Incidence of Prediabetes and its Development Risk Factors among Bachelor Students at Kampala International University’s Western Campus in Uganda

Kavubu Michael

Faculty of Clinical Medicine and Dentistry Kampala International University Western Campus Uganda.


Prediabetes marks blood glucose levels above normal yet below the diabetes threshold. Its prevalence is escalating worldwide, with projections estimating over 470 million affected individuals by 2030. Notably, there is a dearth of studies offering insight into prediabetes prevalence among university students in Uganda. This research was designed to assess prediabetes prevalence and associated risk factors among apparently healthy Kampala International University Western Campus (KIU-WC) bachelor students. Employing a prospective cross-sectional study design, the investigation involved structured self-administered questionnaires, anthropometric measurements, and blood biochemistry, targeting registered university students of all ages at KIU-WC. Sample size calculations were based on a formula, with BMI for age and sex referenced against Agarwal charts. Fasting blood glucose (FBG) levels were classified per ADA criteria. A total of 121 students (61.2% male, 38.8% female) aged 15-35 participated. Results indicated a significant prediabetes prevalence of 19.8%. Notably, prediabetes rates varied among distinct age groups, particularly higher among middle-aged or young adults (18-25 years). The study underscores lifestyle modifications as pivotal in preventing or delaying prediabetes progression to Type 2 Diabetes Mellitus (T2DM). Moreover, it highlights the necessity for further comprehensive prospective studies with larger sample sizes and adequate funding to precisely quantify prediabetes burden, its risk factors, complications, preventive measures, and validate the epidemiological findings observed in this investigation.

Keywords: Diabetes, Prediabetes, Lifestyle modification, Hypertension, Obesity.


Diabetes also known as diabetes mellitus (DM) is a syndrome of impaired carbohydrate, fat and protein metabolism caused by either lack of insulin secretion or decreased sensitivity of the tissues to insulin [1-3]. There are generally two types of diabetes. Type 1 diabetes (Insulin Dependent Diabetes Mellitus) which is caused by a lack of insulin secretion. Type 2 diabetes (Non-Insulin Dependent Diabetes Mellitus) which is caused by decreased sensitivity of target tissues to the metabolic effect of insulin. The reduced sensitivity of insulin is often referred to as insulin resistance [4-6]. According to the World Health Organization (WHO), DM is a leading cause of death and disability worldwide [7, 8]. Its global prevalence was about 8% in 2011 and is predicted to rise to 10% by 2030. Nearly 80% of people with DM live in low and middle-income countries like Uganda. In Africa, 12.1 million people were estimated to be living with diabetes in 2010 and this is projected to increase to 23.9 million by 2030 with type 2 diabetes accounting for most cases. In Uganda according to the Uganda Diabetes Association (UDA), the current prevalence of DM is 1.4% i.e. about 500,000 people have DM. Impaired Fasting Glucose (IFG) which is a risk factor for type 2 diabetes affects 2.1% of Ugandans. Higher prevalence of diabetes and prediabetes of 7.4% and 8.6% respectively have been reported in rural Eastern Uganda. The majority of people with high blood sugar are not aware of their blood sugar status. The mean age of people having diabetes in Uganda is 35 years. Also, the quality of diabetes care in Uganda is still inadequate or totally poor [9]. Diabetes affects the quality of life, has a major impact on people’s families and has a significant public health impact. People being diagnosed with diabetes are at high risk of having diabetic neuropathy, blindness due to diabetic retinopathy, hypertension, and kidney diseases due to diabetic nephropathy, stroke, heart diseases, dental diseases and amputations [10-13]. Before people develop type 2 diabetes, they undergo a risk state called prediabetes intermediate hyperglycemia or preclinical state. This prediabetes phase provides an opportunity to identify the patients and initiate timely prevention. Prediabetes, typically defined as blood glucose levels above normal but below diabetes threshold is a risk state that defines a high chance of developing type 2 diabetes. ADA classifies prediabetes as the initial stage of acquiring diabetes. It is a practical and convenient term referring to Impaired Fasting Glucose(IFG), Impaired Glucose Tolerance(IGT) or a glycated haemoglobin (A1C) of 6.0% to 6.4%, each of which places individuals at high risk of developing diabetes and its complications [14, 15]. The prevalence of prediabetes is increasing worldwide and its projected that above 470million people will have prediabetes in 2030. WHO and ADA refer to prediabetes as “high risk of developing diabetes”. High risk of developing diabetes is associated with the simultaneous presence of insulin resistance and β-cell dysfunction. Risk factors associated with development of prediabetes and diabetes include family history of diabetes, sedentary life style, obesity, age, sex, lack of physical activity, stress, hypertension, fast food consumption [16, 17]. Awareness and knowledge regarding prediabetes, its management, complications and risk factors are crucial for steps for its control and better quality of life. Lifestyle modification is the cornerstone of prediabetes and diabetes prevention with evidence of a 40% to 70% relative risk reduction. To the best of my knowledge, there are hardly any studies providing the prevalence of prediabetes among university students in Uganda. This research is planned to study the prevalence of prediabetes and determine associated risk factors in apparently healthy university students.


