Abstract

PurposeThis study aimed to estimate the prevalence of prediabetes and undiagnosed type 2 diabetes mellitus (T2DM) according to fasting plasma glucose (FPG), 2-h plasma glucose (PG) during oral glucose tolerance test (OGTT), and glycated hemoglobin (HbA1c) among a sample of Kuwaiti adults. In addition, associations of prediabetes and undiagnosed T2DM with sex, age, and body mass index (BMI) were assessed.MethodsA cross-sectional study enrolled 1238 subjects aged 18–65 years who reported no prior history of DM. After overnight fasting, FPG and HbA1c were measured in the total study sample, and 2-h PG during a 75-g OGTT was measured in a subsample of 155 subjects. Prediabetes and undiagnosed T2DM were defined according to the American Diabetes Association criteria. Associations were assessed using Poisson regression with robust variance estimation, and adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) were estimated.ResultsWe enrolled a total of 618 males and 620 females, with an average age of 43.0 years. The prevalence of prediabetes was estimated to be 47.9% (588/1228) by FPG, 36.8% (57/155) by 2-h PG OGTT, and 31.0% (355/1144) by HbA1c. The prevalence of undiagnosed T2DM was 6.9% (85/1228) by FPG, 11.0% (17/155) by 2-h PG OGTT, and 4.9% (56/1144) by HbA1c. Sex-related differences in the prevalence of prediabetes and undiagnosed T2DM were observed. Prediabetes and undiagnosed T2DM prevalence estimates showed increasing trends as age and BMI increased. For instance, obese subjects compared to under/normal weight subjects had an increased HbA1c-defined prediabetes prevalence (aPR = 1.62, 95% CI: 1.21–2.16).ConclusionPrediabetes and undiagnosed T2DM affect a considerable proportion of Kuwaiti adults, and variations across sex, age, and BMI exist. Hence, early identification and management of affected individuals may help reduce the public health burden.

Highlights

  • Diabetes mellitus (DM), a significant global public health concern, is a disorder of glucose metabolism that has a substantial impact on the well-being of affected individuals as well as their families and societies

  • To better understand the magnitude of prediabetes and undiagnosed type 2 DM (T2DM) among Kuwaiti adults and to inform healthcare planning and public health pre­ ventive strategies, this study sought to estimate the pre­ valence of prediabetes and undiagnosed T2DM according to fasting plasma glucose (FPG), 2-h plasma glucose (PG) oral glucose tolerance test (OGTT), and HbA1c criteria among a sample of Kuwaiti adults with no prior history of DM

  • This cross-sectional study estimated the prevalence of prediabetes and undiagnosed T2DM according to FPG, HbA1c, and 2-h PG OGTT among a sample of Kuwaiti adults

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Summary

Introduction

Diabetes mellitus (DM), a significant global public health concern, is a disorder of glucose metabolism that has a substantial impact on the well-being of affected individuals as well as their families and societies. The International Diabetes Federation (IDF) estimated in 2019 that around 463 million people (prevalence: 9.3%) globally are living with DM, with this number expected to rise by 2045 to approximately 700 million people (prevalence: 10.9%).[1] The economic impact of DM is demonstrated by the high global estimate of direct health expenditure that. It is estimated that, on average, 50% (range: 24.1% to 75.1%) of people living with diabetes are unaware of their condition.[1,7] As such, individuals with prediabetes and undiagnosed T2DM represent a public health challenge and missed opportunities to prevent complications

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