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

Objective This study aimed to determine the prevalence and factors associated with pre-diabetes and undiagnosed type 2 diabetes (UDD) in Cambodia. Design This analysis used data from the WHO World Health Survey Plus, which was collected using a cross-sectional design with a GIS-based, three-stage sampling approach. Multiple logistic regression was used to identify key associated factors, based on a significance level of p<0.05. Setting Data were collected from all 25 provinces in Cambodia between 12 March 2023 and 31 May 2023. Participants 4427 individuals aged 18 years or older, residing in the selected household for at least 6months in the past year. Primary outcome measures Pre-diabetes (Haemoglobin A1c (HbA1c) 5.7%–6.4%) and UDD (HbA1c≥6.5%), without prior knowledge of having type 2 diabetes (T2D). Results The weighted prevalences of pre-diabetes and UDD were 26.4% (95% CI 24.0% to 29.0%) and 9.3% (95% CI 7.9% to 11.0%). Pre-diabetes prevalence was higher in urban areas compared with rural areas (adjusted OR, aOR=1.2, 95%CI 1.0 to 1.4), males (aOR=1.7, 95%CI 1.3 to 2.3), individuals aged 40–49 (aOR=1.8, 95%CI 1.4 to 2.4), individuals aged 50+ years group (aOR=2.9, 95%CI 2.3 to 3.6) compared with the 18–39 years group, overweight individuals (aOR=1.7, 95%CI 1.4 to 2.0), obese (aOR=2.1, 95%CI 1.5 to 3.0) and those with elevated total triglycerides (aOR=1.3, 95%CI 1.1 to 1.5). Similar risk factors were identified for UDD, with the addition of hypertension (aOR=1.6, 95%CI 1.3 to 2.0) and high waist circumference (aOR=2.0, 95%CI 1.5 to 2.7). Conclusions The high prevalence of pre-diabetes 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 persons and individuals with metabolic risk factors.