{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T01:03:33Z","timestamp":1792803813830,"version":"4.5.0"},"reference-count":52,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T00:00:00Z","timestamp":1773619200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Prediabetes is a reversible intermediate stage of dysglycemia that substantially increases the risk of diabetes and cardiovascular disease. India is witnessing a rapid rise in the burden of prediabetes; however, national evidence on biomarker-verified prediabetes among older adults remains limited. The present study aimed to estimate the prevalence of prediabetes and identify its associated factors among older adults in India.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a secondary cross-sectional analysis of wave one longitudinal aging study in India (LASI) data, a nationally representative survey of adults aged \u226545\u202fyears. A total of 58,386 participants with valid biomarker data on blood glucose levels were included. Prediabetes was defined as HbA1c 5.7\u20136.4%. Factors associated with prediabetes were examined using Poisson regression models to estimate adjusted prevalence ratios (aPRs) and 95% CIs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The weighted prevalence of prediabetes among adults aged \u226545\u202fyears was 30.4% (95% CI: 29.5\u201331.2), and dysglycemia (prediabetes\u202f+\u202fdiabetes) was 49.8% (95% CI: 48.9\u201350.7). Factors independently associated with higher prediabetes prevalence were age 60\u201374\u202fyears (aPR 1.22, 95% CI 1.15\u20131.29), \u226575\u202fyears (aPR 1.30, 95% CI 1.16\u20131.45), female sex (aPR 1.12, 95% CI 1.06\u20131.19), not currently working (aPR 1.08, 95% CI 1.02\u20131.15), other religions versus Hindu (aPR 1.12, 95% CI 1.02\u20131.22), no acute anemia in the past 2\u202fyears (aPR 1.12, 95% CI 1.02\u20131.22), overweight (aPR 1.56, 95% CI 1.41\u20131.73), and obesity (aPR 1.90, 95% CI 1.70\u20132.13). Prediabetes was most prevalent in Telangana (70.0%) and lowest in Sikkim (6.6%), while dysglycemia was highest in Telangana (78.0%), and lowest in Meghalaya (16.7%). Higher dysglycemia prevalence was independently associated with older age (60\u201374 and \u226575\u202fyears), urban residence, not currently working, family history of diabetes, hypertension, and excess adiposity, with the strongest associations observed for overweight (aPR 1.65, 95% CI 1.53\u20131.78) and obesity (aPR 1.86, 95% CI 1.72\u20132.02) (all\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Prediabetes affects more than one in four older adults in India. The marked regional and socioeconomic disparities underscore the urgent need for population-specific, biomarker-based screening and prevention strategies targeting older adults to curb progression to diabetes and related complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1766812","type":"journal-article","created":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T05:22:50Z","timestamp":1773638570000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Prevalence and factors associated with prediabetes among older adults in India: evidence from a national survey"],"prefix":"10.3389","volume":"14","author":[{"given":"Rashita","family":"Ravi","sequence":"first","affiliation":[{"name":"Department of Public Health, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham","place":["Kochi, Kerala, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeby Jose","family":"Olickal","sequence":"additional","affiliation":[{"name":"Department of Public Health, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham","place":["Kochi, Kerala, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aajna","family":"Adoor","sequence":"additional","affiliation":[{"name":"Research Unit of Population Health, University of Oulu","place":["Oulu, Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Devasia","sequence":"additional","affiliation":[{"name":"Department of Preventive and Social Sciences, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER)","place":["Puducherry, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kavumpurathu Raman","family":"Thankappan","sequence":"additional","affiliation":[{"name":"Department of Public Health, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham","place":["Kochi, Kerala, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,16]]},"reference":[{"key":"ref1","first-page":"S20","article-title":"Diagnosis