Table 3.
Key findings, strengths, and limitations of included studies.
| SN | References | Key findings | Strengths and limitations |
|---|---|---|---|
| 1 | Acharya et al. (33) | • About 31.3% (3592/11481) participants had hypertension. • Among the hypertensive persons, 40.2% (1,444/3,592) were aware of their hypertension status. • Among these who were aware, 79.4% (1,146/1,444) were taking antihypertensive medicine. • However, the overall proportion of hypertensive patients taking medicine was 32.0% (1,146/3,592). • The BP was controlled among 46% (527/1444) of participants who were under medication. |
• At least three measures were taken, from which the last two were recorded • Representativeness of the sampling is not mentioned • Geography, caste/ethnicity and age distribution of the participants are not described |
| 2 | Adhikari (34) | • Hypertension proportion (Camp) is 70% (1,301/1,857; Pre-HTN, HTN1 and HTN2) • Proportion of hypertension among in-patients is 13.7% |
• The report is service coverage based rather than outcome based. |
| 3 | Agho et al. (35) | • Prevalence of prehypertension and hypertension was 26.9 and 17.2% respectively • Prehypertension was present in 30.4% (95%CI: 28.7, 32.2) of males and 24.3% (95% CI: 23.1, 25.6) of females, while hypertension was present in 20.4%, (95% CI 18.9, 22.0) of males and 14.8%. |
• Nationally representative sample • Lack of temporal relationship with the risk factors and outcome • Limited risk factors considered for study • Post-earthquake situation which might interfere in psychosocial status interfering pre/HTN |
| 4 | Bhattarai et al. (36) | • CVDs contributed to 26.9% of total deaths and 12.8% of total DALYs • Ischemic heart disease and stroke were the predominant CVDs, contributing 16 4% (UI, 18.2–14.6) and 7.5% (UI 8.6–6.7) to total deaths and 7.5% (UI, 8.7–6.3) and 3.5% (UI, 4.0–3.0) of total DALYs, respectively. |
• This is the first study to report on trends and distribution of the CVD burden at a national level in Nepal. |
| 5 | Bist et al. (37) | • The prevalence of raised blood pressure was 24% • The prevalence of raised blood sugar was 5.8% • The prevalence of raised cholesterol was 11% • The proportion of overweight was 24% |
• Nationally representative sample |
| 6 | Brewis et al. (38) | • The proportion of raised BP is 25.4% among male and 19.3% in female | • Nationally representative sample • The relationship between de/hydration and BP and the direction of effect was measured |
| 7 | Aryal et al. (39) | • Proportion of hypertension (including under treatment) is 46.1 and 40.9% in urban and rural areas of Mustang, respectively; and 54.5 and 29.1% in urabn and rural areas of Humla • 30.9% of participants are prediabetic • 6.9% were diabetic • Prevalence of pre-diabetes was significantly higher in rural settings compared to urban settings (p < 0.01) |
• Selection bias on sampling the survey used non-fasting blood samples for determination of a lipid profile which might interfere with the TG level. |
| 8 | Das Gupta et al. (40) | • Prevalence of hypertension was 21% (JNC7) and 44% (2017 ACC/AHA) • Prevalence of hypertension awareness was 37.1 and 43.9% in male and female, respectively. • Prevalence of antihypertensive medication was 47.5 and 50.1% in male and females, respectively • Prevalence of control of hypertension among the hypertensive was 53.5 and 49.2% among male and female, respectively. |
• Blood pressure was measured three times in a single day for the study whereas JNC7 guideline recommends longitudinal measurement • Possibly misclassification bias • Robust association between the outcome variables and caste could not be obtained due to missing data |
| 9 | Das Gupta et al. (41) | • Overall prevalence of hypertension was 21.1% | • Three blood pressure measurements were recorded; all were done in a single visit within a 5-min interval |
| 10 | Datta and Humagain (42) | • Overall prevalence of prehypertensive and hypertensive women were 24.30% and 10.86 whose husband did not consume alcohol•4.5% point gap in hypertension prevalence between wives of alcohol-consuming husbands and those of husbands not consuming alcohol • Likelihood of being hypertensive of Nepalese women was 12.8% |
