Abstract

Background and objectives: Prediabetes is an intermediate state of hyperglycemia with a range from 100mg/dl to 126mg/dl as per the definition by the American Diabetes Association. Prehypertension is defined as elevated blood pressure ranging from systolic blood pressure (120mmHg to 139mmHg) and/or diastolic blood pressure (80 to 89mmHg). This study is aimed at determining the prevalence of prediabetes and prehypertension among young people and also looks at the risk factors of developing prediabetes and prehypertension.

Subjects and Methods: This prospective study included 119 healthy young people of age 18 to 35 years who met the inclusion criteria. A rapid diagnostic test was done to measure the fasting blood sugar, with the use of a sphygmomanometer blood pressure was measured, the weight, height, and waist circumference were also measured.

Results: Among 119 participants that met the inclusion criteria, the prevalence of prehypertension was 27(22.6%) while the prevalence of prediabetes was 15(12.6%). Risk factors like age group, family history, body mass index, and waist circumference had a statistical significance relationship with prehypertension whereas alcohol consumption and the number of hours used for exercise had no statistical significance relationship.

Risk factors like alcohol consumption, body mass index, and waist circumference showed a statistical significance relationship with prediabetes whereas age, family history, and hours of exercise a week were not statistically significant. There was no significant correlation between FBS and BP

Discussion and Conclusion: There was a high prevalence of prediabetes 12.6% (15/119) and prehypertension 22.6% (27/119). This high prevalence was attributed to the presence of risk factors like Body Mass Index, dietary habits and waist circumference. In this light, there is a recommendation for the creation of more awareness and management/prevention of prediabetes and prehypertension at an early stage from reaching diabetes and hypertension respectively.

CHAPTER ONE

INTRODUCTION

1.1 Backgrounds

The World Health Organization (WHO) has defined prediabetes as a state of intermediate hyperglycemia using two specific parameters, impaired fasting glucose (IFG) defined as fasting plasma glucose (FPG) of 6.1-6.9 mmol/L (110 to 125 mg/dL) and impaired glucose tolerance (IGT) defined as 2 h plasma glucose of 7.8-11.0 mmol/L (140-200 mg/dL) after ingestion of 75 g of oral glucose load [1].

The American Diabetes Association (ADA) also gave a definition based on the same parameters with the same cut off value for impaired glucose tolerance but has a lower cut-off value for IFG (100-125 mg/dL) with the addition of hemoglobin A1c (HbA1c) with cut off values of 5.7% to 6.4% for the diagnosis of predispprediabetes [2].

Prediabetes remains a state of high risk for developing diabetes with a yearly conversion rate of 5%-10%. Observational evidence suggests an association between prediabetes and complications of diabetes such as early nephropathy, small fiber neuropathy, early retinopathy, and risk of macrovascular disease. Several studies have shown efficacy of lifestyle interventions with regards to diabetes prevention with a relative risk reduction of 40%-70% in adults with prediabetes [1].

The National High Blood Pressure Education Program Coordinating Committee of the National Heart, Lung, and Blood Institute in the United States released the Seventh Report of the Joint National Committee (JNC) on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (the JNC 7 report), on May 14th, 2003.

According to this report, a systolic BP of 120 to 139 mm Hg and/or a diastolic BP of 80 to 89 mm Hg was considered as pre-hypertension. The definition of pre-hypertension remains the same in the latest JNC-8 report published in 2014 [3].

A large proportion of prehypertensives have at least one cardiovascular risk factor and there is a moderate to high risk of prehypertensives progressing to hypertension [4]. Obesity, stress, unhealthy diet, family history of CVD, male gender, and sleep deprivation are some of the risk factors of hypertension [5]. General obesity will be considered as BMI > 23.33 kg/m2. For abdominal obesity two cut-offs will be considered: Level one -if the waist circumference (WC) is 78cm or more for males; 72cm or more for females. Level two-if the WC is 90 cm or more for males and 80 cm or more for females [6].

1.2 Rational

Non-communicable diseases are increasingly important causes of morbidity and mortality in Africa due to the rapid demographic transition and changes in lifestyle. In African countries, the prevalence of diabetes in 2017 was 3.3%, the overall prevalence of hypertension was 55.2%in 2017, and overweight and obesity were estimated to cause 3.4 million deaths in 2017 [7,8].

Concerns about the health risks associated with adults developing diabetes and hypertension are a health concern in most African countries. With this in mind, we saw a need for research on the prevalence of prediabetes and prehypertension among young people so as to recommend measures that can be taken by those confirmed to be prediabetes or prehypertensive not to develop diabetes or hypertension in the future.

1.3 Hypothesis

The prevalence of prediabetes among young people is less than 10% and hypertension is less than 50%

1.4 Research Question

1. What are the risk factors that predispose young people to prehypertension and prediabetes?
2. What is the risk of young people developing diabetes and hypertension in the future?

1.5 Objectives

1.5.1 Main objective:

To determine the risk of developing diabetes and hypertension by young people of age 18 to 35 years attending the Yaoundé University Teaching Hospital.

1.5.2 Specific objectives:

1. To determine the prevalence of prediabetes and prehypertension among young people attending the Yaoundé University Teaching Hospital.
2. To determine the correlation between prediabetes and prehypertension among young people attending the Yaounde University Teaching Hospital.
3. To determine the risk factors of prediabetes and prehypertension among young people attending the Yaounde University Teaching Hospital.