The Prevalence of and Factors Associated with Prediabetes Among Adolescents in Central Sudan: A Community-Based Cross-Sectional Study

<b>Background:</b> Prediabetes is a significant precursor to type 2 diabetes mellitus (T2DM) and its well-known complications. In Sudan, data on the epidemiology of prediabetes among adolescents are scarce, especially in the central region. Thus, this study aimed to determine the prevalence of and factors associated with prediabetes among adolescents in central Sudan. <b>Methods:</b> This community-based cross-sectional study was carried out in East Gezira, central Sudan, from April to June 2025 and included 379 adolescents. Sociodemographic characteristics, anthropometric data (body mass index and BMI-z-score), and clinical information were gathered. Prediabetes was defined as a glycated hemoglobin (HbA1c) level in the range of 5.7% to 6.4%. Multivariate binary analysis was applied to identify the factors associated with prediabetes. <b>Results:</b> The median (interquartile range, IQR) age and BMI-z-score of the 379 enrolled adolescents were 14 (12-16) years and -1.4 (-2.1--0.39), respectively. Sixty-four (17.0%) adolescents had prediabetes. Univariate analysis did not reveal any significant associations between the investigated factors and prediabetes. However, multivariate binary analysis showed that being female was independently associated with prediabetes among adolescents (adjusted odds ratio, AOR = 1.80, 95% confidence interval, CI 1.01-3.18). Age, BMI z-score, parent education, and occupation were not associated with prediabetes. <b>Conclusions:</b> The prevalence of prediabetes among adolescents in central Sudan is substantial, highlighting a potential future surge in T2DM. The finding that female adolescents are at a higher risk underscores the need for targeted, gender-sensitive screening and preventive health programs to mitigate the progression from prediabetes to T2DM.