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Can Foot Dermatophyte Infections Signal Future Diabetes Risk? Findings from a Register-based Study.

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Dermatophyte infections, common fungal skin issues, do not significantly predict undiagnosed type 2 diabetes (T2D). However, a sensitivity analysis suggests a possible link when prior antifungal use is considered.

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Area of Science:

  • Medical Mycology
  • Epidemiology
  • Endocrinology

Background:

  • Dermatophyte infections are prevalent, particularly in individuals with type 2 diabetes (T2D).
  • The association between dermatophyte infections and undiagnosed T2D requires further investigation.

Purpose of the Study:

  • To determine if positive PCR tests for dermatophyte infections indicate undiagnosed type 2 diabetes (T2D).
  • To assess the incidence rates and risk ratios for new-onset T2D in individuals with dermatophyte infections.

Main Methods:

  • A register-based cohort study in Denmark.
  • Inclusion of individuals with positive PCR tests for foot or nail dermatophyte infections, matched to controls.
  • Exclusion of individuals with known diabetes, type 1 diabetes, or under 20 years old.

Main Results:

  • Primary analysis: No significant association between dermatophyte infections and new-onset T2D (IRR=1.00).
  • Sensitivity analysis (excluding prior topical antifungal use): Modest increased risk of T2D (IRR=1.15, p=0.001).

Conclusions:

  • Dermatophyte infections alone are not a strong predictor of undiagnosed T2D in the general population.
  • Reduced exposure misclassification in sensitivity analysis suggests a potential, albeit modest, role for dermatophyte infections as an early T2D signal in specific contexts.