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..