• Husband's alcohol consumption, as a factor of wives' hypertension status. |
| 11 | Dhungana et al. (43) | • The most prevalent comorbidity of hypertension and diabetes was 5.7% followed by HTN and COPD (4.8%), and HTN and CKD (4%) | • Secondary analysis of the data from the NCD survey 2018 • Chronic disease multimorbidity determinants and patterns study |
| 12 | Dhungana et al. (44) | • Prevalence of hypertension was 34.6% and diabetes 10.5% • 23.2% were not taking any antihypertensive medications among the aware hypertensive patients • 47.2% had controlled blood pressure level among the hypertensive medicine users • Among the Diabetics, only 59.3% were taking medication |
• Cross-sectional study • Recall bias while recording dietary and medication history and assessing seven days physical activities |
| 13 | Ene-Iordache et al. (45) | • Prevalence of hypertension was 23% in the general population and 38% among high risk cohorts (Framingham risk score) • Prevalence of awareness being onset of disease is 59 and 71% for HTN and Diabetes (74 vs. 56% for HTN and 80 vs. 69% for Diabetes among high risk cohorts and general population) • Self-reported of onset of having disease is 11 and 4%, respectively among high risk cohorts and general population |
• Individuals were screened based on convenience sampling, section bias on recruiting volunteers who will provide the testing |
| 14 | Ghimire et al. (46) | • Proportion of Hypertension was 57.2% • Proportion of Diabetes was 15% |
• Nationally representative survey data • Age group of only 60–69 years, though >30% population is over 70 years, so generalizability is limited. |
| 15 | Ghimire et al. (47) | • Prevalence of raised blood pressure was 31.4% | • Self-reporting of disease status • Non-response rate-21.84% |
| 16 | Gyawali et al. (48) | • Mean cost case treatment was ranged from 484.8 to 445.9 USD per annum and per visit 5.1–16.2 USD • Prevalence of DM Type 2 ranges from 4.5% to as high as 19% in urban Nepal and rural prevalence ranging from 0.3 to 2.5% |
• Costing study of DM • Limited to the selected database source • Urban-focused |
| 17 | Paudel et al. (49) | • Almost one-fourth (29.49%) of the adult population in the community suffered from hypertension. • Less than half (43.2%) of the hypertensive patients were aware of their conditions • 94.9% were taking antihypertensive medication and 68.4% had their blood pressure controlled |
• This study is one of the few studies of Kaski district, Nepal to assess the awareness, treatment and control status of hypertensive patients. • This study limits its scope as the causal inferences could not be drawn. • This study is based on one district of Nepal and is not representative of the whole country due to the high ethnic, dietary, cultural, and geographical variation in the country |
| 18 | Peoples et al. (50) |
Quantitative finding
• Medicine cost was rated “too expensive” by 52 and 63% of rural and urban participants, respectively. • Perceived poor bedside manner was tied to negative perceptions of PHC quality, and vice versa. • Lack of resources and excessive barriers to care were mentioned by every interviewee. Qualitative finding • PHC use was high and satisfaction was low. • Most of the people were found unaware and didn't have any idea how to manage the disease when they were interviewed |
• The study is claimed to be the first to examine perception and use of PHC services for Cardiometabolic diseases (CMDs) in Nepal. • The use of only two districts of Nepal as study sites, the use of cluster convenience sampling, and the limited sample size. |
