Background: Fungal infections are increasingly recognized as a significant complication among patients with type 2 diabetes mellitus (T2DM), largely due to impaired immunity and poor glycemic control. This study aimed to evaluate the prevalence, clinical spectrum, and associated risk factors of fungal infections in patients with T2DM.

Materials and Methods: A cross-sectional, hospital-based study was conducted among 345 patients with T2DM. Demographic data, clinical history, glycemic status (HbA1c), and risk factors such as obesity, recent antibiotic use, hospitalization, and immunosuppressive therapy were recorded. Fungal infections were diagnosed clinically and confirmed through microbiological methods. Statistical analysis was performed to identify associations between fungal infections and potential risk factors. 

Results: Among the 345 participants, the majority were aged 50–59 years (32.5%), and 54.2% were male. Fungal infections were present in 42.9% of cases, with candidiasis (25.8%) being most common, followed by dermatophytosis (17.7%) and onychomycosis (12.2%). Invasive infections included aspergillosis (5.2%) and mucormycosis (2.0%). Fungal infections were significantly more prevalent in patients with poor glycemic control—66.7% in those with HbA1c ≥9% versus 23.5% with HbA1c <7%. Significant risk factors included poor glycemic control (p<0.001), obesity (p=0.032), recent antibiotic use (p=0.016), and hospitalization history (p=0.004); immunosuppressive therapy was not statistically significant (p=0.072). The genital region (32.4%) and oral cavity (27.7%) were the most affected sites, followed by nails (28.4%) and interdigital feet (22.3%); 16.2% had multiple site involvement.

Conclusion: Fungal infections are prevalent in over 40% of patients with T2DM, particularly those with poor glycemic control, obesity, recent antibiotic use, and hospitalization. Early identification and appropriate management are essential to prevent complications and improve quality of life in diabetic patients