The prevalence of prediabetes among KIU-WC bachelor students was found to be 19.8% thus increasing as projected. Prediabetes is more prevalent among middle-aged or young adults (18-35) years. Lifestyle modification is the cornerstone in the prevention of prediabetes and/or delays its progression to T2DM in a given population. Relevant research studies on prediabetes among university students are scanty thus providing a need to conduct more across all given population studies in Uganda. Healthcare providers and policymakers need to collaborate and prioritize diabetes care to ensure that health care is easily accessible and affordable by all people in Uganda despite being a developing country with a low socio-economic status.


  1. Alum EU, Umoru GU, Uti DE, Aja PM, Ugwu OP, Orji OU, Nwali BU, Ezeani N, Edwin N, Orinya FO. Hepato-protective effect of Ethanol Leaf Extract of Datura stramonium in Alloxan-induced Diabetic Albino Rats. Journal of Chemical Society of Nigeria. 2022; 47 (3): 1165 – 1176.
  2. Ugwu OPC, Alum EU, Okon MB, Aja PM, Obeagu EI, Onyeneke EC. Ethanol root extract and fractions of Sphenocentrum jollyanumabrogate hyperglycemia and low body weight in Streptozotocin-induced diabetic Wistar albino Rats, RPS Pharmacy and Pharmacology Reports. 2023; 2,1-6.
  3. Agbafor KN, Onuoha SC, Ominyi MC, Orinya OF, Ezeani N, Alum EU. Antidiabetic, Hypolipidemic and Antiathrogenic Properties of Leaf Extracts of Ageratum conyzoides in Streptozotocin-Induced diabetic rats. International Journal of Current Microbiology and Applied Sciences. 2015; 4 (11): 816-824.,%20K.%20N,%20et%20al.pdf
  4. Uti DE, Igile GO, Omang WA, Umoru GU, Udeozor PA, Obeten UN, Ogbonna ON, Ibiam UA, Alum EU, Ohunene OR, Chukwufumnanya MJ, Oplekwu RI, Obio WA. Anti-Diabetic Potentials of Vernonioside E Saponin; A Biochemical Study. Natural Volatiles and Essential Oils. 2021; 8(4): 14234-14254.
  5. Offor CE, Ugwu OPC, Alum EU. The Anti-Diabetic Effect of Ethanol Leaf-Extract of Allium sativum on Albino Rats. International Journal of Pharmacy and Medical Sciences. 2014; 4 (1): 01-03. DOI: 10.5829/idosi.ijpms.2014.4.1.1103.
  6. Obeagu EI, Scott GY, Amekpor F, Ugwu OPC, Alum EU. COVID-19 infection and Diabetes: A Current Issue. International Journal of Innovative and Applied Research. 2023; 11(01): 25-30. DOI: 10.58538/IJIAR/2007. DOI URL:
  7. World Health Organization (WHO). Global report on diabetes Availablefrom: 9789241565257.
  8. Obeagu EI, Ugwu OPC, Alum EU. Poor glycaemic control among diabetic patients; A review on associated factors. Newport International Journal of Research in Medical Sciences (NIJRMS). 2023; 3(1):30-33.
  9. Uganda Diabetes Association (UDA REGISTRY 2017).
  10. Egwu CO, Offor CE, Alum EU. Anti-diabetic effects of Buchholzia coriacea ethanol seed Extract and Vildagliptin on Alloxan-induced diabetic albino Rats. International Journal of Biology, Pharmacy and Allied Sciences (IJBPAS). 2017; 6 (6): 1304-1314.
  11. Ugwu OPC, Alum EU, Obeagu EI, Okon MB, Aja PM,Samson AO, Amusa MO, Adepoju AO. Effect of Ethanol leaf extract of Chromolaena odorata on lipid profile of streptozotocin induced diabetic wistar albino rats. IAA Journal of Biological Sciences. 2023;10(1):109-117.
  12. Aja PM, Ani OG, Offor CE, Orji UO, Alum EU. Evaluation of Anti-Diabetic Effect and Liver Enzymes Activity of Ethanol Extract of Pterocarpus santalinoides in Alloxan Induced Diabetic Albino Rats. Global Journal of Biotechnology & Biochemistry. 2015; 10 (2): 77-83. DOI: 10.5829/idosi.gjbb.2015.10.02.93128.
