Screening of Prediabetic Patients by using HbA1c in District Narowal Pakistan

Main Article Content

Kashaf Fazal kaream
Saima Ashraf
Muhammad Awais
Asad shabbir
Faiqa Irshad
Hanna Ehsan


Background: The prevalence of prediabetes is on the rise globally, with lifestyle factors and obesity being key contributors to the development of the condition. Studies have consistently shown a link between higher Body Mass Index (BMI) and an increased risk of progressing from prediabetes to type 2 diabetes mellitus (T2DM).

Objective: This study aimed to determine the prevalence of prediabetes and its association with BMI and lifestyle factors in District Narowal, Pakistan.

Methods: A cross-sectional study was conducted with 200 participants from District Narowal. HbA1c levels were measured to classify participants into non-diabetic (4-7%), prediabetic (7-10%), and diabetic (10-13% and 13-16%) groups. BMI was calculated for each participant to assess weight status. Lifestyle factors were evaluated using a standardized questionnaire. Statistical analyses included the independent t-test for mean comparison and standard deviation assessment, with a significance level set at P < 0.05.

Results: Out of 200 participants, 81 (40.5%) were non-diabetic, 60 (30%) were prediabetic, and 16 (8%) were classified as diabetic. The mean HbA1c levels for non-diabetic, prediabetic, and diabetic individuals were 5.7%, 8.5%, and 14.5%, respectively. BMI assessment revealed that higher HbA1c levels were associated with higher BMI, and lifestyle analysis indicated a high consumption of ultra-processed foods among prediabetic individuals.

Conclusion: The study found a notable prevalence of prediabetes in District Narowal, with a significant association between higher BMI and poor dietary habits with elevated HbA1c levels. These findings suggest the necessity of public health strategies focusing on weight management, nutritional education, and lifestyle modification to prevent the progression of prediabetes to T2DM.

Article Details

How to Cite
kaream, K. F., Ashraf, S., Awais, M., shabbir, A., Irshad, F., & Ehsan, H. (2024). Screening of Prediabetic Patients by using HbA1c in District Narowal Pakistan. Journal of Health and Rehabilitation Research, 4(1), 216–221.
Author Biographies

Kashaf Fazal kaream, University of sialkot

MS Student.

Saima Ashraf, University of sialkot

Assistant Professor.

Muhammad Awais, University of sialkot

Ms Student.

Asad shabbir, University of sialkot

Ms Student.

Faiqa Irshad, University of sialkot

MS Student.

Hanna Ehsan, University of sialkot

Ms Student.


American Diabetes Association. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2021. Diabetes Care. 2021;43(Suppl 1):S15-S33.

Siu AL. Screening for abnormal blood glucose and type 2 diabetes mellitus: U.S. preventive services task force recommendation statement. Ann Intern Med. 2015;163(11):861-868.

Rosenzweig JL, Bakris GL, Berglund LF, et al. Primary Prevention of ASCVD and T2DM in Patients at Metabolic Risk: An Endocrine Society* Clinical Practice Guideline. J Clin Endocrinol Metab. 2019. doi: 10.1210/jc.2019-01338.

Echouffo-Tcheugui JB, Selvin E. Prediabetes and What It Means: The Epidemiological Evidence. Annu Rev Public Health. 2021;42:59-77.

Karve A, Hayward RA. Prevalence, diagnosis, and treatment of impaired fasting glucose and impaired glucose tolerance in nondiabetic U.S. adults. Diabetes Care. 2010;33(11):2355-2359.

Centers for Disease Control and Prevention. National Diabetes Statistics Report, 2020. Estimates of Diabetes and Its Burden in the United States. Available from: Published 2020.

Saeedi P, Petersohn I, Salpea P, et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Res Clin Pract. 2019;157:107843.

Gu K, Cowie CC, Harris MI. Mortality in adults with and without diabetes in a national cohort of the U.S. Population, 1971-1993. Diabetes Care. 1998;21(7):1138-1145.

