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The purpose of this study was to develop the modified risk calculator for the Pakistani population based on differences in perceived versus actual risk factors for developing type 2 diabetes mellitus (T2-DM).

A cross-sectional study design was developed to assess the study sample of 296 individuals from the Pakistani population. The data was collected using a questionnaire divided into three parts: general health, the validated Risk Perception Survey for Developing Diabetes (RPS-DD) and actual T2-DM risk assessment.

The study findings showed that among the total participants, 70.27% reported a low perceived risk of developing T2-DM, whereas 29.72% reported a high perceived risk when considering their family history. Regarding actual risk, males showed a 59% higher likelihood of developing T2-DM than females, who have a 50% higher risk. The modified calculator includes physical activity, fatty food consumption, age 34–65 and over 65, depression and artificially sweetened beverages.

This study experienced limited representativeness; many participants provided incomplete nutritional and knowledge information. It involved 296 individuals, mostly from one province and a few from other provinces of Pakistan. Therefore, the results can be generalized to the whole Pakistani population.

This study underscores the need for targeted interventions to enhance risk perception, inform preventive strategies and further investigate the interplay between perceived and actual risks in T2-DM in Pakistan.

The outcomes of this study can help Pakistani individuals who perceive themselves at an elevated risk of developing T2-DM. There is a general awareness among the Pakistani population regarding T2-DM. In contrast to perceived risk, the data on actual risk reveals a significant disconnect.

In Pakistan, there is a lack of research on perceived versus actual risk factors for developing T2-DM. To the best of the authors’ knowledge, this is the first study that evaluates the actual risk factors of developing T2-DM based on culture and dietary diversity in Pakistan.