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 30%) compared to earlier studies (e.g., Pablo Aschner 1992 and Bosi 2009 reporting