Prevalence Of Undiagnosed Diabetes Mellitus Research Articles

Prevalence of undiagnosed diabetes mellitus and associated factors among adult residents of Mizan Aman town, Southwest Ethiopia: Community-based cross-sectional study.

Diabetes mellitus continues to be a significant global public health concern, and it is currently a public health issue in developing nations. In Ethiopia, about three fourth of adult population with diabetes are unaware of their diabetic condition. However, there is a limited research on this specific topic particularly in the study area. To assess prevalence of undiagnosed diabetes mellitus and its associated factor among adult residents of Mizan Aman town, south West Ethiopia. A community-based cross-sectional study was conducted from May 23 to July 7, 2022, on 627 adult residents of Mizan Aman town. A multi stage sampling technique was used to obtain 646 study units. Interviewer-administered structured questionnaires were employed to gather socio-demographic and behavioral data. Anthropometric measurements were obtained and blood samples were taken from each participants. The fasting blood glucose level was measured after an 8-hour gap following a meal, using a digital glucometer to analyze a blood sample. Data were cleaned and entered into Epi-data v 3.1 and exported to SPSS v. 26 for analysis. Bi-variable analysis was done to select candidate variables and multivariable logistic regression model was fitted to identify independent predictors of undiagnosed diabetes mellitus. Adjusted odds ratio (AOR) with 95% CI was computed and variables with p-value < 0.05 were declared to be predictors of undiagnosed diabetes mellitus. The study revealed that, the overall magnitude of undiagnosed diabetes mellitus was 8.13% (95% CI: 6.1, 10.6). Predictors of undiagnosed diabetes mellitus were; physical activity level less than 600 Metabolic equivalent/min per week (AOR = 3.39, 95%CI 1.08 to 10.66), family history of diabetes mellitus (AOR = 2.87, 95% CI 1.41, 5.85), current hypertension(AOR = 2.9, 95% CI 1.26, 6.69), fruit consumption of fewer than three servings per week(AOR = 2.64, 95% CI 1.18 to 5.92), and sedentary life(AOR = 3.33, 95% CI 1.63 to 6.79). The prevalence of undiagnosed diabetes mellitus was 8.13%. Physical inactivity, family history of diabetes mellitus, current hypertension, sedentary life, and fruit servings fewer than three per week were independent predictors of undiagnosed diabetes mellitus.

Diabetes mellitus, the fastest growing global public health concern: Early detection should be focused

AbstractBackground and AimsDiabetes is recognized as a significant factor in both mortality and morbidity worldwide, affecting various demographics regardless of geographic location, age group, or gender. This correspondence aims to express concern and draw the attention of leaders and policymakers worldwide to this critical public health issue.MethodsA thorough literature search was conducted utilizing various databases, including Google Scholar, PubMed, Science Direct, and the International Diabetes Federation (IDF) website, to collect the required data. Keywords were strategically applied to enhance search results, with preference given to English‐language articles containing pertinent information.ResultsAccording to the 2021 report by the IDF, approximately 537 million individuals globally were affected with diabetes, constituting roughly 10.5% of the world's populace. This condition incurred healthcare expenditures totaling $966 billion. Projections indicate a surge in diabetes cases to 783 million by 2045, with associated healthcare costs estimated to surpass $1054 billion. However, almost half of all people with diabetes are unaware of their medical condition, with the highest prevalence of undiagnosed diabetes Mellitus (DM) found in low and middle‐income countries (LMICs) of the regions of Africa, the Western Pacific, and Southeast Asia.ConclusionCollaborating with the World Health Organization (WHO), LMIC governments should improve healthcare accessibility, including more frequent diabetes screenings for individuals aged ≥ 45 years and younger individuals at elevated risk of having a family history.

Universal Fasting Glucose Screening Before Gastric Emptying Scintigraphy and the High Prevalence of Undiagnosed Diabetes and Prediabetes.

