1287-P: Unmasking the Risk Factors for Undiagnosed Diabetes among Adult Ghanaians Using Generalised Structural Equation Modeling—Insight from CarMeR Study

Undiagnosed diabetes mellitus poses a global health challenge, contributing to morbidity and mortality worldwide. In Ghana, the burden of diabetes is escalating, posing substantial challenges to the healthcare system, especially during COVID-19. A considerable number of cases remain undiagnosed, resulting in delayed interventions and heightened complications. Understanding the etiology of diabetes in indigenous communities is critical for implementing early interventions for diabetes prevention and remission. Our goal was to unmask risk factors of undiagnosed diabetes among adults in Ghana. We screened 1200 ostensibly healthy adults aged 25-70 years, predominantly female (63%) across 13 indigenous communities with unique characteristics. Fasting plasma glucose (FPG) assessed glucose tolerance using ADA criteria for FPG. The results revealed overall diabetes prevalence of 3.8% (n=46) [5.2% in females, 1.2% in males; 6.4% in rural, 2.1% in peri-urban, 4.6% in urban], and prediabetes at 14.4% (n=173) [15.3% in females, 12.6% in males; 22.0% in rural, 13.3% in peri-urban, 7.6% in urban]. Body Mass Index (BMI), Triglycerides (TG), Systolic Blood Pressure (SBP), gamma GT, gender and family history directly contributed significantly to diabetes risk. Age, education and Total Cholesterol (TC) indirectly influenced diabetes development through TG. High-Density Lipoprotein (HDL), TC, childhood overweight, physical activity, gender, and occupation indirectly influenced BMI. Alcohol intake, childhood overweight, family history of diabetes, gender, and socioeconomic status influenced waist circumference (WC). WC, TG, age, physical activity, and residency indirectly influenced SBP. Alcohol intake, gender and religion indirectly influenced diabetes prevalence through gamma GT. Controlling these factors may improve diabetes prognosis within indigenous communities.