and classification of diabetes: standards of care in diabetes; 2024","volume":"47","year":"2023","journal-title":"Diabetes Care"},{"key":"ref2","volume-title":"Diabetes Atlas","year":"2025"},{"key":"ref3","volume-title":"National Diabetes Statistics Report","year":"2024"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1038\/nrendo.2017.151","article-title":"Global aetiology and epidemiology of type 2 diabetes mellitus and its complications","volume":"14","author":"Zheng","year":"2018","journal-title":"Nat Rev Endocrinol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"585","DOI":"10.1016\/S2213-8587(17)30174-2","article-title":"Prevalence of diabetes and prediabetes in 15 states of India: results from the ICMR-INDIAB population-based cross-sectional study","volume":"5","author":"Anjana","year":"2017","journal-title":"Lancet Diabetes Endocrinol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"2932","DOI":"10.4103\/ijo.IJO_1627_21","article-title":"Epidemiology of type 2 diabetes in India","volume":"69","author":"Mohan","year":"2021","journal-title":"Indian J Ophthalmol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1605","DOI":"10.1161\/CIRCULATIONAHA.114.008729","article-title":"Cardiovascular diseases in India","volume":"133","author":"Prabhakaran","year":"2016","journal-title":"Circulation"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"2129","DOI":"10.1001\/jama.2009.726","article-title":"Diabetes in Asia","volume":"301","author":"Chan","year":"2009","journal-title":"JAMA"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"2436","DOI":"10.1093\/eurheartj\/eht149","article-title":"Diabetes and vascular disease: pathophysiology, clinical consequences, and medical therapy: part I","volume":"34","author":"Paneni","year":"2013","journal-title":"Eur Heart J"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1113","DOI":"10.1016\/j.jacc.2010.05.034","article-title":"The metabolic syndrome and cardiovascular risk: a systematic review and meta-analysis","volume":"56","author":"Mottillo","year":"2010","journal-title":"J Am Coll Cardiol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1016\/S2666-7568(24)00007-2","article-title":"Prevalence of multimorbidity and polypharmacy among adults and older adults: a systematic review","volume":"5","author":"Nicholson","year":"2024","journal-title":"Lancet Healthy Longev"},{"key":"ref12","volume-title":"Longitudinal Ageing Study in India (LASI) India Report: National Programme for Health Care of Elderly","year":"2020"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"e1543","DOI":"10.1016\/S2214-109X(23)00502-8","article-title":"Prevalence, awareness, treatment, and control of diabetes in India: a nationally representative survey of adults aged 45 years and older","volume":"13","author":"Sekher","year":"2025","journal-title":"Lancet Glob Health"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"2611","DOI":"10.3390\/nu11112611","article-title":"Prevention of type 2 diabetes by lifestyle changes: a systematic review and Meta-analysis","volume":"11","author":"Uusitupa","year":"2020","journal-title":"Nutrients"},{"key":"ref15","volume-title":"National Family Health Survey (NFHS-5), 2019\u201321: India.ruralindiaonline.org.","year":"2022"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"e0246808","DOI":"10.1371\/journal.pone.0246712","article-title":"National noncommunicable disease monitoring survey (NNMS) in India: estimating risk factor prevalence in adult population","volume":"16","author":"Mathur","year":"2021","journal-title":"PLoS One"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"112381","DOI":"10.1016\/j.diabres.2025.112381","article-title":"Addressing the prediabetes epidemic in India: challenges and strategies for prevention - a narrative review","volume":"226","author":"Sowmya","year":"2025","journal-title":"Diabetes Res Clin Pract"},{"key":"ref18","volume-title":"Report of the Meeting of the WHO South-East Asia Regional Expert Group on Noncommunicable Diseases (REG NCD) 2023\u20132024. Who.int.","year":"2023"},{"key":"ref19","volume-title":"Longitudinal Ageing Study in India (LASI) Report 2020","year":"2020"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"3022","DOI":"10.1007\/s00125-011-2291-5","article-title":"Prevalence of diabetes and prediabetes in urban and rural India: phase I results of the ICMR-INDIAB