The aim of this study was to assess the rates of undiagnosed diabetes mellitus (DM) and pre-DM in patients undergoing gastric emptying scintigraphy (GES). Diabetes is an epidemic in the United States, and the disease is associated with altered gut motility. As a result, we suspected that a significant number of patients referred for GES may have undiagnosed DM or pre-DM. Given that established procedure standards for GES require all patients to prepare with an 8-h fast, an opportunity is provided to measure the fasting blood glucose (FBG) in all individuals before they undergo the examination. Methods: The charts of patients undergoing GES were reviewed for a history of DM and correlated with FBG and GES results. FBG values, obtained by point-of-care testing, were categorized as normal, pre-DM, or DM. Results: Patients with known DM made up 23% of those referred for GES, and most (55%) had a normal FBG. In those without a history of DM, there were a significant number with undiagnosed pre-DM (12%) and DM (33%). Conclusion: Our study provides the first measure of the likely prevalence of undiagnosed DM and pre-DM and characterizes the different gastric emptying patterns among patients with normal FBG, likely undiagnosed pre-DM, likely undiagnosed DM, and known DM.

Undiagnosed status and associated factors of diabetes mellitus among adults living in eastern Ethiopia: Unmasking a silent killer of prevalence of diabetes mellitus

BackgroundThe global prevalence of diabetes mellitus (DM) is increasing rapidly, with special concern for the entity silent or undiagnosed diabetes; those unaware of their condition. It is important to uncover the hidden extent of diabetes in order to identify diabetes-related problems early. Therefore, this study aimed to assess the prevalence of undiagnosed DM and associated factors in Eastern Ethiopia. MethodsA quantitative, community-based cross-sectional study was conducted among 609 adults not known to be diabetic from January 03 to February 23, 2023. A multi-stage sampling technique and a validated standardized instrument were used. Each participant was interviewed to collect socio-demographic and behavioral characteristics data. Anthropometric measurements were recorded. The fasting blood glucose (FBG) test was assessed by samples taken early in the morning, 8 h after night fasting. Undiagnosed DM was defined as not being diagnosed with Diabetes mellitus and an FBG level of ≥126 mg/dl. To identify factors associated with undiagnosed DM, logistics regression was used. The level of statistical significance was set at a value of p < 0.05. ResultsThe prevalence of undiagnosed diabetes mellitus was 8.64 % (95 % CI: 6.7–11.2). The multivariable analysis showed that sedentary behavior, family history of diabetes mellitus, current hypertension, and fruit consumption of fewer than three servings per week were independently associated with undiagnosed DM in studied participants. ConclusionAlmost one in eleven adults living in the study area had undiagnosed DM, and various associated factors identified were modifiable risk factors that could be useful in planning intervention measures for lifestyle modification.

The magnitude of undiagnosed diabetes mellitus, prediabetes, and associated factors among adults living in Debre Tabor town, northcentral Ethiopia: A community-based cross-sectional study

BackgroundDiabetes mellitus (DM) is a worldwide public health problem. The burden of diabetes has been continuously increasing from day to day, especially in developing countries like Ethiopia. Globally, half of all cases of diabetes mellitus are undiagnosed. Diabetes mellitus can be easily handled if it is detected early. There is limited evidence on the magnitude of undiagnosed diabetics and prediabetes at the community level in Ethiopia, particularly in the study area. ObjectiveTo assess the magnitude of undiagnosed diabetes mellitus, prediabetes, and associated factors among adults living in Debre Tabor town. MethodsA community-based cross-sectional study was conducted in Debre Tabor town from October to December 2021. A total of 407 participants were selected using a multistage sampling technique. A pretested structural questionnaire was used to collect demographic, behavioral, and clinical data. Anthropometric measurements were taken with standardized and calibrated equipment. A fasting venous blood sample was collected for blood glucose level determination. Logistic regression was used to identify risk factors. A P-value ≤0.05 was considered statistically significant. ResultThe magnitude of undiagnosed diabetes mellitus and prediabetes was found to be 4.5% (95% CI: 2.9–7.4) and 14.5% (95% CI: 11.1–18.1), respectively. Older age (AOR: 6.50, 95% CI: 1.82–23.21), abnormal body mass index (AOR: 6.84, 95% CI: 1.91–24.54), systolic hypertension (AOR: 8.74, 95% CI: 2.53–30.19), and family history of diabetes mellitus (FHDM) (AOR: 12.45, 95% CI: 3.63–42.65) were significantly associated with undiagnosed diabetes mellitus. Using saturated oil (AOR: 1.97, 95% CI: 1.09–3.55), having a high waist circumference (AOR: 2.16, 95% CI: 1.20–3.87), and being hypertensive (AOR: 2.26, 95% CI: 1.04–4.96) were all significantly associated with Prediabetes. ConclusionAdults in Debre Tabor town have a high prevalence of undiagnosed diabetes and prediabetes. A variety of modifiable risk factors were also identified. As a result, focusing the prevention strategy on such modifiable risk factors may help to minimize the prevalence of undiagnosed diabetes mellitus and prediabetes as well as future disease complications.

