title: Prevalence of undiagnosed diabetes and pre-diabetes among hypertensive patients attending Kiambu district Hospital, Kenya: a cross-sectional study.
abstract: BACKGROUND
  Hypertension (HTN) and diabetes mellitus (DM) are two common non-communicable diseases (NCDs) that are closely linked: one cannot be properly managed without attention to the other. The aim of this study was to determine the prevalence of undiagnosed diabetic and pre-diabetic states that is abnormal glucose regulation (AGR) and factors associated with it among hypertensive patients in Kiambu Hospital, Kenya.
  
  
  METHODS
  We conducted a cross-sectional study from February 2014 to April 2014. Hypertensive patients aged ≥ 18 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 anthropometrics. Diabetes status was based on a 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.
  
  
  RESULTS
  We enrolled 334 patients into the study: the mean age was 59 years (Standard deviation = 14.3). Of these patients 254 (76%) were women. Thirty two percent (107/334; 32%) 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 (OR = 3.23; 95% CI 1.37 ≥ 7.62), basal metabolic index (BMI) ≥ 25 Kg/m(2) (OR = 3.13; 95% CI 1.53 - 6.41), low formal education (primary/none)(OR= 2; 95%CI 1.08 - 3.56) and family history of DM (OR = 2.19; 95%CI 1.16 - 4.15).
  
  
  CONCLUSIONS
  There was a high prevalence of undiagnosed AGR among hypertensive patients. This highlights the need to regularly screen for AGR among hypertensive patients as recommended by WHO.
authors.affiliation: Field Epidemiology Training Program, Ministry of Health, Kenya.
authors.forename: Nkatha
authors.initials: N
authors.lastname: Meme
authors.affiliation: Field Epidemiology Training Program, Ministry of Health, Kenya.
authors.forename: Samuel
authors.initials: S
authors.lastname: Amwayi
authors.affiliation: Jomo Kenyatta University of Science and Technology, Kenya.
authors.forename: Ziporrah
authors.initials: Z
authors.lastname: Nganga
authors.affiliation: Makerere University, College of Health Sciences School of Public Health, Uganda.
authors.forename: Esther
authors.initials: E
authors.lastname: Buregyeya
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism*; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006767:Hospitals, District; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D007630:Kenya / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D011236:Prediabetic State / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin
keywords: Diabetes; glycated haemoglobin; hypertensive patients; pre-diabetes