Original data

Objective: Snakebites remain an overlooked public health issue with high morbidity and mortality. In this study, we assess the impact of diabetes on disease severity in patients with venomous snakebites. Methods: A retrospective cohort analysis was conducted on snakebite cases treated at eight hospitals in Fujian Province between December 2019 and December 2023. Snakebite severity was evaluated using the Snakebite Severity Score. Univariate and multivariate logistic regression analyses were performed to identify the factors associated with snakebite severity.Results: The study included 537 patients. The average age of patients is 55 years. 54.93% (n=295) were aged ≥55 years, 57.17% (n=307) were male, and 13.41% (n=72) had diabetes. In the multivariate logistic regression, diabetes (odds ratio [OR] = 5.51; 95% confidence interval [CI]: 3.18–9.55), time from snakebite to hospital (OR = 1.04; 95% CI: 1.01–1.07), and bite site (OR = 0.63; 95% CI: 0.41–0.97) were identified as independent predictors of snakebite severity. Subgroup analysis revealed significant sex differences among patients with diabetes. The odds ratio for moderate-to-severe outcomes was 3.81 (95% confidence interval [CI]: 1.81–7.99) in males and 12.57 (95% CI: 5.72–27.60) in females, with an interaction p-value of 0.030. Additionally, diabetes was significantly associated with prolonged hospital length of stay (p < 0.01), increased costs (p < 0.01), higher complication rates (p < 0.01), and a greater likelihood of requiring debridement surgery (p < 0.01) compared to individuals without diabetes.Conclusion: Diabetes is an independent predictor of disease severity in patients with snakebites, underscoring the need for clinicians to consider the diabetes status when assessing and managing snakebite risk. These findings provide valuable insights for optimizing care strategies for individuals with diabetes who have experienced venomous snakebites.