Prevalence of Diabetes in Low- and Middle-Income Countries' Incarcerated Populations: A Systematic Review and Meta-Analysis.
Saad Arsalan Wasti, Areesha Wasti, Alisha Ahmed et al.
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In 30 seconds
This systematic review and meta-analysis estimated diabetes prevalence among incarcerated people in low- and middle-income countries (LMICs), drawing on 23 studies with 107,473 participants. The tentative pooled prevalence was 3.7% (95% CI: [2.5%-5.1%]; Prediction Interval [0%-12.2%]). Estimates varied substantially across studies (I 2 = 95.4%); prevalence was highest in Asia (5.2%) and lowest in South America (2.3%). The authors rated the evidence as very low certainty, citing risk of bias, possible publication bias and differences in how diabetes was ascertained.
Key findings
- Across 23 studies and 107,473 participants, tentative pooled diabetes prevalence was 3.7% (95% CI: [2.5%-5.1%]; Prediction Interval [0%-12.2%]).
- Between-study heterogeneity was high (I 2 = 95.4%), limiting interpretation of the pooled estimate.
- Pooled prevalence was 5.2% in Asia and 2.3% in South America; Pakistan had the highest reported country estimate at 9.8%.
- The DOI plot indicated substantial asymmetry, and certainty of evidence was rated very low.
Why it matters
The review brings together limited evidence on diabetes in incarcerated populations in LMICs, a group the authors describe as facing health risks and constrained access to care. The wide variation in estimates and very low certainty mean the pooled figure should not be treated as a precise measure of burden. Differences in detection methods and possible underdiagnosis also matter when interpreting prevalence.
What to keep in mind
The evidence was rated very low certainty, with high heterogeneity, possible publication bias and variation in diabetes ascertainment methods across primary studies.