| 19 | Rana et al. (51) | • Women were having lower prevalence of hypertension compared with men for both measured (16.0%, 95% CI: 14.8, 17.3 vs. 22.8%, 95% CI: 21.2, 24.5) and medical hypertension (21.7%, 95% CI: 20.4, 23.0 vs. 29.1%, 95% CI: 27.4, 30.8) and the differences were significant statistically in both measurements (p < 0.001). • People living in urban areas were having higher prevalence of hypertension compared with people living in rural areas for both measured (19.5%, 95% CI: 18.7, 20.4 vs. 17.9%; 95% CI: 16.9, 19.0) and medical (26.2%, 95% CI: 25.2, 27.1 vs. 22.7%; 95% CI: 21.6, 23.8) hypertension and the differences were significant statistically (p < 0.001) only for medical hypertension. • There was an overall 21% increase in the prevalence of hypertension, with the highest increase in the male population (23%) |
• Assessed the association between SES and hypertension according to standard hypertension JNC7 guideline and a new guideline recommended by the ACC/AHA 2017. • The study could not assess the causality of the associations between Socio Economic Status and hypertension due to the cross-sectional nature of the data |
| 20 | Rai et al. (52) | • Hypertension was the common systemic disease associated in 40.8% of the cases, followed by diabetes in 32.5% and combined diabetes and hypertension in 20.2%. • Wealthy urban population in Nepal had higher prevalence, awareness, treatment and control than the poorer and poorest population. • The odds of being hypertensive was higher in men compared to women 1.96 (1.59–2.44) for Nepal) |
• Recorded data was analyzed for HTN and DM, of the eye patients visiting a tertiary eye care center • Ocular co-morbidities have not been included, so a certain proportion might have been missed |
| 21 | Rauniyar et al. (31) | • Prevalence of hypertension in Nepal was 19.6%. • Less than one-third (20.2%) of the hypertensive population received treatment and 10.4% among them had their blood pressure controlled. • The odds of being hypertensive was higher in men compared to women1.96 (1.59–2.44). • Prevalence of hypertension was 7.1 (2.9–11.4) percentage points higher in affluent populations compared to the disadvantaged ones in Nepal. |
• Provides detailed information on existing inequalities in prevalence and management of hypertension • The study cannot be generalized to population aged 50 years and above |
| 22 | Sainju et al. (53) | • Pre-hypertension and hypertension were seen in 11.02 and 30.17% of the study population, respectively • Almost three-fifths of the obese participants were hypertensive |
• Sample is not nationally representative • Single episode of measurement of blood pressure (three readings) was taken, which may not be sufficient to diagnose hypertension in the population. • There could be an error due to observer variation in hearing the Koratkoff sound in crowed places |
| 23 | Saito et al. (54) | • Prevalence of hypertension (36.7%) • Prevalence of diabetes (14.4%) |
• Self-reported assessment of illness may be biased • Face-to-face interview (only by asking) may not suffice to assess all the NCD risk factors • Data was collected in winter season, which might have affected the prevalence |
| 24 | Paudel et al. (55) | • 9% had diabetes with the prevalence higher among males (12.7%) than females (6.9%) • Overweight and obesity, Waist Circumference >102 cm (males) or >88 cm (females), a triglyceride level ≥150 mg/dL and total 14 cholesterol ≥190 mg/dL were associated with Type 2 Diabetes Mellitus |
• Measurement and modeling of multiple behavioral, socio-economic and biological risk factors assessed • STEP survey data of 2013 re-analyzed for 40–69 yrs age group |
| 25 | Gyawali et al. (56) | • Prevalence of type 2 diabetes 11.7% (95% CI: 10.4–13.1) • Prevalence of prediabetes 13.0% (95% CI: 11.8–14.5) • Nearly two-fifths (35%) unaware of their disease • Nearly 94% of those aware were receiving some kind of treatment such as insulin or oral anti-diabetic medications and counseling • Control rate was less than one quarter of those who were receiving treatment (21%) |
• One of the few studies on the awareness, treatment and control of diabetes in Nepal through validated STEPS questionnaire and fasting blood glucose measurements according to the WHO recommendations • The use of self-reported physical activity measures that are subjected to recall bias and over-reporting could have increased the possibility of exposure misclassification |
