Background This study aimed to determine the prevalence and factors associated with pre-type 2 diabetes (pre-T2D) and undiagnosed T2D in Cambodia.

Method This cross-sectional study included 5,271 individuals aged ≥ 18 years from all provinces in Cambodia. Pre-T2D and undiagnosed T2D were defined using the World Health Organization (WHO)’s haemoglobin A1c criteria.

Results The weighted prevalences of pre-T2D and undiagnosed T2D 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 undiagnosed T2D, with the addition of elevated blood pressure (aOR = 1.5, 95% CI: 1.1 - 2.1).

Conclusion The high prevalence of pre-T2D and undiagnosed T2D in Cambodia highlights the need for intensive public health interventions focusing on urban residents, older adults, and those with metabolic risk factors to effectively prevent and manage T2D.

What is already known on this topic

▪ In 2023, the national prevalence of pre-type 2 diabetes (pre-T2D), measured by impaired fasting glycemia, among adults (18+) in Cambodia was estimated to be 5.5%, with a higher prevalence in older adults and females.

▪ The prevalence of undiagnosed pre-T2D was not estimated.

What this study adds

▪ This study revealed a significant prevalence of pre-T2D (27.2%) and undiagnosed T2D (10.9%) among adults (18+ years) 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 undiagnosed T2D, including urban residence, older age, overweight or obesity, high waist circumference, elevated triglyceride levels, and elevated blood pressure.

How this study might affect research, practice, or policy

The authors have declared no competing interest.

This study did not receive any funding

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

IRB of the National Ethics Committee for Health Research Ethics gave ethical approval for this work on July 20, 2022 (approval code 221 NECHR).

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