Prevalence and predictors of undiagnosed type 2 diabetes and pre-diabetes among adult Egyptians: a community-based survey

Abstract

Background The global prevalence of abnormal glycemic level comprising diabetes mellitus (DM) and pre-diabetes (PDM) is rapidly increasing with special concern for the entity silent or undiagnosed diabetes; those unaware of their condition. Identification of people at risk became much easier with the use of risk charts than the traditional methods. The current study aimed to conduct a community-based screening for T2DM to estimate the prevalence of undiagnosed DM and to assess the AUSDRISK Arabic version as a predictive tool in an Egyptian context. Methods A cross-sectional study was conducted among 719 Adults aging 18 years or more and not known to be diabetics through a population-based household survey. Each participant was interviewed to fill demographic and medical data as well as the AUSDRISK Arabic version risk score and undergo testing for fasting plasma glucose (FPG) and oral glucose tolerance test (OGTT). Results The prevalence of DM and PDM were 5% and 21.7% respectively. The multivariate analysis revealed that age, being physically inactive, history of previous abnormal glycemic level and waist circumference were the predictors for having abnormal glycemic level among the studied participants. At cut off points ≥ 13 and ≥ 9, the AUSDRISK respectively discriminated DM [sensitivity (86.11%), specificity (73.35%), and area under the curve (AUC): 0.887, 95% CI: 0.824–0.950] and abnormal glycemic level [sensitivity (80.73%), specificity (58.06%), and AUC: 0.767, 95% CI: 0.727–0.807], p < 0.001. Conclusions Overt DM just occupies the top of an iceberg, its unseen big population have undiagnosed DM, PDM or been at risk of T2DM because of sustained exposure to the influential risk factors. The AUSDRISK Arabic version was proved to be sensitive and specific tool to be used among Egyptians as a screening tool for the detection of DM or abnormal glycemic level. A prominent association has been demonstrated between AUSDRISK Arabic version score and the diabetic status.

The Validity of the American Diabetes Association’s Diabetes Risk Test in A Sample of Egyptian Population

“…The current study showed that among the studied group, the prevalence of prediabetes was 60/580 (10.3%) and diabetes was 220/580 (37.9%), and the rest had normal diabetes according to the HbA1c test based on ADA standards. However, Farag et al (10) in a crosssectional study from Egypt revealed that the occurrence of diabetes mellitus & pre-diabetes (pre-DM) was 5% & 21.7% respectively, among a group of 719 persons aged eighteen or older. The difference in prevalence may be due to differences in sample size, mean age, physical activity, and other environmental factors.…”

Analysis of influencing factors and interaction of body weight and disease outcome in patients with prediabetes

“…The progression of prediabetes is reversible, and effective intervention is important for the outcome of patients with prediabetes[ 21 ]. Weight loss can reduce or even reverse ectopic deposition and reduce progression of prediabetes to T2DM.…”

Prediction of Diabetes and Prediabetes among the Saudi Population Using a Non-Invasive Tool (AUSDRISK)

“…Respondents were asked about associated comorbidities, such as hypertension, thyroid issues, renal disease, liver disease, ischemic heart disease, chronic obstructive airway disease, cerebrovascular disease, and autoimmune disease. The second section included the validated Arabic version of the AUSDRISK tool [18], which assesses nine risk factors: age, sex, family history of diabetes, history of high blood glucose, hypertension, smoking, fruit and vegetable intake, physical activity, and waist circumference (Table 1). The sensitivity and specificity of the Arabic version of AUSDRISK at a cut-off point of 13 were 86.11% and 73.35%, respectively, with a 0.887 (95% confidence interval (CI): 0.824-0.95) area under the curve (AUC), p < 0.001.…”

“…The sensitivity and specificity of the Arabic version of AUSDRISK at a cut-off point of 13 were 86.11% and 73.35%, respectively, with a 0.887 (95% confidence interval (CI): 0.824-0.95) area under the curve (AUC), p < 0.001. Sensitivity and specificity for the detection of abnormal hyperglycemia levels were at a cut-off point of 9 with an AUC of 0.767 (CI: 0.727-0.807), p < 0.001 [18]. Anthropometric measurements: To measure waist circumference, assessors gently surrounded the waist of the respondent with measuring tape, positioning it at the level of the top of the hip bone.…”