Prevalence and associated factors of prediabetes in adult East African population: A systematic review and meta-analysis.

Introduction: Diabetes mellitus is a major public health problem with serious consequences, and more than three-fourths of diabetes live in low- and middle-income countries. According to a recent study, people with prediabetes have nearly six times the risk of developing diabetes than those with normal glucose levels. However, due to the inconsistency and absence of representative data, this study aimed to estimate the prevalence of prediabetes and its associated factors in the adult East African population. Methods: Databases were systematically searched for articles published between January 1, 2013, and December 30, 2022. All observational community-based studies that reported prediabetes prevalence and/or associated factors in adult East African populations were included in the meta-analyses. Three authors independently extracted all required data using the Excel data extraction format and analyzed using Stata™ Version 11. An I2 test was conducted to determine significant heterogeneity. Finally, a random effects model was used to determine the overall prevalence of prediabetes and its associated factors. The study was registered with Prospero number CRD42023389745. Results: The search strategy identified 267 articles. After screening for full-text review, twenty-one articles were included in the final analysis. The overall prevalence of prediabetes was 12.58 % (95 % CI:10.30, 14.86 %) in the adult East African population. Furthermore, the subgroup analysis revealed that prediabetes in the urban population 20 % (95 % CI: 1.60, 38.37) was twice as prevalent as in rural 10.0 % (95 % CI: 5.52, 14.48) populations. The prevalence of prediabetes by the ADA diagnostic criteria was 21.45 % (95 % CI: 15.54, 27.35) three times higher than the WHO 7.20 % (95 % CI: 5.70, 8.69). Moreover, prediabetes was significantly associated with old age (OR = 1.64, 95 %, CI: 1.07, 2.53), hypertension (OR = 2.43, 95 %, CI: 1.02-5.79), obesity and overweight (OR = 1.70, 95 %, CI: 1.09,2.65). Conclusion: This study showed a high prevalence of prediabetes, which was significantly associated with old age, hypertension, and high BMI. This study suggests that health policymakers should pay attention to the prevention and control strategies that is targeted at those with obesity, hypertension, and old age.