Abstract
BACKGROUND: There is a lack of national data on the pooled prevalence of prediabetes among adult Saudis. This study aimed to provide a comprehensive estimate of the prevalence of prediabetes among Saudi adults. METHODS: We searched databases for cross-sectional studies conducted between January 2000 and September 2024. We included studies written in English and conducted in Saudi Arabia. The studies had to report the prevalence of prediabetes among adults (≥18 years) using American Diabetes Association (ADA) or the World Health Organization (WHO) criteria. We excluded studies that involved non-adult or non-Saudi populations. We also excluded studies published before 2000 or those without clear diagnostic criteria or prevalence data. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement guidelines. Pooled prevalence was calculated using a random-effects model. Subgroup and sensitivity analyses were performed. We assessed the quality of the included studies using the Joanna Briggs Institute (JBI) checklist for prevalence studies. We used Comprehensive Meta-Analysis software version 4.0 to perform the statistical calculations. RESULTS: Eighteen cross-sectional studies were analyzed, including 47,718 adult Saudis from the general population. The pooled national prevalence of prediabetes among Saudi adults was estimated at 24.1% (95% CI [19.5%-29.4%]). Sensitivity analysis confirmed this pooled prevalence. Funnel plot inspection and Egger's test indicated no substantial publication bias. Subgroup analyses revealed a higher prevalence in fasting blood glucose (FBG) studies compared to glycated hemoglobin (HbA1c) studies: 25.7% (95% CI [16.6%-37.6%]) vs. 23.7% (95% CI [16.7%-32.5%]); males had a higher prevalence than females 34.8% (95% CI [25.4%-45.5%]) vs. 18.7% (95% CI [10.9%-30.2%]). Meta-regression analysis indicated a slight upward trend in prevalence over time, with a positive coefficient for 'Year' (0.027). DISCUSSION: A high pooled prevalence of prediabetes was documented among the adult Saudi population, with a markedly higher prevalence among males. These findings emphasize the need for early lifestyle interventions, optimized screening programs, and effective resource allocation to prevent the progression to type 2 diabetes. We acknowledge the high level of heterogeneity among the included studies. Additionally, we note that no eligible studies specifically from the northern region of Saudi Arabia were included in the meta-analysis.