Identifying Risk Factors Associated with the Severity of Foot Ulcers in Type 2 Diabetic Patients: Evidence from a Hospital-Based Study in Rajshahi, Bangladesh
Summary: This 2026 cross-sectional study of 159 type 2 diabetes patients with foot ulcers at Rajshahi Diabetic Association General Hospital (Bangladesh) found that 63.5% had severe DFU (Wagner grades 3–5). Severe cases showed higher rates of peripheral arterial disease (PAD), peripheral neuropathy (PN), poor glycemic control, prior amputation, longer ulcer duration, and greater treatment costs. Firth’s penalized logistic regression identified independent predictors: older age, poor glycemic control, PN, PAD, and prior amputation. The predictive model demonstrated strong performance (AUC 0.924, accuracy 85.5%). Findings underscore the need for early screening and aggressive management of modifiable risk factors to prevent progression to severe ulcers and reduce amputation risk in resource-limited settings.
Key Highlights:
- 63.5% of DFU cases were severe (Wagner 3–5); higher costs and complications in severe group
- Independent risk factors: older age (aOR 1.08), poor glycemic control (aOR 3.90), PN (aOR 3.41), PAD (aOR 7.54), prior amputation (aOR 13.67)
- Strong model performance with good calibration and clinical utility
- Authors: Shah Tanzen Jahan, Durga H. Kutal, Anicha Akter, Md. Selim Reza, Md. Kabirul Islam, Md. Monimul Huq
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Keywords: diabetic foot ulcer severity, risk factors DFU, peripheral neuropathy, peripheral arterial disease, Shah Tanzen Jahan