Prediabetes among individuals with sickle cell disease: a hospital-based cross-sectional study

Background: Studies have shown that comorbidity of sickle cell disease (SCD) and diabetes mellitus (DM) leads to adverse microvascular complications. Recent studies elsewhere have reported co-existence in some populations. The need to determine the relationship between SCD and DM is reasonable due to improved life expectancy among individuals with sickle cell disease and the increasing reports of high DM incidence and prevalence among this population. Objective: This study aimed to determine whether SCD patients attending the Korle-Bu Teaching Hospital (KBTH) have a lower DM prevalence than non-SCD patients. Methods: This hospital-based cross-sectional study involving 53 SCD participants and 60 non-SCD randomly selected participants was conducted at KBTH from February to June 2019. About 3 ml of venous blood samples were collected from all consenting patients, and fasting blood glucose (FBG) was estimated using the VITROS Chemistry Analyser. Point of care glucometer (OneTouch® Select™ Plus brand) was used to estimate random blood glucose (RBG) from SCD participants' capillary blood samples taken 2 hours after they ate. RBG levels were not estimated for non-SCD participants. WHO diabetes diagnostic criteria were used to determine the diabetes status of all participants. Results: While no SCD participant had diabetes, 3.3% (n = 2) of non-SCD participants had diabetes. The mean age and body mass index (BMI) of the non-SCD participants (48 years, 27.0 kg/m2) were higher than that of the SCD participants (36 years, 22.9 kg/m2). Most SCD participants (52.8%, n = 28) had impaired glucose tolerance (prediabetes) (5%, n = 3). Male SCD participants were significantly less likely to have prediabetes than their female counterparts (OR = 0.109, 95% CI: 0.016 – 0.737, p = 0.023). Conclusion: The prevalence of prediabetes among SCD individuals was high. This might be due to increasing BMI with age among the SCD cohort, suggesting the need for continuous monitoring of DM status among ageing SCD patients.