Prevalence of chronic non-communicable diseases in Ethiopia: A systematic review and meta-analysis of evidence.

BackgroundNon-communicable diseases (NCDs) are a growing global health challenge disproportionately impacting low- and middle-income settings, including Ethiopia. Currently, the body of evidence describing the burden of NCDs is fragmented, inconsistent, health facility- or institution-based, and out-dated in Ethiopia. We conducted a systematic review of the literature and meta-analysis of the prevalence of NCDs in community settings in Ethiopia.Review methodologyCommunity-based quantitative studies published in English between January 1st, 2012, and June 30th, 2022, that reported on the prevalence of NCDs in Ethiopia were included. A systematic search of Medline, Embase, Scopus, CINAHL, and Global Health using pretested search terms related to NCDs was conducted, and data were extracted using a piloted data extraction proforma adapted from the Joanna Briggs Institute tool. Meta-analysis was performed using Stata 16. While the pooled prevalence of Diabetes Mellitus (DM) and undiagnosed (DM) was computed and presented using forest plots, then overall prevalence of NCDs and other various types of NCDs were narratively synthesized. I2 was used to assess heterogeneity. Studies that did not fulfill the criteria (used similar tool to measure the types of NCDs) for meta-analysis were narratively synthesized.ResultsTwenty-two studies met the inclusion criteria. Five studies measured the prevalence of NCDs (all NCDs together), ranging from 29 to 35% (prevalence estimates not pooled). The pooled prevalence of Diabetes Mellitus (DM) across ten studies was 5% (95% CI: 4–7%). Three studies each reported on the prevalence of undiagnosed DM (pooled prevalence 5%, 95% CI: 4–7%) and pre-DM (pooled prevalence 7%, 95% CI: 3–14%%). In a narrative analysis the prevalence of cardiovascular conditions ranged from 13.4 to 32.2% (n = 3 studies), cancer mortality ranged from 4 to 18% (n = 3 studies) and respiratory conditions ranged from 1 to 18% (n = 3 studies). Some studies have determined more than one NCDs and that is why the total number of studies are exceeding more than twenty studies.Conclusion and recommendationsOur analysis found that approximately one-third of Ethiopians have an NCD, with cardiovascular diseases the most common of all NCDs. The prevalence of respiratory conditions also appears high, but there are insufficient data for a pooled estimate. Whilst the prevalence of DM appears relatively low, there is evidence that the magnitude is increasing. Public health actions to address the high burden of cardiovascular and respiratory diseases, as well as the increasing magnitude of DM in Ethiopia, must be prioritized.Systematic review registrationPROSPERO [CRD42020196815].

Undiagnosed Diabetes Mellitus and Its Predictors Among Socially Marginalized Menja Communities in Southwest Ethiopia.

Background:Diabetes mellitus (DM) is a metabolic disorder marked by a persistently high blood glucose level over a prolonged period of time linked to either defects in insulin secretion, insulin action, or both. It is responsible for 537 million adult cases and 6.7 million deaths in 2021. However, about half of the people with diabetes go undiagnosed. Low-income and socially disadvantaged communities are the most vulnerable to the disease. Despite this fact, nothing has been done among these communities, so this study aimed to assess the extent of undiagnosed diabetes and its predictors among the socially marginalized Menja communities of Southwest Ethiopia, 2021.MethodsA community-based cross-sectional study was done in the Menja communities from April 21/2021 to June 30/2021. The required sample size was calculated using the single population proportion formula and systematic sampling techniques were employed to select the households. Data were collected through face-to-face interviews utilizing an interviewer-administered questionnaire to collect socio-demographic and behavioral characteristics, and anthropometric measurements were taken from each participant. Diabetes was defined as participants who had an FBG ≥ 126 mg/dL or RBG > 200 mg/dL. The multivariate logistic regression model was used to identify the predictors of diabetes; adjusted OR with a 95% CI was computed to assess the strength of associations.ResultsThe prevalence of undiagnosed DM among the socially marginalized Menja communities was 14.7% [95% CI: (11.1–18.3)], and sex-specific prevalence was 16.8%, and 11.1% for men and women respectively. Factors like alcohol consumption (AOR = 3.0, 95% CI 1.49 to 6.05), family history of DM 4.4 (AOR = 4.37, 95% CI 2.04 to 9.35), lower vegetable consumption 3.5 (1.19–10.31) (AOR = 3.5, 95% CI 1.19 to 10.31), and less physical exercise 3.3 (AOR = 3.34, 95% CI 1.61 to 6.90) were the independent predictors that increase the risk of diabetes among Menja communities.Conclusion and RecommendationsUndiagnosed diabetes was high as compared to other settings. Alcohol use, family history of diabetes, vegetable consumption, and physical exercise were predictors of diabetes. Hence, the study suggests frequent screening and treatment for high-risk groups. Minimizing alcohol drinking, frequent vegetable consumption, and physical exercises were recommended measures for the prevention and control of DM among the population of Ethiopia.

