Impact of cardiometabolic and renal phenotypes on the prevalence of type 2 diabetes in the geriatric population of Añisok, Equatorial Guinea: A prospective cohort study (2024–2025)

Abstract Background Type 2 diabetes (T2D) represents a global health crisis with an 11.5% prevalence, projected to rise to 853 million by 2050. In 2026, the management paradigm has shifted toward comprehensive multiorgan protection. In sub-Saharan African geriatric populations, the convergence of frailty and cardiometabolic risk presents critical diagnostic challenges. This study analyzes T2D prevalence among older adults in Añisok, Equatorial Guinea, evaluating the impact of clinical phenotypes on organ damage. Methods A prospective cohort study was conducted between 2024 and 2025. A sample of 1,702 subjects aged 60–100 years was recruited and stratified into: a High Cardiometabolic Risk Cohort ($n = 1,500$; BMI $\geq 30$ kg/m² and BP $\geq 140/90$ mmHg) and a Low Risk Cohort ($n = 202$). Metabolic variables and markers of organ damage, including metabolic dysfunction-associated steatotic liver disease (MASLD), were analyzed. Results The overall prevalence of T2D was 52.3% ($n = 890$). In the high-risk cohort, 50% had confirmed diabetes and 27% prediabetes (RR = 2.52; $p < 0.05$). Among patients with T2D, 52.3% exhibited an atherogenic lipid profile (LDL-C $> 200$ mg/dL) and poor glycemic control (HbA1c 7–8%). Severe complications, including MASLD and peripheral necrosis, reflected a lack of effective organocentric protection. Conclusions The high burden of cardiorenal disease in Añisok underscores the urgent need for evidence-based therapies, specifically GLP-1 receptor agonists (GLP-1 RA) and SGLT2 inhibitors (SGLT2i), transitioning toward early detection models.