Prevalence and associated factors of delayed diagnosis of type 2 diabetes mellitus among adults attending a comprehensive specialized hospital in Central Ethiopia: A facility-based cross-sectional study

Background Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by insulin resistance and progressive pancreatic β-cell dysfunction, leading to persistent hyperglycemia. Delayed diagnosis is a major public health challenge because many patients are recognized only after developing chronic complications, yet evidence on this problem remains limited in Central Ethiopia. Objective To assess the prevalence and associated factors of delayed diagnosis of T2DM among patients attending Wachemo University Nigist Eleni Mohammed Memorial Comprehensive Specialized Hospital (WUNEMMCSH), Central Ethiopia. Methods A facility-based cross-sectional study was conducted among 390 adult T2DM patients attending follow-up care at WUNEMMCSH between January 2021 and December 2025 (data collection: February 2026), selected by simple random sampling from medical records. Delayed diagnosis was defined as an interval exceeding three months between the first chart-documented fasting plasma glucose (FPG) ≥126 mg/dL and formal physician-documented diagnosis. Bivariable and multivariable binary logistic regression analyses were performed in SPSS version 25, with significance declared at p < 0.05 using adjusted odds ratios (AOR) and 95% confidence intervals (CI). Results The prevalence of delayed diagnosis of T2DM was 25.4% (95% CI: 21.1–29.7). In the multivariable model, rural residence (AOR = 2.37; 95% CI: 1.32–4.24), alcohol consumption (AOR = 3.91; 95% CI: 2.27–6.76, i.e., alcohol users had higher odds of delay than non-users), absence of a history of regular medical check-up (AOR = 3.93; 95% CI: 1.69–9.14), and travel distance to a health facility of one hour or more (AOR = 6.55; 95% CI: 3.16–13.58) were significantly associated with delayed diagnosis. Family history of diabetes, educational status, symptoms at first visit, hypertension, and smoking history were not independently associated with delayed diagnosis in the adjusted model. Conclusion Approximately one in four adults with T2DM attending WUNEMMCSH experienced delayed diagnosis. Strengthening opportunistic blood glucose screening, promoting regular preventive check-ups, expanding diagnostic access for rural and geographically distant populations, and targeted outreach for alcohol-using populations are essential to reduce delayed diagnosis and its downstream complications.