Contributions of 2‐h post‐load glucose, fasting blood glucose and glycosylated haemoglobin elevations to the prevalence of diabetes and pre‐diabetes in adults: A systematic analysis of global data
Authors' conclusion
The largest contributors to the prevalence of diabetes and pre-diabetes are 2hPG and HbA1c, respectively. Isolated FPG and HbA1c elevations account for over a quarter of all diabetes and more than half of all pre-diabetes.
Study context
- Population
- Adults without previously diagnosed diabetes, cross-sectional studies or baseline surveys of cohort studies; mean age 24 to 68 years; mostly American Diabetes Association (ADA) diagnostic cutoffs32 studies
- Outcome
- Contributions of 2hPG, FPG and HbA1c elevations (proportion among all cases) to the prevalence of diabetes and pre-diabetes
Methodological detailsrandom-effects model, five electronic databases searched to February 2024, 10-item quality appraisal tool, sensitivity analyses by comorbidities and study quality, 24 studies (75%) at low risk for ≥7 of 10 quality items, 25 studies on newly detected diabetes (n = 289 094); 15 on pre-diabetes (n = 221 988)
- Random-effects model
- Five electronic databases searched to February 2024
- 10-item quality appraisal tool
- Sensitivity analyses by comorbidities and study quality
- 24 studies (75%) at low risk for ≥7 of 10 quality items
- 25 studies on newly detected diabetes (n = 289 094); 15 on pre-diabetes (n = 221 988)
Pooled result
As reported in the abstract
Marker elevations among newly detected diabetes (n = 24 214)
- Elevated 2hPG
- 69%
- Elevated FPG
- 44%
- Elevated HbA1c
- 61%
- Isolated FPG elevation
- 7%
- Isolated HbA1c elevation
- 20%
- Pre-diabetes (n = 133 621): elevated 2hPG
- 33%
- Pre-diabetes: elevated FPG
- 51%
- Pre-diabetes: elevated HbA1c
- 68%
- Pre-diabetes: isolated FPG elevation
- 17%
- Pre-diabetes: isolated HbA1c elevation
- 34%
Further pooled results
Weighted prevalence in the general population (ADA criteria)
- Diabetes
- 15%
- Pre-diabetes
- 69%
Sensitivity analyses by comorbidities and study quality
- Results consistent with the main findings
Original publication
Contributions of 2‐h post‐load glucose, fasting blood glucose and glycosylated haemoglobin elevations to the prevalence of diabetes and pre‐diabetes in adults: A systematic analysis of global data. Diabetes Obes Metab. Published 15 September 2025. doi:10.
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