Background: Type 2 diabetes mellitus represents a major global public health challenge, particularly in low- and middle-income countries, with a large proportion of cases remaining undiagnosed. Early identification of high-risk individuals is essential to prevent disease progression and complications. The Finnish Diabetes Risk Score is a simple, non-invasive screening tool that has been widely used to estimate the risk and diagnosis of type 2 diabetes mellitus and may offer a practical alternative to laboratory-based screening in resource-limited settings.
Aim of the study: To assess the ability of the Finnish Diabetes Risk Score to identify undiagnosed type 2 diabetes mellitus and prediabetes among Iraqi adults.
Patients and methods: Cross-sectional study was conducted at primary health care centers in Karbala Health Directorate/ Iraq from February 2025 to February 2026 and included 200 adult participants without previously diagnosed diabetes or prediabetes. Data collection included anthropometric measurements, and clinical history. The Finnish Diabetes Risk Score was calculated for each participant. Laboratory assessment included fasting blood sugar and glycated hemoglobin. analysis was used to evaluate diagnostic accuracy.
Results: According to laboratory findings, 26 participants (13%) were diabetic, 35 (17.5%) were prediabetic, and 139 (69.5%) were non-diabetic. The mean fasting blood sugar was 180.7 ± 63.1 mg/dL, and the mean HbA1c was 7.5 ± 4.2%. The mean FINDRISC score was 13.8 ± 4.6 (range: 4–24), with 71 participants (35.5%) classified as high risk (≥15 points), 14 (7.0%) as moderate risk (12–14 points), and 115 (57.5%) as low risk (<12 points). FINDRISC demonstrated good diagnostic accuracy for detecting diabetes, with an area under the curve (AUC) of 0.86 at a cutoff ≥15, yielding a sensitivity of 82.2%, specificity of 71.3%, positive predictive value of 77.5%, negative predictive value of 76.4%, and overall accuracy of 77.6%. For prediabetes, the AUC was 0.78 at a cutoff ≥12, with sensitivity of 74.6%, specificity of 64.5%, and accuracy of 69.2%. Significant associations with glycemic status were observed for age (p = 0.021), body mass index (p = 0.033), central obesity (p = 0.031), physical inactivity (p = 0.041), low fruit and vegetable intake (p = 0.028), hypertension (p = 0.009), family history of diabetes (p = 0.022), and history of hyperglycemia (p < 0.001), while gender was not significantly associated (p = 0.063).
Conclusions: The Finnish Diabetes Risk Score showed good diagnostic accuracy in identifying undiagnosed type 2 diabetes mellitus and acceptable accuracy for prediabetes among Iraqi adults.