Prevalence and Associated Factors of Delayed Diagnosis of Type 2 Diabetes Mellitus in a Tertiary Hospital: A Retrospective Cohort Study
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Objective: To determine the prevalence and associated factors of delayed diagnosis of type 2 diabetes mellitus (DM) among outpatients in a tertiary hospital. Methods: This retrospective cohort study was conducted among outpatients aged ≥35 years with twice fasting plasma glucose (FPG) levels ≥126 mg/dl between 1 January 2018, and 31 December 2020. The prevalence and pattern of delayed diagnosis of DM were defined using the Thai Clinical Practice Guideline (CPG) for Diabetes, 2017, and the American Diabetes Association (ADA) 2017. The cut-off time for FPG level confirmation of 3 months was used to evaluate delayed diagnoses and associated factors. Multiple logistic regression was used to identify variables associated with delayed diagnoses. Results: Of 260 participants, 96.9% and 85.4% had delayed diagnoses as defined by the Thai CPG and the ADA, respectively. Factors significantly associated with delayed diagnosis were hypertension, non-cash insurance, and >10 years of physician experience. Conclusion: Undiagnosed diabetes and diagnosis delay should be a concern in tertiary settings. Senior physicians should focus on patients with higher FPG levels, particularly those who have hypertension, and use non-cash insurance schemes.
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Clinicians with outdated or inadequate knowledge often fail to identify diseases and symptoms in their early stages and may misinterpret clinical guidelines.
“clinicians with outdated or inadequate knowledge often fail to identify diseases and symptoms in their early stages and may misinterpret clinical guidelines [83].”
From Toward Safer Diagnoses: A SEIPS-Based Narrative Review of Diagnostic Errors (2026) · cites this paper as [83]
The Discussion (Statement of Principle Finding; page not provided) links less up-to-date guideline knowledge with delayed type 2 diabetes diagnosis and says insufficient clinical knowledge can lead to misinterpretation of diabetes guidelines. It does not establish that clinicians often fail to identify diseases and symptoms generally at early stages; its evidence concerns diabetes diagnosis and treatment. (LLM, conf=0.85)
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- Authors
- Dulyapach, K., Ngamchaliew, P., Vichitkunakorn, P., Sornsenee, P., & Choomalee, K.
- Affiliations
- Prince of Songkla University (TH)
- Corresponding author
- Ngamchaliew, Pitchayanont
- Venue
- International Journal of Public Health
- Publisher
- Frontiers Media SA
- Published
- 2022-11-28
- Volume
- 67
- Pages
- 1605039-1605039
- ISSN
- 1661-8556 (ISSN-L)
- 1661-8564
- PMC
- PMC9742202
- OpenAlex
- W4310028622
- Cited by
- 17
- References
- 24
- Citations by year
- 2026: 7 · 2025: 6 · 2024: 2 · 2023: 1 · 2022: 1
- FWCI
- 1.85
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- International Journal of Public Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Faculty of Medicine, Prince of Songkla University
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- type 2 diabetes, delayed diagnosis, fasting blood glucose, diabetes screening, hypertension, insurance status, physician experience, outpatients, prevalence, diagnostic criteria
- MeSH terms
- Blood Glucose, Diabetes Mellitus, Diabetes Mellitus, Type 2, Humans, Hypertension, Retrospective Studies, Prevalence, Delayed Diagnosis, Tertiary Care Centers
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