Undiagnosed diabetes mellitus and associated factors among adults in Ethiopia: a systematic review and meta-analysis

Diabetes has become a major public health problem, with 4.6 million deaths annually. The number of people living with undiagnosed diabetes is on the rise and has a diverse prevalence. Thus, this systematic review and meta-analysis was aimed to synthesize the pooled estimate prevalence of undiagnosed diabetes mellitus, impaired fasting glucose and its associated factors in Ethiopia. The databases Medline, Hinari, Google Scholar, and Google search were used to find potential studies published from January 2013 until January 2021. Extracted data were entered into the excel spreadsheet. The random effects model with Der Simonian-Laird weights was used to assess the pooled estimate of prevalence of undiagnosed diabetes, impaired fasting glucose, and its associated factors. The Cochrane Q-test and I2 statistics were used to screen for statistical heterogeneity. A funnel plot and Egger's statistical test were also used to search for any publication bias (small study effect). After extensive searching of articles on different databases, a total of nine studies were included for this systematic review and meta-analysis. In random effects model, the pooled prevalence of undiagnosed diabetes mellitus and impaired fasting glucose was 5.75%, 95% CI (3.90–7.59%), and 8.94%, 95% CI (2.60–15.28%), respectively. Regarding the associated factors, participants family history of diabetes was significantly associated with diabetes status. The pooled odds of developing diabetes mellitus among participants with a family history of diabetes mellitus were about 3.56 times higher than those without a family history of diabetes mellitus (OR = 3.56, 95% CI (2.23, 5.68)). In this review, the higher prevalence of undiagnosed diabetes mellitus and impaired fasting glucose was observed among adults in Ethiopia. Family history of diabetes was found to have an association with increased risk of diabetes mellitus. Our finding highlights the need of screening at the community level, with special focus on adults with family history of diabetes mellitus.

Undiagnosed Diabetes and Prediabetes in Patients with Chronic Coronary Syndromes-An Alarming Public Health Issue.

Dysglycemia is a public health challenge for the coming decades, especially in patients with chronic coronary syndromes (CCS). We want to assess the prevalence of undiagnosed diabetes mellitus (DM) and prediabetes, as well as identify factors associated with the development of dysglycaemia in patients with CCS. In total, 1233 study participants (mean age 69 ± 9 years), who, between 6 and 18 months earlier were hospitalized for acute coronary syndrome or elective revascularization, were examined (71.4% men). The diagnosis of DM, impaired fasting glucose (IFG), impaired glucose tolerance (IGT) have been made according to World Health Organization (WHO) criteria. Based on the oral glucose tolerance test (OGTT) results, DM has been newly diagnosed in 28 (5.1%, mean age 69.9 ± 8.4 years) patients, 75% were male (n = 21). Prediabetes has been observed in 395 (72.3%) cases. IFG was found in 234 (42.9%) subjects, 161 (29.5%) individuals had IGT. According to multinomial logistic regression, body mass index (BMI) and high-density lipoprotein cholesterol (HDL-C) should be considered when assessing risk of development of dysglycaemia after discharge from the hospital. Among people with previously diagnosed DM, a significantly higher percentage were willing to change their lifestyles after the index event compared to other patients. Patients with chronic coronary syndromes suffer a very high frequency of dysglycaemia. Most patients with chronic coronary syndromes, especially those with high BMI or low HDL-C, should be considered for screening for dysglycemia using OGTT within the first year after hospitalization. A higher percentage of patients who were aware of their diabetic status changed their lifestyles, which added the benefit of timely diagnosis and treatment of diabetes.

