Mohammad Anwar, Ziyab Ali H, Mohammad Talal
Department of Biochemistry and Molecular Biology, Dasman Diabetes Institute, Kuwait City, Kuwait.
Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Safat, Kuwait.
Diabetes Metab Syndr Obes. 2021 May 17;14:2167-2176. doi: 10.2147/DMSO.S296848. eCollection 2021.
This study aimed to estimate the prevalence of prediabetes and undiagnosed type 2 diabetes mellitus (T2DM) according to fasting plasma glucose (FPG), 2-h plasma glucose (PG) during oral glucose tolerance test (OGTT), and glycated hemoglobin (HbA1c) among a sample of Kuwaiti adults. In addition, associations of prediabetes and undiagnosed T2DM with sex, age, and body mass index (BMI) were assessed.
A cross-sectional study enrolled 1238 subjects aged 18-65 years who reported no prior history of DM. After overnight fasting, FPG and HbA1c were measured in the total study sample, and 2-h PG during a 75-g OGTT was measured in a subsample of 155 subjects. Prediabetes and undiagnosed T2DM were defined according to the American Diabetes Association criteria. Associations were assessed using Poisson regression with robust variance estimation, and adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) were estimated.
We enrolled a total of 618 males and 620 females, with an average age of 43.0 years. The prevalence of prediabetes was estimated to be 47.9% (588/1228) by FPG, 36.8% (57/155) by 2-h PG OGTT, and 31.0% (355/1144) by HbA1c. The prevalence of undiagnosed T2DM was 6.9% (85/1228) by FPG, 11.0% (17/155) by 2-h PG OGTT, and 4.9% (56/1144) by HbA1c. Sex-related differences in the prevalence of prediabetes and undiagnosed T2DM were observed. Prediabetes and undiagnosed T2DM prevalence estimates showed increasing trends as age and BMI increased. For instance, obese subjects compared to under/normal weight subjects had an increased HbA1c-defined prediabetes prevalence (aPR = 1.62, 95% CI: 1.21-2.16).
Prediabetes and undiagnosed T2DM affect a considerable proportion of Kuwaiti adults, and variations across sex, age, and BMI exist. Hence, early identification and management of affected individuals may help reduce the public health burden.
本研究旨在根据空腹血糖（FPG）、口服葡萄糖耐量试验（OGTT）期间的2小时血浆葡萄糖（PG）以及糖化血红蛋白（HbA1c），估算科威特成年人群样本中糖尿病前期和未诊断出的2型糖尿病（T2DM）的患病率。此外，还评估了糖尿病前期和未诊断出的T2DM与性别、年龄和体重指数（BMI）之间的关联。
一项横断面研究纳入了1238名年龄在18至65岁之间且无糖尿病既往史的受试者。在整个研究样本中进行过夜禁食后测量FPG和HbA1c，并在155名受试者的子样本中测量75克OGTT期间的2小时PG。根据美国糖尿病协会标准定义糖尿病前期和未诊断出的T2DM。使用具有稳健方差估计的泊松回归评估关联，并估计调整后的患病率比（aPRs）和95%置信区间（CIs）。
我们共纳入了618名男性和620名女性，平均年龄为43.0岁。通过FPG估算的糖尿病前期患病率为47.9%（588/1228），通过2小时PG OGTT估算为36.8%（57/155），通过HbA1c估算为31.0%（355/1144）。通过FPG估算的未诊断出的T2DM患病率为6.9%（85/1228），通过2小时PG OGTT估算为11.0%（17/155），通过HbA1c估算为4.9%（56/1144）。观察到糖尿病前期和未诊断出的T2DM患病率存在性别差异。糖尿病前期和未诊断出的T2DM患病率估计值显示随着年龄和BMI的增加呈上升趋势。例如，与体重过轻/正常的受试者相比，肥胖受试者的HbA1c定义的糖尿病前期患病率增加（aPR = 1.62，95% CI：1.21 - 2.16）。
糖尿病前期和未诊断出的T2DM影响了相当比例的科威特成年人，并且在性别、年龄和BMI方面存在差异。因此，对受影响个体的早期识别和管理可能有助于减轻公共卫生负担。