| 26 | Shrestha et al. (57) | • The prevalence of T2DM, pre diabetes, and impaired glucose tolerance in Nepal was estimated to be 10, 19.4, and 11%, respectively. • Normal waist circumference, normal blood pressure and no history of T2DM in a family has 64.1, 62.1, and 67.3%, respectively |
• Heterogeneity in the studies due to variation in the T2DM diagnostic criteria and different demographics of the population |
| 27 | Shrestha et al. (58) | • Prevalence of prediabetes and diabetes was 9.2% (95% CI 6.6–12.6%) and 8.5% (95% CI 6.9–10.4%), respectively. • 52.7% (95% CI 41.7–63.4%) were aware of their diabetes status. 45.3% (95%CI 31.6–59.8%) were taking antidiabetic medications. |
• High heterogeneity between the reported diabetes prevalence across the included studies |
| • Nearly one-third of those under antidiabetic treatment (36.7%; 95% CI 21.3–53.3%) had their blood glucose under control | |||
| 28 | Shrestha et al. (59) | • Prevalence of hypertension and pre-pre hypertension was 40.67 and 36.77%, respectively • Age AOR for being hypertensive for males compared with females was 0.86 (95% CI 0.72–1.02) • Sex AOR for being hypertensive was 1.61 (95% CI 1.35–1.91) for the age group 55–69 compared with age group 40–54 years. • Participants with WC measures greater than the cut-off value were twice as likely to be hypertensive (2.02; 95%CI 1.66–2.45) than people with normal WC |
• Waist to height ratio and waist circumference were also included for picking up obesity with higher cardiovascular risk despite normal body mass index • Underlying causes and co-morbidities are not included |
| 29 | Silvanus et al. (60) | • Prevalence of known diabetes (50/306) was an estimated 16.34% (95% CI: 12.62% to 20.90%) • 46.09% were classified as high risk, 44.53% as moderate risk and 9.38% as low risk for developing diabetes • The tabulated sensitivity (true positive rate) of the IDRS cut-off score ≥60 (high risk classification) was found to be 84.21% with a specificity (true negative rate) of 55.24% • The false positive rate and false negative rate was 44.76 and 15.79%, respectively. • The positive predictive value was 20.0% and negative predictive value was 96.34% |
• Community-based study design to screen for undiagnosed diabetes, the step wise approach including the non-invasive tool and estimation of RCBG and the use of both FPG and the 2 h PG following a 75 g OGTT to identify diabetes and prediabetes • A community-based screening program can attract persons who have the health condition, those with a propensity to seek health care or who are more interested in their health which can introduce a selection bias |
| 30 | Silvanus et al. (61) | • Prevalence of undiagnosed diabetes was 4.32% (95% CI 1.75–8.70%) and that of prediabetes was 7.14% (95% CI 3.89–12.58%) • The overall prevalence of persons with “raised blood glucose” was 11.73% (95% CI 5.64–21.28%) • All of the persons with prediabetes (n = 12) had IGT |
• Recognizing the use of glucometer and capillary sampling in low- and middle-income countries • Two glucometers were used during the screening camp, within glucometer variation was not studied |
| 31 | Tan et al. (62) | • Most individuals with hypertension could link hypertension to its causes, symptoms and complications • Some individuals with hypertension occasionally stopped medication due to forgetfulness, negligence, laziness, and affordability issues |
• First qualitative study in Nepal involving a range of stakeholders to gather multidimensional insights into hypertension management • Qualitative design and small sample size limit the generalizability of the study findings |
| 32 | Tang et al. (63) | • The range of 8.2–12.1% and 4.3–9.1% missed and overidentified hypertensive, respectively found when only 1st measurement was taken. • The range of 4.9–6.4% and 2.0–4.4% missed and overidentified hypertensive, respectively, found when only 2nd measurement was taken but for this, all the participants needed to go through screening. • The range of 3.8–8.1% and 2.0–3.9% missed and overidentified hypertensive, respectively, found when 2nd measurement was taken only for those having BP ≥ 130/80 during 1st screening. The range (%) of the participants needed to screen in the conditional screening (BP ≥ 130/80) for 2nd time is only 33.8–59.8% • Hence, resource cost is reduced by 40.2–66.2% when conditional sequential screening is carried out |
