Investigating the Prevalence of Undiagnosed Diabetes and Its Associated Factors Among Healthcare Workers: A Cross-sectional Study in South of Iran

Abstract Context: Undiagnosed diabetes mellitus (DM) is a hidden aspect of the diabetes epidemic. Globally, over 50% of cases are estimated to be undiagnosed. Undiagnosed DM poses serious public health concerns due to increased risks of complications. Aims: This study aimed to investigate the prevalence and associated factors of undiagnosed diabetes among healthcare workers in southern Iran. Settings and Design: This cross-sectional study analyzed baseline data from the Shiraz University of Medical Sciences Employees Health Cohort Study, involving 5918 healthcare workers aged from 20 to 70 years. Materials and Methods: Participants completed questionnaires, underwent anthropometric measurements, and provided blood samples for clinical laboratory tests. Undiagnosed diabetes was defined as fasting plasma glucose ≥126 mg/dL in those without a previous diagnosis. Statistical Analysis Used: Univariate and multivariate logistic regression analyses were used to determine associated factors. Results: The prevalence of undiagnosed diabetes was 1.2%. Diagnosed diabetes had a prevalence of 3.1%. Together, undiagnosed cases accounted for 27.4% of total cases. Age (odds ratio [OR] = 1.09, 95% confidence interval [CI] [1.05–1.12]), male gender (OR = 1.67, 95% CI [1.01–2.74]), general obesity (OR = 3.64, 95% CI [2.45–5.91]), abdominal obesity (OR = 2.62, 95% CI [1.52–4.52]), hypertension (OR = 1.84, 95% CI [1.06–3.17]), and dyslipidemia were associated factors for undiagnosed diabetes. Conclusions: Although lower than national estimates, over one-quarter of diabetic cases among health workers remained undiagnosed, highlighting the need for improved screening, especially in high-risk groups. Expanding screening programs, raising health literacy, and increasing community access to preventive services are essential steps in addressing the public health issue of undiagnosed diabetes.