Gregg EW, Cheng YJ, Srinivasan M, et al. Trends in cause-specific mortality among adults with and without diagnosed diabetes in the USA: an epidemiological analysis of linked national survey and vital statistics data. Lancet. 2018;391(10138):2430-2440.

Vaidya V, Gangan N, Sheehan J. Impact of cardiovascular complications among patients with Type 2 diabetes mellitus: A systematic review. Expert Rev Pharmacoecon Outcomes Res. 2015;15(3):487-497.

Bailey RA, Wang Y, Zhu V, Rupnow MF. Chronic kidney disease in US adults with type 2 diabetes: An updated national estimate of prevalence based on Kidney Disease: Improving Global Outcomes (KDIGO) staging. BMC Res Notes. 2014;7:415.

US Renal Data System. 2018 UKRDS Annual Data Report | Volume 2: ESRD in the United States - Chapter 1: Incidence, Prevalence, Patient Characteristics, and Treatment Modalities. Am J Kidney Dis. 2019;73(3):S291-S332.

Yau JWY, Rogers SL, Kawasaki R, et al. Global prevalence and major risk factors of diabetic retinopathy. Diabetes Care. 2012;35(3):556-564.

Gregg EW, Gu Q, Williams D, et al. Prevalence of lower extremity diseases associated with normal glucose levels, impaired fasting glucose, and diabetes among U.S. adults aged 40 or older. Diabetes Res Clin Pract. 2007;77(3):485-488.

Cai X, Zhang Y, Li M, et al. Association between prediabetes and risk of all cause mortality and cardiovascular disease: updated meta-analysis. BMJ. 2020;370:m2297.

Yang W, Dall TM, Beronjia K, et al. Economic costs of diabetes in the U.S. in 2017. Diabetes Care. 2018;41(5):917-928.

Dall TM, Yang W, Gillespie K, et al. The economic burden of elevated blood glucose levels in 2017: Diagnosed and undiagnosed diabetes, gestational diabetes mellitus, and prediabetes. Diabetes Care. 2019;42(9):1661-1668.

Zhuo X, Zhang P, Barker L, Albright A, Thompson TJ, Gregg E. The lifetime cost of diabetes and its implications for diabetes prevention. Diabetes Care. 2014;37(9):2557-2564.

Bommer C, Heesemann E, Sagalova V, et al. The global economic burden of diabetes in adults aged 20-79 years: a cost-of-illness study. Lancet Diabetes Endocrinol. 2017;5(6):423-430.

Bertram MY, Vos T. Quantifying the duration of pre-diabetes. Aust N Z J Public Health. 2010;34(3):311-314.

Harris MI, Klein R, Welborn TA, Knuiman MW. Onset of NIDDM occurs at least 4-7 yr before clinical diagnosis. Diabetes Care. 1992;15(7):815-819.


Saibhavani G, Kamalaja T, Aparna K, Sreedevi PA. Nutritional status assessment in Prediabetic subjects of Karimnagar District. J Pharmacogn Phytochem. 2020;9:683-6.

Bennasar-Veny M, Fresneda S, López-González A, Busquets-Cortés C, Aguiló A, Yáñez AM. Lifestyle and Progression to Type 2 Diabetes in a Cohort of Workers with Prediabetes. Nutrients. 2020;12.

Andes LJ, Cheng YJ, Rolka DB, Gregg EW, Imperatore G. Prevalence of Prediabetes Among Adolescents and Young Adults in the United States, 2005-2016. JAMA Pediatr. 2019:e194498.

Cassidy S, Okwose NC, Scragg J, Houghton D, Ashley K, Trenell MI, et al. Assessing the feasibility and acceptability of Changing Health for the management of prediabetes: protocol for a pilot study of a digital behavioural intervention. Pilot Feasibility Stud. 2019;5.

Bell KL, Shaw JE, Maple-Brown LJ, Ferris W, Gray S, Murfet GO, et al. A Position Statement on Screening and Management of Prediabetes in Adults in Primary Care in Australia. Diabetes Res Clin Pract. 2020:108188.