• Comparison of 1st, 2nd, and conditional 3rd screening was carried out so as to assess the difference in resources used • Survey data of USA is taken from 1999–2016 whereas findings from opportunistic screenings of May Measurement Month of 2017–18 for India and Nepal were used |
| 33 | Timilsina (64) | • Prevalence of DM among TB patients was 18.84%. | • Sample was taken purposively |
| 34 | Sharma et al. (65) | • The prevalence of diabetes, pre-diabetic and glucose intolerance among tuberculosis patient was 11.9, 17.2, and 17.8%, respectively. • Current alcohol consumer as the significant predictor of diabetes among the tuberculosis patient |
• The Fasting Blood Sugar and 2-h Post-Prandial Blood Sugar were assessed by the glucose oxidase method • Facility-based DOTS center sample was taken |
| 35 | Yadav et al. (66) | • 56% were diagnosed as hypertensive; • 29% were pre-hypertensives; • 16.3% had 1st stage hypertension and 11% had 2nd stage hypertension |
• The study sample was obtained from the tertiary level teaching hospital • Less generalizability at population |
| 36 | Hassan et al. (67) | • Among the total hypertensive participants, identified only in NDHS 2016 survey but not by professionals earlier, prevalence of diagnosed hypertension was -Total, 49.6%; -Province 1, 53%; Madhesh Province, 53.1%; Bagmati Province, 52.7%; Gandaki Province, 46.9%; Lumbini Province, 45.4%; Karnali Province, 39.8%; SudurPaschim Province, 41.9% • Mountain, 47.1%; Hill, 48.3%; Terai, 51.4% • Prevalence of undiagnosed hypertension was 50.4% • Proportion of hypertension awareness among the hypertensives was 49.6%. • Undiagnosed hypertension was disproportionately higher among lower socioeconomic status groups (Concentration Index, C = −0.18, p < 0.001). |
• Nationally representative, cross-sectional data to determine the prevalence • Other behavioral and lifestyle factors potentially relevant to undiagnosed hypertension, for example, physical activity, dietary patterns and family history of hypertension, that were not explored in this study. |
| 37 | Kadaria and Aro (68) | • 52% were moderately active • 28% were highly active |
• Facilitators and barriers physical activity were assessed • Self reporting and its recall bias on measure of physical activity |
| 38 | Karmacharya et al. (69) | • Proportion of hypertension awareness among the hypertensives was 44.7% • Prevalence of taking antihypertensive treatment was only 76.1% (among the known hypertensives and 33.2% among the total) • Prevalence of control of hypertension was 35.3% among the known hypertensive and 11.7% of the total |
• Spectrum of awareness, treatment and control of hypertension • BP was taken in home setting and single day measurement cause false readings and affect the study • The targeted study was conducted at Dhulikhel which has teaching hopsital that could impact on level of awareness and control of HTN among the participants. |
| 39 | Khanal et al. (70) | • Proportion of participants controlling Systolic BP increased to 58.3% from 3.3% compared to only to 40% among the intervention vs. control group • Percentage of the controlled Diastolic BP increased by 30% after the intervention compared to only 20% on usual care (control) |
• The study was study was conducted in one municipality and high number of female respondents thus limited generalization. • The blood pressure measured twice at 3-min interval in a single visit |
| 40 | Khanal et al. (71) | • Prevalence of hypertension was 38.9%2 • 53.4% were aware about their HTN status |
• The study was conducted in one municipality and high number of female respondents thus limited generalization |
| • 29% on treatment among the hypertensive, and • 8.2% had controlled blood pressure among the treated • Self-reported prevalence of Diabetes was 6.9% |
