Global prevalence of prediabetes in children and adolescents: A systematic review and meta‐analysis

BACKGROUND: Prediabetes is a pivotal risk factor for developing diabetes. This meta‐analysis was performed to assess the global prevalence of childhood prediabetes. METHODS: A systematic search was conducted for studies of prediabetes prevalence in the general pediatric population from inception until December 2021. Random‐effects meta‐analysis was used to combine the data. Variations in the prevalence estimates in different subgroups (age group, sex, setting, investigation period, body mass index [BMI] group, family history of diabetes, diagnosis criteria, World Health Organization [WHO] and World Bank [WB] regions) were examined by subgroup meta‐analysis. RESULTS: A total of 48 studies were included in the meta‐analysis. The pooled prevalence was 8.84% (95% CI, 6.74%‐10.95%) for prediabetes in childhood. Subgroup meta‐analyses showed that the prevalence was higher in males than females (8.98% vs 8.74%, P < .01), in older compared to younger children (7.56% vs. 2.51%, p < 0.01), in urban compared to rural areas (6.78% vs. 2.47, p < 0.01), and higher in children with a family history of diabetes than in those without such a history (7.59% vs. 6.80%, p < 0.01). We observed an upward trend in prediabetes prevalence from 0.93% to 10.66% over past decades (p < 0.01). The pooled prevalence increased from 7.64% to 14.27% with increased BMI (p < 0.01). Pooled prevalence was the lowest for criterion A among different diagnosis criteria (p < 0.01). For WHO and WB regions, the European Region and high‐income countries yielded the lowest pooled prevalence (p < 0.01). CONCLUSIONS: Elevated prediabetes prevalence in childhood reaches an alarming level. Intensive lifestyle modification is needed to improve the prediabetes epidemic.