{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T06:26:59Z","timestamp":1788848819325,"version":"build-2803163510"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T00:00:00Z","timestamp":1759795200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>The aim of this study was to explore the factors influencing type 2 diabetes mellitus (T2DM) among adults in Zhejiang Province.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A stratified cluster sampling technique was employed, and adults without known diabetes were included in the analysis. Food consumption was assessed using three consecutive days of 24-h dietary recall. Blood samples were collected to measure fasting blood glucose (FBG), blood lipids [total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), 25-(OH)D vitamin D (VD), and vitamin A (VA). Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were also measured. Ordinal regression was used to explore factors influencing T2DM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The analysis included a total of 5,804 adults. The prevalence rates of T2DM and prediabetes were 5.5 and 5.8%, respectively. Significant differences were observed in age, sex, nutritional status, hypertension, and blood lipid levels among adults with normal fasting blood glucose, prediabetes, and T2DM (<jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.05). Adults aged 55\u202fyears and above, those who were overweight or obese, those with hypertension, and those with higher TG levels had a greater risk of developing diabetes (<jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study revealed that adults aged 55\u202fyears and above, those who are overweight or obese, those with hypertension, and those with higher TG levels have a greater risk of developing diabetes. These findings underscore the need for targeted interventions to manage these risk factors in the prevention and management of T2DM.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2025.1662519","type":"journal-article","created":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T04:15:35Z","timestamp":1759810535000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Factors influencing type 2 diabetes in adults: a cross-sectional 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regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the global burden of disease study 2021","volume":"402","author":"Ong","year":"2023","journal-title":"Lancet"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1923","DOI":"10.1016\/S0140-6736(18)32225-6","article-title":"Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017","volume":"392","year":"2018","journal-title":"Lancet"},{"key":"ref3","volume-title":"IDF Diabetes Atlas","year":"2021"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1677","DOI":"10.1016\/S0140-6736(09)61457-4","article-title":"10-year follow-up of diabetes incidence and weight loss in the diabetes prevention program outcomes study","volume":"374","author":"Knowler","year":"2009","journal-title":"Lancet"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"i5953","DOI":"10.1136\/bmj.i5953","article-title":"Association between prediabetes and risk of cardiovascular disease and all cause mortality: systematic review and meta-analysis","volume":"355","author":"Huang","year":"2016","journal-title":"BMJ"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"963","DOI":"10.2337\/dc17-1962","article-title":"Global economic burden of diabetes in adults: projections from 2015 to 2030","volume":"41","author":"Bommer","year":"2018","journal-title":"Diabetes Care"},{"key":"ref7","year":""},{"key":"ref8","doi-asserted-by":"publisher","first-page":"e0228570","DOI":"10.1371\/journal.pone.0228570","article-title":"Prevalence and factors associated with prediabetes and diabetes in fishing communities in Penang, Malaysia: a cross-sectional study","volume":"15","author":"Rahim","year":"2020","journal-title":"PLoS One"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1622","DOI":"10.1097\/HJH.0000000000004061","article-title":"Correlation of the Mediterranean-dietary approaches to stop hypertension diet vs. ultra-processed diet with health outcomes in type 2 diabetes and hypertension: new insights from a 12-month interventional study","volume":"43","author":"Minari","year":"2025","journal-title":"J Hypertens"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"862","DOI":"10.3390\/nu17050862","article-title":"The role of the planetary diet in managing metabolic syndrome and cardiovascular disease: a narrative review","volume":"17","author":"Muszalska","year":"2025","journal-title":"Nutrients"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1293","DOI":"10.3390\/nu13041293","article-title":"Regional differences in the prevalence of anaemia and associated risk factors among infants aged 0-23 months in China: China nutrition and health surveillance","volume":"13","author":"Li","year":"2021","journal-title":"Nutrients"},{"key":"ref12","first-page":"83","article-title":"Cooperative Meta-analysis Group of the Working Group on obesity in China predictive values of body mass index and waist circumference for risk factors of certain related diseases in Chinese adults\u2013study on optimal cut-off points of body mass index and waist circumference in Chinese adults","volume":"15","author":"Zhou","year":"2002","journal-title":"Biomed Environ Sci"},{"key":"ref13","first-page":"671","volume-title":"Zhonghua Xin Xue Guan Bing Za Zhi","author":"Lou","year":"2022"},{"key":"ref14","volume-title":"China food composition","author":"Yang","year":"2018"},{"key":"ref15","first-page":"12","article-title":"Chinese Elderly Type 2 Diabetes Prevention