Prevalence of diabetes and impaired fasting glucose and associated factors in Rwanda: findings from the 2022 national STEPS survey

Abstract Background Diabetes mellitus (DM) and impaired fasting glucose (IFG) are growing public health challenges in Rwanda. However, nationally representative data on their prevalence and associated factors remain limited. Methods The study analyzed data from 5,200 adults aged 18–69 years who participated in the 2022 Rwanda NCD STEPS Survey. DM was defined as fasting blood glucose (FBG) ≥ 126 mg/dL or current/recent use of diabetes medication. IFG was defined as FBG between 110 and 125 mg/dL. Weighted regression models were used to estimate crude and adjusted prevalence ratios for sociodemographic, behavioral, and clinical factors. Results The prevalences of DM and IFG were 2.9% (95% CI: 2.1–3.8) and 4.7% (95% CI: 3.8–5.6), respectively. Higher DM prevalence was independently associated with age ≥ 45 years, higher education, physical inactivity, hypertension, elevated total cholesterol, overweight, obesity, and high-risk waist circumference. Elevated total cholesterol was also significantly associated with IFG, whereas higher education was associated with lower IFG prevalence. For the combined DM/IFG outcome, older age and elevated total cholesterol were independently associated with higher prevalence, whereas rural residence and lower monthly earnings were independently associated with lower prevalence. Conclusions Older age, physical inactivity, hypertension, elevated total cholesterol, overweight, obesity, and high-risk waist circumference were independently associated with DM in Rwanda, while elevated total cholesterol was independently associated with IFG and higher education was independently associated with lower IFG prevalence.