Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder marked by insulin resistance and progressive pancreatic β-cell dysfunction, producing persistent hyperglycemia. Delayed diagnosis of T2DM is a significant public health concern because many patients are first identified only after they develop chronic complications. The burden and drivers of delayed diagnosis had been incompletely documented in Central Ethiopia, motivating the present investigation.
The study aimed to determine the prevalence of delayed diagnosis of T2DM and to identify factors associated with delayed diagnosis among adults attending follow-up care at Wachemo University Nigist Eleni Mohammed Memorial Comprehensive Specialized Hospital (WUNEMMCSH) in Central Ethiopia.
Researchers conducted a facility-based cross-sectional study using patient medical records from WUNEMMCSH. Records covered the period January 2021 through December 2025. Data extraction occurred in February 2026. The investigation was reported as an observational, retrospective review of charts for patients receiving follow-up care at this comprehensive specialized hospital.
The analysis included 390 adult patients with T2DM who were attending follow-up care at WUNEMMCSH. Participants were selected from medical records by simple random sampling. The abstract does not report additional demographic breakdowns, inclusion and exclusion criteria, or detailed characteristics of the sampled population beyond being adults with T2DM under follow-up care at the study hospital.
Delayed diagnosis was operationalized as an interval greater than three months between the first fasting plasma glucose (FPG) value recorded in the chart that met the diagnostic threshold (FPG ≥126 mg/dL) and the formal physician-documented diagnosis of T2DM. This time-based definition was applied consistently to identify cases meeting the study outcome.
Bivariable and multivariable binary logistic regression models were fitted using SPSS version 25. Associations were summarized as adjusted odds ratios (AOR) with 95% confidence intervals (CI). Statistical significance was declared at a two-sided p value < 0.05. The abstract reports results from the multivariable model for a set of candidate predictors; detailed model-building steps and model diagnostics were not reported in the abstract.
The prevalence of delayed diagnosis among the 390 included adults with T2DM was 25.4% (95% CI: 21.1–29.7). This indicates that approximately one in four patients in this facility-based sample experienced a delay in formal diagnosis exceeding three months after an initial hyperglycemic fasting plasma glucose measurement.
In the multivariable logistic regression model, four factors were independently associated with increased odds of delayed diagnosis:
Rural residence: AOR = 2.37 (95% CI: 1.32–4.24), indicating higher odds of delay among patients from rural areas compared with urban residents.
Alcohol consumption: AOR = 3.91 (95% CI: 2.27–6.76); patients who consumed alcohol had substantially increased odds of delayed diagnosis compared with non-users.
Absence of regular medical check-up history: AOR = 3.93 (95% CI: 1.69–9.14); lack of routine preventive visits was associated with higher odds of delay.
Travel distance to health facility of one hour or more: AOR = 6.55 (95% CI: 3.16–13.58); longer travel time to reach care was strongly associated with delayed diagnosis.
The authors report that the following variables were not independently associated with delayed diagnosis in the adjusted model: family history of diabetes, educational status, presence of symptoms at the first visit, hypertension, and smoking history. The abstract does not provide the unadjusted estimates or p values for these variables.
Approximately one-quarter of adult patients with T2DM attending follow-up at WUNEMMCSH experienced delayed diagnosis as defined by more than three months between an initial diagnostic FPG and a documented physician diagnosis. Based on the observed associations, the authors recommend several strategies to reduce delayed diagnosis and its downstream complications: strengthening opportunistic blood glucose screening, promoting regular preventive check-ups, expanding diagnostic access for rural and geographically distant populations, and targeted outreach for populations who consume alcohol.
The authors declared no competing interests. Several methodological and result details were not reported in the abstract, including granular participant demographics, subgroup prevalence estimates, detailed sampling frame description beyond 'simple random sampling from medical records', full modeling details, and a formal limitations section. These items may be available in the full text but are not included in the abstract.
The findings underline the role of access barriers (rural residence, long travel time), health-seeking behavior (absence of regular check-ups), and behavioral risk factors (alcohol use) in delayed recognition of T2DM within this hospital-based Ethiopian sample. Interventions that improve screening opportunities at point of care, reduce geographic and logistical barriers to diagnosis, and engage populations with higher alcohol use could plausibly reduce delays in diagnosis. Further detail on population characteristics and healthcare system factors would be required to inform specific programmatic actions; such detail was not available in the abstract.