and Treatment of Clinical Guidelines Writing Group; Geriatric Endocrinology and Metabolism Branch of Chinese Geriatric Society; Geriatric Endocrinology and Metabolism Branch of Chinese Geriatric Health Care Society; Geriatric Professional Committee of Beijing Medical Award Foundation; National Clinical Medical Research Center for Geriatric Diseases (PLA General Hospital). [Clinical guidelines for prevention and treatment of type 2 diabetes mellitus in the elderly in China (2022 edition)].","author":"Dalong","year":"2022"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1190934","DOI":"10.3389\/fphar.2023.1190934","article-title":"2023 Chinese guideline for lipid management","volume":"14","author":"Li","year":"2023","journal-title":"Front Pharmacol"},{"key":"ref17","volume-title":"Method for vitamin D deficiency screening. Chinese National Health and family planning commission","year":"2022"},{"key":"ref18","volume-title":"Method for vitamin a deficiency screening. Chinese National Health and family planning commission","year":"2017"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"101674","DOI":"10.1016\/j.arr.2022.101674","article-title":"The pancreatic \u03b2-cell in ageing: implications in age-related diabetes","volume":"80","author":"Tudur\u00ed","year":"2022","journal-title":"Ageing Res Rev"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"348","DOI":"10.2174\/1871530323666230822095932","article-title":"Investigation of pancreatic-beta cells role in the biological process of ageing","volume":"24","author":"Chaudhary","year":"2024","journal-title":"Endocr Metab Immune Disord Drug Targets"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"1486861","DOI":"10.3389\/fendo.2024.1486861","article-title":"Prevalence and risk factors for type 2 diabetes mellitus in women with gestational diabetes mellitus: a systematic review and meta-analysis","volume":"15","author":"Chen","year":"2024","journal-title":"Front Endocrinol"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"2418","DOI":"10.1111\/liv.15377","article-title":"Adipose tissue dysfunction and visceral fat are associated with hepatic insulin resistance and severity of NASH even in lean individuals","volume":"42","author":"Saponaro","year":"2022","journal-title":"Liver Int"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"713","DOI":"10.2147\/DMSO.S351218","article-title":"The prevalence of diabetes, prediabetes and associated risk factors in Hangzhou, Zhejiang Province: a community-based cross-sectional study","volume":"15","author":"Shi","year":"2022","journal-title":"Diabetes Metab Syndr Obes"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"1332","DOI":"10.1038\/s41598-025-85367-7","article-title":"The effects of interaction between smoking and abdominal obesity on pre-diabetes mellitus","volume":"15","author":"Xiong","year":"2025","journal-title":"Sci Rep"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1038\/s41574-019-0310-7","article-title":"Waist circumference as a vital sign in clinical practice: a consensus statement from the IAS and ICCR working group on visceral obesity","volume":"16","author":"Ross","year":"2020","journal-title":"Nat Rev Endocrinol"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1080\/27697061.2025.2450711","article-title":"Metabolic status and hypertension: the impact of insulin resistance-related indices on blood pressure regulation and hypertension risk","volume":"44","author":"Hu","year":"2025","journal-title":"J Am Nutr Assoc"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"831","DOI":"10.1097\/HJH.0b013e3282f624a0","article-title":"Renin-angiotensin system, natriuretic peptides, obesity, metabolic syndrome, and hypertension: an integrated view in humans","volume":"26","author":"Sarzani","year":"2008","journal-title":"J Hypertens"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"e209743","DOI":"10.1001\/jamanetworkopen.2020.9743","article-title":"Assessment of prevalence, awareness, and characteristics of isolated systolic hypertension among younger and middle-aged adults in China","volume":"3","author":"Mahajan","year":"2020","journal-title":"JAMA NetwOpen"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1097\/MCO.0000000000000696","article-title":"Dietary fibers reduce obesity-related disorders: mechanisms of action","volume":"23","author":"Dayib","year":"2020","journal-title":"Curr Opin Clin Nutr Metab Care"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"e15435","DOI":"10.1111\/dme.15435","article-title":"The effect of high-fibre diets on glycaemic control in women with diabetes in pregnancy: a systematic review and meta-analysis","volume":"42","author":"Jones","year":"2025","journal-title":"Diabet Med"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"1557923","DOI":"10.3389\/fnut.2025.1557923","article-title":"Global burden of type 2 diabetes mellitus attributable to dietary risks in elderly adults: insights from the global burden of disease study 2021","volume":"12","author":"Tang","year":"2025","journal-title":"Front Nutr"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"5476","DOI":"10.4103\/jfmpc.jfmpc_1625_23","article-title":"Study of pattern of lipid profile amongst type II diabetic patients of two major tribal populations of Tripura","volume":"13","author":"Debbarma","year":"2024","journal-title":"J Family Med Prim Care"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"370","DOI":"10.1111\/jdi.14398","article-title":"Clinical significance of small dense low-density lipoprotein cholesterol measurement in type 2 diabetes","volume":"16","author":"Hirano","year":"2025","journal-title":"J Diabetes 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