Diabetes Mellitus screening and associated factors in Peru: A cross-sectional analysis of a national health survey

Screening rates for Type 2 diabetes mellitus (T2DM) in Peru remain low despite an increasing prevalence of the disease. In 2022, the American Diabetes Association (ADA) recommended screening adults aged 18-34 with overweight or obesity and at least one risk factor, including Latino ethnicity and lowered the universal screening age to 35 years. This study aimed to determine the T2DM screening prevalence in Peru and the factors associated with lack of screening in the population that meets ADA screening criteria. A cross-sectional, secondary data analysis was conducted based on the 2022 Peruvian Demographic and Health Survey database. Screening was defined as apparently healthy individuals having their blood glucose measured in the last year. Participants aged 18-34 years with overweight or obesity, as well as all participants aged ≥ 35 years, were included. Bivariate analysis was performed using the chi-squared test, and multivariate Poisson regression was used to estimate prevalence ratios (PRs), adjusting for potential confounders. Of 26,166 individuals who met inclusion criteria, 25.3% were screened for T2DM. The factors most strongly associated with lack of screening were: age 18-34 years (aPR: 1.08; 95% CI: 1.05-1.11), having only elementary education (aPR: 1.18; 95% CI: 1.13-1.23), not having health insurance (aPR: 1.15; 95% CI: 1.12-1.18), belonging to the lowest wealth quintile (aPR: 1.09; 95% CI: 1.05-1.13), and daily smoking (aPR: 1.10; 95% CI: 1.01-1.19). The national rate of screening for T2DM in Peru is low (25.3%). There is a higher prevalence for a lack of screening in people who: are younger, have only primary education, do not have health insurance, belong to the lowest wealth quintile, and are smokers. Targeted interventions are needed to improve screening coverage in these high-risk populations.