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. 2025 Jan 18;17(1):e77618.
doi: 10.7759/cureus.77618. eCollection 2025 Jan.

Prevalence and Determinants of Undiagnosed Diabetes Mellitus Among Adults in Zakho City, Kurdistan Region, Iraq: A Community-Based Cross-Sectional Study

Brisik Rashad  1 , Nawfal R Hussein  1 , Vindad Hashim Dirbas  2 , Ibrahim A Naqid  1
Affiliations

Prevalence and Determinants of Undiagnosed Diabetes Mellitus Among Adults in Zakho City, Kurdistan Region, Iraq: A Community-Based Cross-Sectional Study

Brisik Rashad et al. Cureus. .

Abstract

Objective This study aimed to study the prevalence of undiagnosed diabetes mellitus (DM) and its associated factors in adults aged over 18 in Zakho City, Kurdistan Region, Iraq. Methods A cross-sectional study was conducted recruiting 537 participants with a mean age of 35.43±13.88 years. Data on sociodemographic characteristics, health behaviors, clinical history, and anthropometric measurements, including body mass index (BMI) and waist circumference, were collected. Results The study sample comprised 345 (64.2%) men and 192 (35.8%) women, with 324 (60.3%) being married and 246 (45.8%) having a university-level education or higher. Regarding health behaviors, 218 (40.6%) participants engaged in physical activity, 180 (33.5%) were smokers, and 196 (36.5%) reported sleep disturbances, averaging 7.10±2.02 hours per night. Anthropometric assessments revealed that 209 (38.9%) were overweight, 131 (24.4%) were obese, and 273 (50.8%) had high waist circumference. The prevalence of abnormal glucose levels was 51 (9.5%) (95% CI: 7.02-11.98) including 14 (2.6%) (95% CI: 1.26-3.95) with undiagnosed DM and 37 (6.9%) (95% CI: 4.75-9.03) with prediabetes mellitus (pre-DM). Multivariate analysis showed significant associations between abnormal glucose levels and increased age (p<0.0001), high BMI (≥25 kg/m²) (p<0.0001), and high waist circumference (p<0.0001). Specifically, age was a significant predictor for pre-DM (adjusted odds ratio (aOR) 1.04; 95% CI: 1.01-1.07), while age and high waist circumference predicted undiagnosed DM (aOR 1.90; 95% CI: 1.03-1.16). Conclusion This study provided the first estimate of undiagnosed DM in the Kurdistan Region. The current study showed that the prevalence of undiagnosed DM and impaired fasting glucose were significant emphasizing age, BMI, and waist circumference as significant risk factors. These findings suggest the need for targeted screening and preventive strategies in this population to improve DM detection and management.

Keywords: community; diabetes mellitus; prevalence; undiagnosed; zakho city.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Scientific Research and Ethics Committee of the College of Medicine, University of Zakho issued approval Oct 2023/UoZ e18. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

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