AUTHOR=Alanazi Sultan Mohammed , Alabonassir Ohoud Aied , Almasabi Saleh Hussain A. , Alhazmi Khalid , Alotni Majid Ali , Mirdad Dahlia Soleman A. , Alghamdi Salah TITLE=The association between dietary inflammatory index and diabetic foot ulcers in type 2 diabetes: a case-control study JOURNAL=Frontiers in Nutrition VOLUME=Volume 12 - 2025 YEAR=2025 URL=https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2025.1683264 DOI=10.3389/fnut.2025.1683264 ISSN=2296-861X ABSTRACT=BackgroundDiabetic 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.MethodsIn 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.ResultsDFU 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]).ConclusionOur 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.