study","volume":"54","author":"Anjana","year":"2011","journal-title":"Diabetologia"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"e1352","DOI":"10.1016\/S2214-109X(18)30387-5","article-title":"The increasing burden of diabetes and variations among the states of India: the global burden of disease study 1990\u20132016","volume":"6","author":"Tandon","year":"2018","journal-title":"Lancet Glob Health"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1093\/bmb\/ldu018","article-title":"Non-communicable diseases in South Asia: contemporary perspectives","volume":"111","author":"Siegel","year":"2014","journal-title":"Br Med Bull"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1016\/j.diabres.2024.111889","article-title":"Prediabetes and diabetes in India: an HbA1c based epidemiology study","volume":"217","author":"Vora","year":"2024","journal-title":"Diabetes Res Clin Pract"},{"key":"ref24","volume-title":"IDF Diabetes Atlas","year":"2021"},{"key":"ref25","doi-asserted-by":"crossref","first-page":"797","DOI":"10.2337\/dc11-1321","article-title":"Spuriously high prevalence of prediabetes diagnosed by HbA1c in young Indians partly explained by iron-deficiency anaemia","volume":"35","author":"Hardikar","year":"2012","journal-title":"Diabetes Care"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1016\/j.cca.2016.10.003","article-title":"Effect of iron deficiency anaemia and iron supplementation on HbA1c levels\u2014implications for diagnosis of prediabetes and diabetes mellitus in Asian Indians","volume":"468","author":"Madhu","year":"2017","journal-title":"Clin Chim Acta"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s13410-022-01129-5","article-title":"RSSDI clinical practice recommendations for the management of type 2 diabetes mellitus 2022","volume":"42","author":"Makkar","year":"2022","journal-title":"Int J Diabetes Dev Ctries"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1001\/jamainternmed.2017.8094","article-title":"Diabetes and hypertension in India: a nationally representative study of 1.3 million adults","volume":"178","author":"Geldsetzer","year":"2018","journal-title":"JAMA Intern Med"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"3094","DOI":"10.2337\/dc20-0886","article-title":"Contrasting associations between diabetes and cardiovascular mortality rates in low-, middle-, and high-income countries: cohort data from the PURE study","volume":"43","author":"Anjana","year":"2020","journal-title":"Diabetes Care"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1007\/s11892-018-1002-8","article-title":"Diabetes in south Asians: phenotype, clinical presentation, and natural history","volume":"18","author":"Unnikrishnan","year":"2018","journal-title":"Curr Diab Rep"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"112374","DOI":"10.1016\/j.diabres.2025.112374","article-title":"Novel data-driven pathophysiological phenotypes among women with prediabetes in an Indian population","volume":"226","author":"Mathews","year":"2025","journal-title":"Diabetes Res Clin Pract"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1186\/1479-5868-11-26","article-title":"Physical activity and inactivity patterns in India\u2014results from the ICMR-INDIAB study (phase 1)","volume":"11","author":"Anjana","year":"2014","journal-title":"Int J Behav Nutr Phys Act"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"1258","DOI":"10.1177\/1741826711424567","article-title":"Twenty-year trends in cardiovascular risk factors in India and influence of educational status","volume":"19","author":"Gupta","year":"2012","journal-title":"Eur J Prev Cardiol"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1016\/j.ihj.2015.03.020","article-title":"Consensus statement on the management of dyslipidaemia in Indian subjects: a different perspective","volume":"67","author":"Enas","year":"2015","journal-title":"Indian Heart J"},{"key":"ref35","volume-title":"National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NP-NCD)","year":"2023"},{"key":"ref36","volume-title":"National Family Health Survey (NFHS-5), 2019\u201321: India","year":"2021"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"247","DOI":"10.4330\/wjc.v8.i3.247","article-title":"Lipoprotein abnormalities in south Asians and its association with cardiovascular disease","volume":"8","author":"Bilen","year":"2016","journal-title":"World J Cardiol"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"382","DOI":"10.1016\/j.ihj.2017.02.020","article-title":"Recent