Diabetic foot ulcers (DFUs) remain a major cause of morbidity and lower-limb amputation in people with diabetes mellitus. A systematic review and meta-analysis published in the International Journal of Diabetes in Developing Countries evaluated the prevalence of fungal infections and associated risk factors in DFUs.
The analysis included English-language studies identified through PubMed, Scopus, Web of Science, and ProQuest through February 2025. Among 2,145 screened records, 25 studies were included in the final meta-analysis. Pooled prevalence estimates and subgroup analyses were performed to assess fungal infection patterns in DFUs.
Findings
- The pooled prevalence of fungal infection in DFUs was 19% (P < 0.001).
- Men showed significantly higher fungal DFU prevalence than women (0.62 vs 0.35).
- Patients with T2DM had a higher prevalence of fungal ulcers than those with T1DM (0.67 vs 0.30).
- Candida species were commonly implicated in fungal DFUs.
- Funnel plot analysis suggested possible publication bias, although Egger’s test had limited statistical power because of the small number of studies.
- Substantial heterogeneity was observed across included studies (I² >50%).
Fungal infections, particularly Candida-associated infections, were frequently identified in DFUs and appeared more common in men and in individuals with T2DM. The findings support increased clinical awareness and targeted preventive strategies to reduce DFU-related complications.
