PREVALENCE AND ASSOCIATED FACTORS FOR UNDIAGNOSED DIABETES AMONG HYPERTENSIVE PATIENTS ATTENDING KIAMBU DISTRICT HOSPITAL

Abstract

Non-Communicable Diseases (NCD) are a leading cause of mortality globally and in 2012 were responsible for 68% of deaths worldwide. Hypertension (HTN) and Diabetes Mellitus (DM) are two common non-communicable diseases (NCDs) that are closely linked. The aim of this study was to determine the prevalence of undiagnosed diabetic states that is abnormal glucose regulation (AGR) and factors associated with it among hypertensive patients in Kiambu Hospital, Kenya. A cross-sectional study was conducted from February to May 2014. Hypertensive patients above 18 years attending the out-patient medical clinic were included in the study. Pregnant and known diabetic patients were excluded. Data was collected on socio-demographics, behavior, and anthropometric measurements. Diabetes status was based on glycated haemoglobin (HbA1c) classification of ≥ 6.5% for diabetes, 6.0-6.4% for pre-diabetes and ≤ 6.0% for normal. AGR was the dependable variable and included two diabetic categories; diabetes and pre-diabetes. 334 participants were enrolled into the study. The mean age was 59 years (Standard deviation (SD) 14.3). Of these participants 254 (76%) were women. Thirty two percent (107/334) were found to have AGR, with 14% (46) having un-diagnosed DM and 18% (61) with pre-diabetes. Factors associated with AGR were age ≥ 45 years (Odds Ratio (OR) = 3.23; 95% Confidence Interval (95% CI) 1.37 – 7.62), body mass index (BMI) ≥ 25 Kg/M2 (OR= 3.13; 95% CI 1.53 - 6.41), low formal education (primary/non-formal) (OR= 2; 95% CI 1.08 - 3.56) and family history of DM (OR=2.19; 95% CI 1.16 - 4.15). In conclusion this study found a high prevalence of undiagnosed AGR among hypertensive patients in the clinical setting highlighting missed opportunities for diagnosis. Risk factors for AGR were; age greater than 45 years, BMI >25 kg/m2 and a family history of DM. Targeted screening for DM in patients with such a risk profile would lead to early diagnosis and management