical outcomes

Core Tip: Malnutrition is a critical yet underrecognized issue in hospitalized patients with type 2 diabetes mellitus-related diabetic foot ulcers, directly impacting clinical outcomes. In this retrospective study of 268 patients with type 2 diabetes mellitus-related diabetic foot ulcers, malnutrition was identified in 35.8% and was independently associated with age > 65 years, serum albumin < 36.6 g/L, hemoglobin < 111.2 g/L, glycated hemoglobin > 7.1%, and multidrug-resistant organisms. Malnourished patients experienced longer hospital stays and lower 60-day wound healing rates. Early nutritional assessment and targeted intervention for these modifiable risk factors are essential to improve prognosis in this high-risk population.

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