Assessment of Undiagnosed Type 2 Diabetes in Adults Using the Indian Diabetes Risk Score: A Cross-Sectional Study from a Tertiary Care Medical College in South India

Background: Diabetes mellitus remains a major non-communicable disease globally and in India, with many individuals undiagnosed due to its asymptomatic early stages, reflecting the iceberg phenomenon.This study aimed to identify individuals at elevated risk for undiagnosed type 2 diabetes mellitus using the Indian Diabetes Risk Score (IDRS) and assess its effectiveness as a community-level screening tool.Methods: A hospital-based cross-sectional study was conducted over 12 months in the Department of General Medicine at Amala Institute of Medical Sciences, Thrissur, Kerala.A total of 138 adults aged 18 years were included.Individuals previously diagnosed with diabetes or unwilling to participate were excluded.Data were collected using a semi-structured questionnaire, and statistical analysis was performed using standard descriptive methods.Results: The mean IDRS was 55.819.2.Among participants, 52 (37.7%) had scores between 50-60, while 47 (34.1%) scored between 70-80.Diabetes was detected in 25 participants (33.8%) with IDRS 60, whereas none with IDRS <60 had diabetes.The IDRS demonstrated a sensitivity of 100%, specificity of 58.2%, positive predictive value of 33.8%, negative predictive value of 100%, and an overall diagnostic accuracy of 66.1%.Conclusion: IDRS is a simple, sensitive, and cost-effective tool for identifying undiagnosed diabetes in adults.Its ease of use and high negative predictive value make it ideal for large-scale community screening, particularly in resource-limited settings.Early identification enables timely intervention, reducing long-term complications and disease burden.