Prevalence and Clinical Profile of Undiagnosed Diabetes Mellitus: Data from a Tertiary Hospital

The prevalence of diabetes mellitus in Vietnam is relatively low compared to other Asian countries, but it is accelerating with the economic and cultural transition. This study aimed to estimate the current prevalence and clinical profile of undiagnosed diabetes mellitus in a tertiary hospital in the south of Vietnam. A cross-sectional investigation was conducted to recruit 1, 250 participants, who were at least 18 year-old and randomly sampled from Cho Ray Hospital, Ho Chi Minh City, Vietnam. Fasting plasma glucose concentration and HbA1c were measured for each individual. The American Diabetes Association criteria were used to diagnose diabetes. Demographic data and other clinical characteristics of diabetes were also documented, including age, sex, residence, educational status, weight, height, waist and hip circumferences, blood pressure, familial history of diabetes, and lipid profile. The prevalence of undiagnosed diabetes mellitus was 7.5% in the population studied. Age, waist circumference, waist-hip ratio, body mass index, and hypertension, as well as dyslipidaemia were well-correlated with the diabetes rate. The prevalence of undiagnosed diabetes mellitus is increasing far more than expected. Newly diagnosed diabetic patients usually presented with multiple comorbidities, including overweight/ obesity, hypertension, and dyslipidaemia.

Engagement of private healthcare providers for case finding of tuberculosis and diabetes mellitus in Pakistan

BackgroundThe rising co-epidemic of tuberculosis (TB) and diabetes mellitus (DM) is a challenge for constrained health systems in low and middle-income countries. Diabetes is a known risk factor for tuberculosis and associated with poor tuberculosis treatment outcomes, while tuberculosis is associated with worsening glycemic control. We investigated the performance of bi-directional TB and DM case finding approaches through a private-sector engagement model in Karachi, Pakistan.MethodsBetween July 2016 and July 2018, private health care providers were engaged to generate referrals for bi-directional TB and DM screening at private diagnostic and treatment centers in Karachi, Pakistan. Individuals diagnosed with TB underwent glycated hemoglobin (HbA1c) testing at the time of anti-tuberculous treatment initiation and at three -month follow up stage. All individuals with a history of diabetes or random blood sugar of greater than 200 mg/dl were screened for TB using a chest X-ray and Xpert MTB/RIF.ResultsA total of 6312 persons with tuberculosis were tested on HbA1c at treatment initiation, of whom 1516 (24%) were newly diagnosed with DM. About one third of those with HbA1c in the diabetic range (≥ 6.5%) at baseline were found to have a normal HbA1c (< 5.7%) result at 3-month follow-up. A total of 3824 individuals with DM, of whom 2396 (63%) were known cases and 1428 (37%) were newly identified with random blood sugar > 200 mg/dl, underwent chest x-ray and Xpert MTB/RIF testing, with 321 (13.4%) known and 54 (3.8%) new diabetics respectively identified with tuberculosis.ConclusionThis study demonstrates a high yield of TB and DM through bidirectional screening and the feasibility of engagement of private sector in finding missing cases of tuberculosis and diabetes. Given the high prevalence of undiagnosed DM in individuals with TB tuberculosis patients, there is a need to scale-up DM screening within TB programmes. Increased awareness of the high risk of TB among individuals with DM is needed among private health providers and screening for TB among diabetics should be strongly considered.

Imminent risk of COVID-19 in diabetes mellitus and undiagnosed diabetes mellitus patients.

Diabetes mellitus is a non-infectious disease and has affected about 425 million adults globally and nearly 15.9 million of them reside in Africa. Moreover, the prevalence of undiagnosed diabetes mellitus is very high in Africa and approximates to around 62%. Nearly 75% of the total deaths due to diabetes are in individuals lesser than 60 years of age. The multifaceted disease of diabetes mellitus produces chronic complications such as, neuropathy, nephropathy, retinopathy, microangiopathy etc. These patients of diabetes mellitus are more susceptible to infections due to compromised immune system. Hence these patients of diabetes mellitus and undiagnosed diabetes mellitus are at greater risk of contracting COVID-19 infections. The dual impact of pathophysiology of COVID-19 infections in diabetes mellitus may increase morbidity and mortality in these patients. Hence there is need of health awareness in diabetics as well in the high-risk group for diabetes such as persons with hypertension and obesity. The scarcity of health resources, shortage of trained medical personnel and disease burden of infectious and non-infectious diseases has laid a heavy impact on the economy in Africa and this has been further strained due to the COVID-19 pandemic. The practice of preventive measures by the risk group of Undiagnosed Diabetes Mellitus patients will prevent them from getting infected by COVID-19 and at the same time decrease mortality rates and hence the undiscovered group that is the patients of undiagnosed diabetes mellitus needs to be vigilant regarding safe preventive practices.

