Incidence of Prediabetes and its Development Risk Factors among Bachelor Students at Kampala International University’s Western Campus in Uganda
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.
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 . 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.
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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. https://doi.org/10.59298/INOSRES/2023/2.9.1000