trends in epidemiology of dyslipidaemias in India","volume":"69","author":"Gupta","year":"2017","journal-title":"Indian Heart J"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"139","DOI":"10.4103\/0971-5916.164234","article-title":"Prevalence of generalised and abdominal obesity in urban and rural India\u2014the ICMR-INDIAB study","volume":"142","author":"Pradeepa","year":"2015","journal-title":"Indian J Med Res"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"1103","DOI":"10.1007\/s00125-020-05132-5","article-title":"Why are south Asians prone to type 2 diabetes? A hypothesis based on underexplored pathways","volume":"63","author":"Narayan","year":"2020","journal-title":"Diabetologia"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"2628","DOI":"10.1210\/jc.2016-1370","article-title":"A reappraisal of prediabetes","volume":"101","author":"Davidson","year":"2016","journal-title":"J Clin Endocrinol Metab"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"204","DOI":"10.1038\/jhh.2014.57","article-title":"Prevalence of and risk factors for hypertension in urban and rural India: the ICMR-INDIAB study","volume":"29","author":"Bhansali","year":"2015","journal-title":"J Hum Hypertens"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"1170","DOI":"10.1097\/HJH.0000000000000146","article-title":"Hypertension in India: a systematic review and meta-analysis","volume":"32","author":"Anchala","year":"2014","journal-title":"J Hypertens"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"394","DOI":"10.1038\/s41371-022-00692-y","article-title":"Hypertension treatment cascade in India: results from NNMS","volume":"37","author":"Amarchand","year":"2022","journal-title":"J Hum Hypertens"},{"key":"ref45","volume-title":"Global Action Plan for the Prevention and Control of Non-Communicable Diseases 2023\u20132030","year":"2023"},{"key":"ref46","first-page":"11","article-title":"Persistent high prevalence of cardiovascular risk factors in the urban middle class in India: Jaipur heart Watch-5","volume":"60","author":"Gupta","year":"2012","journal-title":"J Assoc Physicians India"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"1175","DOI":"10.1007\/s00125-006-0219-2","article-title":"Secular trends in the prevalence of diabetes in urban South India\u2014CURES-17","volume":"49","author":"Mohan","year":"2006","journal-title":"Diabetologia"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"e14424","DOI":"10.1111\/dme.14424","article-title":"Temporal changes in diabetes prevalence and care goals in urban South Asia","volume":"38","author":"Anjana","year":"2021","journal-title":"Diabet Med"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"474","DOI":"10.1016\/S2213-8587(23)00119-5","article-title":"Metabolic non-communicable disease health report of India: the ICMR-INDIAB national cross-sectional study (ICMR-INDIAB-17)","volume":"11","author":"Anjana","year":"2023","journal-title":"Lancet Diabetes Endocrinol"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"430","DOI":"10.1016\/S2213-8587(22)00072-9","article-title":"Achievement of guideline-recommended diabetes treatment targets in India","volume":"10","author":"Anjana","year":"2022","journal-title":"Lancet Diabetes Endocrinol"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"1441","DOI":"10.2337\/dc14-2814","article-title":"Incidence of diabetes and prediabetes and predictors of progression among Asian Indians: 10-year follow-up of CURES","volume":"38","author":"Anjana","year":"2015","journal-title":"Diabetes Care"},{"key":"ref52","doi-asserted-by":"publisher","first-page":"dc230696","DOI":"10.2337\/dc23-0696","article-title":"Effect of conventional lifestyle interventions on type 2 diabetes incidence by glucose-defined prediabetes phenotype: an individual-participant data meta-analysis of randomized controlled trials","volume":"46","author":"Sathish","year":"2023","journal-title":"Diabetes Care"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1766812\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T05:22:53Z","timestamp":1773638573000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1766812\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,16]]},"references-count":52,"alternative-id":["10.3389\/fpubh.2026.1766812"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1766812","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,16]]},"article-number":"1766812"}}