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Aims/Introduction  A retrospective study was carried out to investigate the clinical characteristics and associated factors for invasive fungal disease in patients with type 2 diabetes mellitus.    Materials and Methods  Demographic and clinical data were recorded. Associated factors were analyzed by logistic regression analysis.    Results  Invasive fungal disease was diagnosed in 120 patients with type 2 diabetes mellitus (prevalence, 0.4%). Yeast infection (56/120, 46.7%), including candidiasis (31/56, 55.4%) and cryptococcosis (25/56, 44.6%), was the most common. The urinary tract was mainly involved in candidiasis (12/31, 38.7%). More than half of the cryptococcosis (16/25, 64.0%) presented as pneumonia. Mold infection accounted for 40.8% of the cases, and predominantly involved the lung (34/49, 69.4%). A total of 15 (12.5%) patients had mixed fungal infection.  Candida albicans  (24/111, 21.6%),  Cryptococcus neoformans  (19/111, 17.1%) and  Aspergillus fumigatus  (14/111, 12.6%) were the leading agents. Co‐infection occurred in 58 (48.3%) patients, mainly presenting as pneumonia caused by Gram‐negative bacteria. The inpatient mortality rate of invasive fungal disease was 23.3% (28/120). Glycated hemoglobin levels were higher in non‐survivors than survivors (8.8 ± 2.5 vs 7.7 ± 2.1%,  P  = 0.02). Anemia (adjusted odds ratio, 3.50, 95% confidence interval 1.95–6.27,  P  < 0.001), hypoalbuminemia (adjusted odds ratio, 5.42, 95% confidence interval 3.14–9.36,  P <  0.001) and elevated serum creatinine (adjusted odds ratio, 2.08, 95% confidence interval 1.07–4.04,  P  = 0.03) were associated with invasive fungal disease in type 2 diabetes mellitus patients.    Conclusions  Invasive fungal disease is a life‐threatening complication in type 2 diabetes mellitus patients.  C. a albicans ,  C. neoformans , and  A. fumigatus  are the leading agents. Prolonged hyperglycemia results in unfavorable outcomes. Correction of anemia and hypoalbuminemia might improve prognosis.

Opportunistic invasive fungal disease in patients with type 2 diabetes mellitus from Southern China: Clinical features and associated factors