Prevalence and factors associated with prediabetes and undiagnosed diabetes in Cambodia: Cross-sectional study based on the World Health Survey Plus 2023

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Abstract Background This study aimed to determine the prevalence and factors associated with pre-type 2 diabetes (pre-T2D) and undiagnosed T2D (UDD) in Cambodia. Methods This cross-sectional study included 5,271 individuals aged ≥ 18 years from all provinces in Cambodia. Pre-T2D and UDD were defined using the World Health Organization (WHO)’s haemoglobin A1c criteria. Results The weighted prevalences of pre-T2D and UDD were 27.2% and 10.9%. Pre-T2D prevalence was higher in urban areas compared to rural areas (aOR = 1.2, 95% CI: 1.0 - 1.4), females aged 30-39 (aOR=1.4, 95% CI: 1.0 - 2.0), females 40-49 (aOR=2.4, 95% CI: 1.7 - 3.3), females 50+ (aOR = 3.8, 95% CI: 2.8 - 5.1), and males aged 30-39 (aOR=2.0, 95% CI: 1.3 - 3.0), males 40-49 (aOR=2.3, 95% CI: 1.5 - 3.3), males 50+ (aOR = 3.3, 95% CI: 2.4 - 4.7) relative to females aged 18-29, overweight individuals (aOR = 1.6, 95% CI: 1.3 - 1.9), obese individuals (aOR = 1.9, 95% CI: 1.5 - 2.4), those with high waist circumference (aOR = 1.5, 95% CI: 1.2 - 1.8), and elevated total triglycerides (aOR = 1.3, 95% CI: 1.1 - 1.5). Similar risk factors were identified for UDD, with the addition of elevated blood pressure (aOR = 1.5, 95% CI: 1.1 - 2.1). Conclusion The high prevalence of pre-T2D and UDD in Cambodia is a pressing public health concern. Urgent and intensive interventions are needed to effectively prevent and manage T2D, particularly among urban residents, older adults, and individuals with metabolic risk factors. Key messages What is already known on this topic In 2023, the national prevalence of pre-type 2 diabetes (pre-T2D), measured by impaired fasting glycaemia, among adults (18+) in Cambodia was estimated to be 5.5%, with a higher prevalence in older adults and females. The prevalence of undiagnosed T2D (UDD) was not estimated. What this study adds This study revealed a significant prevalence of pre-T2D (27.2%) and UDD (10.9%) among adults (18+ years old) in Cambodia, indicating a substantial public health challenge that requires immediate attention. This study identified modifiable and non-modifiable factors associated with pre-T2D and UDD, including urban residence, older age, overweight or obese, high waist circumference, elevated triglyceride levels, and elevated blood pressure. How this study might affect research, practice, or policy These findings underscore the importance of prevention and screening initiatives aimed at early detection to mitigate T2D and to delay or prevent complications in individuals with UDD.

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