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 analyzed 159 type 2 diabetes patients with foot ulcers at Rajshahi Diabetic Association General Hospital. Severe ulcers (Wagner grades 3–5) occurred in 63.5% of cases and were associated with higher BMI, longer ulcer duration, greater treatment costs, and increased prevalence of peripheral arterial disease (PAD), peripheral neuropathy (PN), poor glycemic control, and prior amputation. Using Firth’s penalized logistic regression, independent predictors of severity were older age, poor glycemic control, PN, PAD, and prior amputation. The predictive model showed excellent performance (AUC 0.924, accuracy 85.5%). The findings emphasize the importance of early screening and aggressive management of modifiable risk factors to prevent progression to severe diabetic foot ulcers and reduce amputation risk in similar settings.
Key Highlights:
- 63.5% of DFU cases classified as severe (Wagner 3–5)
- Independent risk factors: older age, poor glycemic control, PN, PAD, prior amputation
- Strong predictive model (AUC 0.924) with good clinical utility
- Authors: Shah Tanzen Jahan, Durga H. Kutal, Anicha Akter, Md. Selim Reza, Md. Kabirul Islam
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Keywords: DFU severity, risk factors diabetic foot, peripheral neuropathy, peripheral arterial disease, Shah Tanzen Jahan