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Research Article: A nomogram incorporating nutritional risk for predicting 31-day unplanned readmission in adults with type 2 diabetes mellitus using LASSO regression

Date Published: 2026-09-30

Abstract:
To develop and validate a nomogram incorporating nutritional risk for predicting 31-day unplanned readmission in patients with type 2 diabetes mellitus (T2DM). This retrospective study included 1,627 T2DM patients. A nomogram was constructed using least absolute shrinkage and selection operator (LASSO) regression on a training set ( n =?1,139) and an internal hold-out set ( n =?488). Predictors were selected from demographics, lifestyle, clinical, and nutritional parameters. Model performance was evaluated using ROC curves, calibration plots, and decision curve analysis. The 31-day unplanned readmission rate was 18.50%. Six predictors were identified: smoking history, peripheral vascular disease in patients with type 2 diabetes mellitus (PVD in T2DM), diabetes duration, glycated hemoglobin (HbA1c), nutritional risk and neutrophil-to-lymphocyte ratio (NLR). The nomogram showed good discrimination in both training (AUC?=?0.846; 95% CI: 0.814–0.878) and internal hold-out set (AUC?=?0.817; 95% CI: 0.761–0.873), with acceptable calibration. In this single-center retrospective cohort, the nomogram demonstrated potential for predicting 31-day unplanned readmission in T2DM patients by integrating clinical, metabolic, inflammatory, and nutritional dimensions. Routine nutritional assessment at admission may help identify high-risk individuals; however, external validation in geographically and temporally diverse populations is necessary before clinical application.

Introduction:
The prevalence of diabetes worldwide is on a continuous upward trend and is estimated to reach around 800 million by 2045 ( 1 ). China is one of the countries with the largest increase in the prevalence of diabetes and the highest mortality rate in the world. Among them, patients with Type 2 diabetes mellitus (T2DM) account for 90.0% of all diabetes patients ( 2 ). Patients with type 2 diabetes have insulin resistance and/or insufficient insulin secretion in B-cells, which prevents glucose from effectively…

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