Assessment of the type 2 diabetes risk using the Finnish Diabetes Risk Score questionnaire, and its predictors at the...

Type 2 diabetes (T2D) represents a major public health challenge in Poland. This study investigated geographic heterogeneity and municipality‑level ecological predictors of a high T2D risk in the Świętokrzyskie Voivodeship (Poland), a region undergoing rapid socioeconomic transition.

We aimed to identify associations between the T2D risk, assessed by the Finnish Diabetes Risk Score (FINDRISC), and socioeconomic and environmental factors.

This cross‑sectional study analyzed data from 252 427 residents of the Świętokrzyskie Voivodeship aged 45-64 years, without diagnosed diabetes, who participated in a regional prevention program (2019-2022). Individual risk, assessed via the FINDRISC questionnaire, was linked with municipality‑level ecological data. We used a logistic regression model with municipality‑clustered standard errors to identify predictors of a high T2D risk (FINDRISC ≥15).

Overall, 13.6% of the participants were at a high risk of diabetes (FINDRISC ≥15), with significant geographic variation (P <0.001). Among municipality‑level predictors, higher unemployment rate was significantly associated with increased odds of a high T2D risk (odds ratio [OR], 1.14 per 1% increase; P <0.001), whereas higher proportions of legally disabled residents and higher annual mean concentrations of particulate matter with aerodynamic diameter of 2.5 μm or smaller were inversely associated with the prevalence of a high T2D risk (OR, 0.98; P = 0.03 and OR, 0.92 per 1 μg/m3; P = 0.001, respectively). Results were robust across sensitivity analyses using alternative FINDRISC cutoffs.

Unemployment was a key population‑level determinant of a high T2D risk, whereas other socioeconomic and environmental factors showed null or inverse associations. These findings underscore the importance of considering local context when assessing population‑level health determinants.