Prevalence and incidence of prediabetes in Latin America. A systematic review and meta-analysis

Introduction: Prediabetes represents a significant public health challenge in Latin America. Its prevalence varies considerably depending on the diagnostic criteria used, which hinders a precise understanding of its magnitude in the region. Objective: To estimate the prevalence and incidence of prediabetes in Latin America through a systematic review (SR). Methods: A SR and meta-analysis was conducted searching through October 25, 2024 in SCOPUS, EMBASE, Web of Science, and PubMed. Studies were included if they: (1) used probabilistic sampling methods, (2) included adult participants (≥ 18 years), (3) assessed prediabetes using WHO criteria, fasting glucose, postprandial glucose, or HbA1c, and (4) were published in English, Spanish, or Portuguese. Studies using non-probabilistic sampling, focusing on specific medical conditions, or lacking sufficient data to calculate prevalence or incidence were excluded. Random-effect models were used to estimate pooled prevalence, with heterogeneity assessed using I² statistics and publication bias through funnel plots. Results: Twenty-five studies from 9 countries published between 1992 and 2023 were analyzed. The pooled prevalence of prediabetes was 24% (95% CI: 18–30%). According to specific criteria, the prevalences were: WHO 11% (95% CI: 5–18%), FG 18% (95% CI: 10–27%), PPG 20% (95% CI: 3–46%), and HbA1c 32% (95% CI: 21–52%). High heterogeneity was observed among studies (I² = 99–100%, p < 0.001). Only one study analyzed the incidence, which was 12.8%. Conclusions: Prediabetes prevalence in Latin America is high, with significant variations by diagnostic criteria. The limited number of incidence studies and high heterogeneity highlight the need for standardized approaches in future research. Implementation of preventive strategies and strengthening of epidemiological surveillance systems are crucial for addressing this public health challenge. © The Author(s) 2024.