PROFILING UNDIAGNOSED DIABETES IN A WORKING AGE KAZAKH POPULATION

Abstract

Undiagnosed diabetes (UDM) is a major public health concern. Almost half of all diabetic patients are unaware of their condition, which puts them at higher risk of mortality and serious comorbidities. Timely detection of UDM should decrease the social and economic costs associated with diabetes worldwide and can be achieved through establishing its risk profile, which differs for each country. Diabetes also shows varying degrees of insulin resistance (IR) and β-cell function possibly affecting the disease progression. UDM has been understudied in Kazakhstan, and this research aims to update the current understanding of its prevalence, cardiovascular risks and glucose metabolism profile in the local population. Total of 476 people were included in the analysis. The prevalence of UDM was 11.97% (95% CI, 9.20-15.24%), and it was represented by a significantly older population and worse cardiovascular risk profile. Stepwise-forward logistic regression identified systolic blood pressure, older age and total cholesterol as significant predictors of UDM. Using HOMA-IR and HOMA-β scores, k-means clustering defined three distinct UDM phenotypes. Phenotypes with β-cell dysfunction were more prevalent and showed higher risk for cardiovascular disease, which has possible implications for personalized treatment in diabetes care.