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

BackgroundThis study aimed to determine the prevalence and factors associated with pre-type 2 diabetes (pre-T2D) and undiagnosed T2D (UDD) in Cambodia. MethodsThis 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. ResultsThe 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). ConclusionThe 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 messagesO_ST_ABSWhat is already known on this topicC_ST_ABSO_LIIn 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. C_LIO_LIThe prevalence of undiagnosed T2D (UDD) was not estimated. C_LI What this study addsO_LIThis 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. C_LIO_LIThis 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. C_LI How this study might affect research, practice, or policyO_LIThese 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. C_LI