PREVALENCE OF UNDIAGNOSED PREDIABETES IN YOUNG ADULTS IN PAKISTAN AND ITS ASSOCIATION WITH SEDENTARY BEHAVIOR: A SCREENING-BASED ORIGINAL STUDY

Abstract

BACKGROUND: Prediabetes is a growing metabolic concern in Pakistan, particularly among young adults, where lifestyle transitions and sedentary behavior contribute to early glucose dysregulation. Despite its reversibility, prediabetes often remains undiagnosed, leading to delayed intervention and a heightened risk of developing type 2 diabetes mellitus.

OBJECTIVE: To determine the prevalence of undiagnosed prediabetes among young adults in Pakistan and to assess its association with sedentary behavior across urban populations.

 METHODOLOGY: A cross-sectional, community-based study was conducted between January and August 2023 in three urban centers—Lahore, Karachi, and Peshawar. A total of 186 apparently healthy adults aged 18–35 years were enrolled using stratified random sampling. Data were collected through structured questionnaires, anthropometric measurements, and biochemical screening, including fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c) testing. Sedentary behavior and physical activity levels were evaluated using the International Physical Activity Questionnaire–Short Form (IPAQ-SF). Statistical analyses were performed using SPSS version 26, applying chi-square tests, t-tests, and binary logistic regression.

 RESULTS: The overall prevalence of undiagnosed prediabetes was 14.2%. Participants with sedentary time ≥7 hours per day had significantly higher odds of prediabetes (Adjusted Odds Ratio: 2.71; 95% CI: 1.28–5.74; p=0.009). Overweight and obesity (BMI ≥25 kg/m²) were also strongly associated (AOR: 2.36; 95% CI: 1.05–5.28; p=0.037). The mean HbA1c among prediabetic participants was 6.1 ± 0.2%, compared to 5.3 ± 0.4% in normoglycemic individuals.

CONCLUSION: A notable prevalence of undiagnosed prediabetes exists among young adults in Pakistan, with sedentary behavior identified as a significant modifiable risk factor. Targeted public health interventions emphasizing early screening and active lifestyles are essential to curb the rising diabetes burden.

 KEY TERMS: Adolescents, Body Mass Index, Diabetes Mellitus Type 2, Pakistan, Physical Inactivity, Prediabetic State, Sedentary Behavior