Prevalence of Diabetes Mellitus, Prediabetes and Its Associated Factors in Dessie Town, Northeast Ethiopia: A Community-Based Study.

BackgroundDiabetes mellitus is becoming an epidemic public health problem in developing countries such as Ethiopia. As the International Diabetes Federation indicates, the number of adults living with diabetes globally has been increasing from time to time. If early screening and follow-up are done, diabetes is a manageable disease. However, diabetes study at the community level in Ethiopia is limited and scarce. Therefore, the present study was conducted to assess the current prevalence of DM, prediabetes and its associated factors in Dessie Town, Northeast Ethiopia.MethodsA community-based cross-sectional study was conducted from January to March 2019 among people aged 18 years and above in Dessie Town, Northeast Ethiopia. A multistage sampling technique was used to select a total of 587 study participants. Sociodemographic and behavioral characteristic data were collected using a pretested semi-structured questionnaire. Venous blood samples were used to determine the level of blood glucose and lipid profile. Diagnosis and classification of diabetes mellitus and prediabetes were based on the criteria of the American Diabetes Association.ResultsThe prevalence of diabetes mellitus and prediabetes was 6.8% (95% CI 4.9–9.0) and 15.7% (95% CI 12.9–18.7), respectively. The prevalence of previously undiagnosed diabetes mellitus was 72.5%. Positive family history of diabetes mellitus (AOR: 20.24, 95% CI 4.74–86.43), smoking habit (AOR: 12.12, 95% CI 2.30–63.73), overweight (AOR: 21.95, 95% CI 6.73–71.603), systolic hypertension (AOR: 4.61, 95% CI 1.09–19.50) and hypercholesterolemia (AOR: 8.97, 95% CI 2.05–39.23) were significantly associated with diabetes mellitus. Prediabetes was associated with advanced age (AOR: 3.55, 95% CI 1.16–10.79), marital status (single) (AOR: 3.06, 95% CI 1.40–6.67), educational status (illiterate) (AOR: 2.35, 95% CI 1.04–5.35) and overweight (AOR: 2.11, 95% CI 1.05–4.23).ConclusionThere was a higher prevalence of diabetes mellitus and prediabetes. In addition, the prevalence of undiagnosed diabetes mellitus was high in our study area. Therefore, targeting the control and prevention strategy to such modifiable risk factors associated with diabetes and prediabetes may contribute to the reduction of the prevalence and further complications of diabetes mellitus.

Prevalence of undiagnosed diabetes mellitus and associated factors among adult residents of Bahir Dar city, northwest Ethiopia: a community-based cross-sectional study

ObjectiveTo assess the prevalence of undiagnosed diabetes mellitus (DM) and associated factors among adult inhabitants of Bahir Dar city, northwest Ethiopia.DesignA community-based cross-sectional study was conducted on adults (n=607) of...

The Burden of Undiagnosed Diabetes Mellitus in Adult African Population: A Systematic Review and Meta-Analysis.

