Abstract

Background/Objectives: In Romania, diabetes mellitus remains a significant public health challenge, characterized by high prevalence and significant undiagnosed cases. This study assessed the prevalence of elevated glycated hemoglobin (HbA1c) levels within the adult population participating in the European Health Examination Survey (EHES) and examined their associations with major cardiometabolic risk factors, subjective health perception, and patient awareness of previously diagnosed chronic conditions. Methods: This cross-sectional study analyzed data from the EHES in Romania, including systematic, population-weighted sample of adults aged 25–64 years. Data were analyzed using the Complex Samples module in SPSS, version 29.0 (IBM Corp., Armonk, NY, USA). HbA1c levels were measured through standardized clinical examination, with values of 5.7–6.4% classified as at risk for diabetes mellitus, and values ≥6.5% as diabetes mellitus. Results: Among 5380 representative adults, the prevalence of elevated HbA1c (≥6.5%) was 7.1%, while prediabetes (HbA1c 5.7–6.4%) affected 35.4% of participants; both conditions were significantly more prevalent in men than in women. Elevated HbA1c and prediabetes were substantially more frequent among individuals with hypertension and hypercholesterolemia, and glycemic control among participants with previously diagnosed diabetes was generally poor (all p ≤ 0.05). Individuals who are aware of having a chronic health condition appear to engage more actively in self-care practices, including increased physical activity and more frequent monitoring of key biological parameters. Conclusions: Elevated HbA1c and prediabetes were more prevalent than estimates reported in other studies using HbA1c-based diagnostic criteria. These observations highlight the importance of early detection and timely diagnosis, as awareness of one’s health status may facilitate healthier behaviors that mitigate metabolic complications.

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