Social Inequalities in T2DM-Related Risk Patterns and Diabetes-Related Knowledge Among Hungarian Secondary School Students Aged 16-20 Years: A Cross-Sectional Study Using an Adapted FINDRISC-Based Screening Framework

Type 2 diabetes mellitus (T2DM) is a major public health challenge, and several lifestyle-related factors associated with later T2DM may already emerge during the secondary school years. Socioeconomic status (SES), nutrition-related behaviors, physical activity, and basic diabetes-related knowledge may shape these early risk-related patterns. This study examined the relationships between SES, adapted FINDRISC-based T2DM-related risk patterns, and diabetes-related knowledge among Hungarian secondary school students aged 16-20 years.

A nationwide, cross-sectional questionnaire survey was conducted among students attending Hungarian Baptist secondary schools (N = 1585). SES was classified by Two-Step cluster analysis based on parental education, parental occupation, number of books in the household, and frequency of travel abroad. Relative T2DM-related risk patterns were described using an age-adapted FINDRISC-based screening approach, and basic diabetes-related knowledge was assessed using a 12-item questionnaire. Associations were examined using cross-tabulation and regression analyses in SPSS version 27.0.

Most respondents fell into the lower categories of the adapted FINDRISC-based screening framework, whereas 7.4% were classified into the moderate or high adapted FINDRISC-based screening categories. SES was significantly associated with adapted FINDRISC-based screening categories (p < 0.001). Compared with the medium-SES group, students in the low-SES group had higher odds of belonging to a higher adapted FINDRISC-based screening category (OR = 1.81; 95% CI: 1.27-2.57; p = 0.001). SES was also significantly associated with basic diabetes-related knowledge profiles (p = 0.015); students with high SES were less likely to be in the low-knowledge group than in the high-knowledge group (OR = 0.62; p = 0.039).

Social inequalities in T2DM-related risk patterns and diabetes-related knowledge are already visible among secondary school students aged 16-20 years. The adapted FINDRISC-based approach may be useful as a school-based, non-invasive descriptive screening framework for characterizing relative T2DM-related risk patterns, but it is not a validated risk prediction instrument for this age group.