Background The prevalence of diabetes is rapidly increasing in Africa. Type two diabetes may remain undetected for many years, leading to severe complications and healthcare costs. This underlines the importance of understanding the magnitude of undiagnosed diabetes in different populations of Africa. This study is intended to summarize and pool the results of community-based studies to provide a continental level estimate of the undiagnosed diabetes mellitus. Methods We searched MEDLINE/PubMed, HINARI, Cochrane Library, and Google Scholar for community-based studies on diabetes mellitus in Africa. Descriptive information for the original studies was presented in a table, and the quantitative results were presented in forest plots. The Cochran's Q test and I2 test statistic were used to test heterogeneity across studies. The pooled prevalence of undiagnosed diabetes and subgroup analyses within urban and rural population and diagnostic methods were computed by a random effects model from 2011 to 2017. Results One hundred fifty-seven articles were identified through electronic searching using keywords. Of these, seventeen studies, with a total population of 20,350, met the inclusion criteria. A random effects meta-analysis showed that the pooled prevalence of undiagnosed diabetes mellitus in African population was 5.37% (95% CI: 4.57, 6.81). The pooled prevalence from subgroup analyses indicated that undiagnosed diabetes mellitus in the urban population (8.68%, 95% CI: 5.33, 12.03) is twice higher than that in the rural population (3.93%, 95% CI: 2.91, 4.95). The prevalence of UDM by OGTT (8.84%, 95% CI: 1.95, 15.73) was higher than that by the FPG diagnostic method (4.54%, 95% CI: 3.59, 5.49). Conclusion This study found high proportions of undiagnosed diabetes mellitus in different communities of the African countries. Policy makers must consider diagnostic strategies to improve screening for the undiagnosed diabetes mellitus cases for effective care, which can bring about a substantial reduction in diabetes-related complications and mortality. This review is registered with PROSPERO registration number CRD42018092637.

DIABETES MELLITUS;

Objectives: To determine the frequency of undiagnosed diabetes mellitus (DM) in patients of acute myocardial infarction (AMI) presented in a tertiary care hospital. Study Design: Descriptive observational study. Setting: Cardiac Center at Hail Region, Saudi Arabia. Period: October-2016 to September-2017. Methods: One hundred (100) patients of acute ST-elevation myocardial infarction (STEMI and Non-STEMI) presented. Fasting blood sugar (FBS) levels more than 126 mg/dl on two consecutive samples was diagnosed as diabetes mellitus. Patients taking anti-diabetic medications were diagnosed as known cases of diabetes. All the patients records were entered in SPSS v17 for analysis. Prevalence of newly diagnosed and known diabetic patients were presented as frequency and percentage. Results: Mean age of acute MI patients was 51.65+8.23 years. There were 82% male and only 18% female patients with male/female ratio of 4.5/1. There were 74% patients who presented with acute STEMI and remaining 26% patients presented with non-STEMI. Hypertension was present in 43% patients and smoking in 36% patients. There were 32% patients who were previously having diabetes mellitus and diabetes was diagnosed for the first time in 12% patients. Remaining 56% patients were free from diabetes. Conclusion: Prevalence of undiagnosed DM is very common in patients of AMI. Immediate diagnosis should be done in acute MI patients without previous history of DM.

Prevalence of Diabetes Mellitus and Associated Risk Factors Among Adults Attending at Feres Meda Health Centre, Addis Ababa, Ethiopia, 2017

Background: Diabetes is a family of disorders that is characterized by hyperglycemia. The disorders of diabetes differ in their etiology and symptoms and in the consequences of the disease. Diabetes mellitus is a high rising disease all over the world and in our country, because of some lifestyle change of the community. Therefore, this study aims to determine the prevalence of DM and its associated factors among adults in Feres Meda health center at Addis Ababa, Ethiopia. Methods: A cross-sectional study was conducted from November 2016 to March 2017. Patient demographic characteristics were collected using a pre-tested standard questionnaire format. Height, weight and blood pressure were measured physically and 5 ml fasting blood sample was collected to analyze blood glucose by glucose oxidase method using automated chemistry analyzer. Statistical analysis was performed by using Statistical software version 20. Results: Out of the 392 participants, 58.7% of them were females. The age of participants ranged from 19 to 80 years with a mean of 34.34 years. Among the study participants, 2.6% of them had DM and 6.9% of the participants had high fasting blood glucose value (pre-diabetes). Age (P = 0.048), WC (P=0.001), and family history of DM (P= 0.024) were significantly associated with the development of DM. Conclusion: High prevalence of undiagnosed diabetes mellitus was observed among study population. Therefore, regular screening of DM, particularly for those individuals having higher waist circumstance, family history of DM and older age, is mandatory to control blood glucose early.

Diabetes and blindness in people with diabetes in Hungary.

