Prevalence of Prediabetes Based on Fasting Plasma Glucose and Glycosylated Hemoglobin in an At-Risk Mexican Population

Background: In Latin America, there are no published studies of the prevalence of prediabetes using the glycosylated hemoglobin (HbA1c) criterion in addition to fasting plasma glucose (FPG). Therefore, here we determined the prevalence of prediabetes using FPG and/or HbA1c in a Mexican population at risk for type 2 diabetes mellitus (T2DM) and cardiovascular disease. Methods: This cross-sectional study included 384 primary care users without a known diagnosis of prediabetes or T2DM and with at least one risk factor for T2DM and cardiovascular disease. An FPG 100-125 mg/dL and/or an HbA1c 5.7-6.4% were considered positive for prediabetes. Point prevalence and 95% confidence intervals (CI) were estimated overall and stratified by age, sex, and nutritional status. Mann-Whitney and chi-squared tests were used. P values < 0.05 were considered significant. Results: The prevalence of prediabetes was 74.7% (95% CI, 70.2%-78.8%) using FPG or HbA1c criteria for positivity, 60.4% using FPG alone (95% CI, 55.5%-65.3%), 49.8% using HbA1c alone (95% CI, 44.4-55.3%); and 32.9% using FPG and HbA1c (95% CI, 27.8%-38.0%). Prevalence was higher in patients >= 50 years old (p < 0.001) and in the overweight-obesity group (p = 0.04) using all criteria except for HbA1c alone. Conclusions: The prevalence of prediabetes in a Mexican population at risk for cardiovascular disease and/or T2DM was high. Prediabetes is definitely a public health problem. Future studies are needed to examine the effectiveness and efficiency of pragmatic strategies to reverse the status of prediabetes and, therefore, reduce the incidence of T2DM.