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. 2023 May 25;23(1):949.
doi: 10.1186/s12889-023-15819-0.

Prevalence and predictors of undiagnosed type 2 diabetes and pre-diabetes among adult Egyptians: a community-based survey

Hassan Farag Mohamed Farag  1 , Ehab Elrewany  1 , Basem Farouk Abdel-Aziz  2 , Eman Anwar Sultan  3
Affiliations

Prevalence and predictors of undiagnosed type 2 diabetes and pre-diabetes among adult Egyptians: a community-based survey

Hassan Farag Mohamed Farag et al. BMC Public Health. .

Abstract

Background: The global prevalence of abnormal glycemic level comprising diabetes mellitus (DM) and pre-diabetes (PDM) is rapidly increasing with special concern for the entity silent or undiagnosed diabetes; those unaware of their condition. Identification of people at risk became much easier with the use of risk charts than the traditional methods. The current study aimed to conduct a community-based screening for T2DM to estimate the prevalence of undiagnosed DM and to assess the AUSDRISK Arabic version as a predictive tool in an Egyptian context.

Methods: A cross-sectional study was conducted among 719 Adults aging 18 years or more and not known to be diabetics through a population-based household survey. Each participant was interviewed to fill demographic and medical data as well as the AUSDRISK Arabic version risk score and undergo testing for fasting plasma glucose (FPG) and oral glucose tolerance test (OGTT).

Results: The prevalence of DM and PDM were 5% and 21.7% respectively. The multivariate analysis revealed that age, being physically inactive, history of previous abnormal glycemic level and waist circumference were the predictors for having abnormal glycemic level among the studied participants. At cut off points ≥ 13 and ≥ 9, the AUSDRISK respectively discriminated DM [sensitivity (86.11%), specificity (73.35%), and area under the curve (AUC): 0.887, 95% CI: 0.824-0.950] and abnormal glycemic level [sensitivity (80.73%), specificity (58.06%), and AUC: 0.767, 95% CI: 0.727-0.807], p < 0.001.

Conclusions: Overt DM just occupies the top of an iceberg, its unseen big population have undiagnosed DM, PDM or been at risk of T2DM because of sustained exposure to the influential risk factors. The AUSDRISK Arabic version was proved to be sensitive and specific tool to be used among Egyptians as a screening tool for the detection of DM or abnormal glycemic level. A prominent association has been demonstrated between AUSDRISK Arabic version score and the diabetic status.

Keywords: AUSDRISK Arabic Version; PDM; Prevalence; Screening; Sensitivity; Specificity; T2DM; Undiagnosed DM.

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Conflict of interest statement

The approval of the ethics committee of the High Institute of Public Health for conducting the research was obtained. An informed written consent was taken from the study participants and also from legal guardians of illiterate participants after explanation of the purpose and benefits of the research. Anonymity and confidentiality were assured and maintained and there was no conflict of interest. All methods were performed in accordance with the relevant guidelines and regulations confirm the Declaration of Helsinki.

None to be declared.

Figures

Fig. 1
Fig. 1
Studied participant glycemic status based on the WHO criteria
Fig. 2
Fig. 2
ROC curve for the AUSDRISK Arabic version as a screening diagnostic tool for DM (a) and abnormal glycemic level (b) AUC: Area under the curve ROC: Receiver operating characteristic curve DM: Diabetes mellitus
See this image and copyright information in PMC

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