  13. Cho NH, Shaw JE, Karuranga S, Huang Y, da Rocha Fernandes JD, Ohlrogge AW, Malanda B. IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045. Diabetes Res Clin Pract. 2018 Apr;138:271-281. doi: 10.1016/j.diabres.2018.02.023.
  14. Aja PM, Igwenyi IO, Ugwu OPC, Orji OU, Alum EU. Evaluation of Anti-diabetic Effect and Liver Function Indices of Ethanol Extracts of Moringa oleifera and Cajanus cajan Leaves in Alloxan Induced Diabetic Albino Rats. Global Veterinaria. 2015; 14(3): 439-447.DOI:10.5829/idosi.gv.2015.14.03.93129.
  15. Ugwu OPC, Obeagu EI, Alum EU, Okon BM, Aja PM, Amusa MO, Adepoju AO, Samson AO. Effect of Ethanol Leaf extract of Chromolaena odorataon hepatic markers in streptozotocin-induced diabetic wistar albino rats. IAA Journal of Applied Sciences, 2023; 9(1):46-56.
  16. American Diabetes Association (ADA). Diagnosis and classification of diabetes mellitus. Diabetes Care. 2009; 32: S62-67.
  17. World Health Organization (WHO). Global report on diabetes Available from: 9789241565257.
  18. Wiegand, H., Kish, L., Survey Sampling. John Wiley & Sons, Inc., New York, London 1965, IX + 643 S., 31 Abb., 56 Tab., Preis 83 s. Biometrische Zeitschrift. 10, 88–89 (1968).
  19. Chiwanga FS, Njelekela MA, Diamond MB, Bajunirwe F, Guwatudde D, Nankya-Mutyoba J, Kalyesubula R, Adebamowo C, et al. Urban and rural prevalence of diabetes and pre-diabetes and risk factors associated with diabetes in Tanzania and Uganda. Glob Health Action. 2016 May 23;9:31440. doi: 10.3402/gha.v9.31440.
  20. Aldossari KK, Shubair MM, Al-Zahrani J, Alduraywish AA, AlAhmary K, Bahkali S, et al. Association between Chronic Pain and Diabetes/Prediabetes: A Population-Based Cross-Sectional Survey in Saudi Arabia. Pain Res Manag. 2020 Jun 24;2020:8239474. doi: 10.1155/2020/8239474.
  21. International Diabetes Federation (IDF), 2017.
  22. Aja PM, Fasogbon IV, Mbina SA, Alum EU, Eze ED, and Agu PC. Bisphenol-A (BPA) Exposure as a Risk Factor for Non-Communicable Diseases. Intechopen, 2023. DOI:
  23. Uti DE, Ibiam UA, Omang WA, Udeozor PA, Umoru GU, Nwadum SK, et al. Buchholzia coriacea Leaves Attenuated Dyslipidemia and Oxidative Stress in Hyperlipidemic Rats and Its Potential Targets In Silico.  Pharmaceutical Fronts. 2023; 05(03):e141-e152.DOI: 10.1055/s-0043-1772607.
  24. Glechner A, Keuchel L, Affengruber L, Titscher V, Sommer I, Matyas N, et al. Effects of lifestyle changes on adults with prediabetes: A systematic review and meta-analysis. Prim Care Diabetes. 2018 Oct;12(5):393-408. doi: 10.1016/j.pcd.2018.07.003.
  25. Offor CE, Anyanwu E, Alum EU, Egwu C. Effect of Ethanol Leaf-Extract of Ocimum basilicum on Plasma Cholesterol Level of Albino Rats. International Journal of Pharmacy and Medical Sciences. 2013; 3 (2): 11-13.DOI:10.5829/idosi.ijpms.2013.3.2.1101.
  26. Ezeani NN, Edwin N, Alum EU, Orji OU, Ugwu OPC. Effect of Ethanol Leaf Extract of Ocimum gratissmum (Scent Leaf) on Lipid Profile of Alloxan-Induced Diabetic Rats. International Digital Organization for Scientific Research Journal of Experimental Sciences, 2017; 2 (1): 164-179.
  27. Alum EU, Obeagu EI, Ugwu OPC, Aja PM, Okon MB. HIV Infection and Cardiovascular diseases: The obnoxious Duos. Newport International Journal of Research in Medical Sciences (NIJRMS), 2023; 3(2): 95-99.
  28. Aja PM, Chiadikaobi CD, Agu PC, Ale BA, Ani OG, Ekpono EU, et al. Cucumeropsis manniiseed oil ameliorates Bisphenol-A-induced adipokines dysfunctions and dyslipidemia. Food Sci Nutr. 2023 Feb 18;11(6):2642-2653.doi: 10.1002/fsn3.3271.

CITE AS: Kavubu Michael (2023). Incidence of Prediabetes and its Development Risk Factors among Bachelor Students at Kampala International University’s Western Campus in Uganda. INOSR Experimental Sciences 12(2):119-131.