The purpose of the study was to estimate the number of people with diabetes mellitus, the prevalence of diabetes mellitus and the prevalence of blindness and severe visual impairment among people with diabetes mellitus in Hungary based on our recent national representative survey. Altogether 105 clusters of 35 people aged 50 years or older were randomly selected. Standardized rapid assessment of avoidable blindness with the diabetic retinopathy module was used. Each individual received a visual acuity assessment, and every person with diabetes mellitus underwent dilated fundus examination. The estimated number of people with diabetes mellitus was 807,885 in the adult (⩾18 years) population in Hungary with 9.9% prevalence. Diabetic retinopathy exhibited an increasing tendency with age. The prevalence rates of blindness and severe visual impairment in people with diabetes mellitus aged ⩾50 years were 1.0% and 0.9%, respectively. Diabetic retinopathy was responsible for 28% of blindness and 50% of severe visual impairment among participants aged ⩾50 years with diabetes mellitus. The estimated number of people with diabetes mellitus and prevalence of diabetes mellitus were lower than those recently reported. However, if we extend our estimation, prevalence of undiagnosed diabetes mellitus may be higher and thus prevalence of diabetes mellitus may reach a higher value (between 9.9% and 13.4%). Because of the high number of ophthalmologically uncontrolled diabetic eyes and high rate of blindness due to diabetic retinopathy, primary eye care should be improved, and a nationwide telemedical eye-screening programme should be undertaken.

Prevalence and Impact of Diabetes Mellitus on the Frozen Shoulder.

The objective of this study was to estimate the prevalence of undiagnosed diabetes mellitus in patients with newly diagnosed frozen shoulder (FS) and study whether diabetes mellitus increases the severity of FS disease. Patients with newly diagnosed FS were consecutively included in this case-control study. Patients who were not already diagnosed as having diabetes mellitus were invited to be tested with the hemoglobin A1c blood sample test. The study population was compared with a control group, consisting of five individuals from the general population matched on age and sex. The passive range of motion, Oxford Shoulder Score, and visual analog scale (VAS) for average and maximum daily pain was recorded for all of the patients in the study group. A total of 235 patients were included, 34 (14%) of whom were diagnosed as having diabetes mellitus before the examination. Of the remaining 201 patients, 122 (61%) agreed to be tested for diabetes mellitus. None of the tested patients had undiagnosed diabetes mellitus. This was not significantly different from the prevalence in the matched control population (P = 0.09). There was no difference between patients with and without diabetes mellitus in average daily VAS (P = 0.46) nor maximum daily VAS (P = 0.44). The Oxford Shoulder Score was similar in the two groups (P = 0.23) as was the range of motion. The prevalence of undiagnosed diabetes mellitus is low in patients with FS and does not differ from the general population. Diabetes mellitus does not seem to affect patients' perceived severity of an FS.

Abstract WMP52: Prevalence of Undiagnosed Risk Factors in Patients With First-Ever Ischemic Stroke

Introduction: Undiagnosed RF (URF) are a missed opportunity for primary stroke prevention. We sought to determine the prevalence of URF (RF newly diagnosed during inpatient evaluation) among first-ever ischemic stroke (IS) cases within a large, bi-racial population. Methods: Within the population-based Greater Cincinnati/Northern Kentucky (GCNK) stroke study catchment area of 1.3 million, we ascertained all hospitalized first-ever acute IS in 2010 among individuals ≥20 years old through screening of ICD-9 codes 430-436, with all cases verified by study physicians. We evaluated the prevalence of undiagnosed diabetes mellitus (DM), hypertension (HTN), hyperlipidemia (HLD), and atrial fibrillation (AF) among all IS patients and those with each risk factor. We also evaluated the association between URF and insurance status (private, Medicaid/Medicare, or uninsured) for each RF using chi-square tests. Results: There were 1737 first-ever IS cases in the GCNK region in 2010 (55.8% female, 19.5% black, median age 71). Of these, 21% had at least one URF (Table), most commonly HLD (13%) or HTN (6%). Among patients with a given risk factor, 21% of those with HLD, 13% with AF, 9% with DM, and 7% with HTN were undiagnosed prior to inpatient evaluation for first-ever IS. Uninsured individuals (48%) were significantly more likely than those with private (22%) or government (20%) insurance to have at least one URF. Conclusions: One in five IS patients had at least one URF upon presentation with their first-ever stroke, and URF were more prevalent among uninsured individuals. Our data reinforce the importance of screening for URF during IS evaluation and highlight the importance of earlier detection of treatable RF. Future research should evaluate factors that may predict URF, such as insurance status, race, or sex.