• The blood pressure measured twice at 3-min interval in a single visit • Presence of diabetes was determined as reported by participants without blood sugar measurement |
||
| 41 | Kibria et al. (72) | • HTN prevalence, 44.2% (as per 2017 ACC/AHA) but only 21.2% (as per JNC 7 guideline) • HTN awareness proportion, 40.4% (as per 2017 ACC/AHA) but only 23.6% (as per JNC 7 guideline) • 20.4 vs. 9.8% (as per JNC vs. 2017 ACC/AHA category) of those who would have been considered hypertensive were taking antihypertensive medications • Among the hypertensives, about 9.7 and 7.2% had a controlled blood pressure level, respectively (as per JNC vs. 2017 ACC/AHA category) |
• The survey data was nationally representative • Blood pressure of the participants was measured 3 times in a single day while both guidelines recommend the longitudinal measurement • Comparison and effectiveness of two methods of BP measurement and classification |
| 42 | Koirala et al. (73) | • Proportion of controlled BP among the hypertensives was 75% | • Sample size is low and generalizability is limited. |
| 43 | Koirala et al. (74) | • 20.7% of participants were hypertensive Proportion of Intermediate Hyperglycemia was 31.6 and 4.6% was of DM based on Hba1C measure | • Sample size is low and generalizability is limited due to single village taken for sampling • Fasting blood sugar was not taken for confirming DM diagnosis |
| 44 | Kushwaha and Kadel (75) | • Prevalence of diabetes mellitus was found as 4.38%. | • Glucometer with glucose sticks was used to measure the random blood sugar level which was not recommended in respect to fasting blood glucose with biochemistry method |
| 45 | Mehata et al. (76) | • The overall prevalence of MetS is 15 and 16% according to Adult Treatment Panel III (ATP III) and International Diabetes Federation (IDF) criteria, respectively • Triad of low HDL-C, abdominal obesity and high BP was the most prevalent (8.18%), followed by abdominal obesity, low HDL-C cholesterol and high triglycerides (8%) |
• Provides the first nationally representative estimates on prevalence, disaggregated by sub-groups, and factors attributed to metabolic Syndrome among adult population of Nepal |
| 46 | Mehata et al. (77) | • Prevalence of hypertension was 18% (95% CI 16.7–19.2) • Among the total hypertensive individuals, only 38% were aware of their hypertensive status • 18% were taking antihypertensive medication • Half of the hypertensive participants on treatment (52%) had their blood pressure under control. |
• Based on a large national sample consisting of both urban and rural populations in Nepal • Dietary habits, alcohol intake or physical activity as the major determinants of hypertension status could not be explored |
| 47 | Mishra et al. (78) | • Prevalence of hypertension was 19.5% (95% CI: 18.3–20.7) • Of total hypertensives, the prevalence of hypertension awareness, treatment and control was 40.0% (95% CI: 37.5–42.6), 20.2% (95% CI: 18.0–22.2) and 10.5% (95% CI: 8.8–12.2), respectively |
• First nationwide study to examine socio-economic disparities in hypertension burden and cascade of services |
| 48 | Mizuno et al. (79) | • Hypertension was 23% • The urinary lead concentrations were positively associated with both systolic and diastolic blood pressure. • Urinary selenium concentrations were negatively associated with both systolic and diastolic blood pressure. |
• Wide variation of data (17 communities with various characteristics across four Asian countries) • Association of heavy metals (Pb and Se) were associated with hypertension |
| 49 | Bista et al. (80) | • 22.2% were overweight and obese • 11.5% of the participants were hypertensive. • Around 6% of participants had co-occurrence of two NCDs risk factors. |
• Adjusted prevalence ratio (APR) was calculated from multiple poisson regression method • Secondary data analyzed for reproductive aged women |
| 50 | Neupane et al. (81) | • Low, medium, and high levels of knowledge about hypertension were 43, 24, and 31%, respectively • No significant differences were observed in the knowledge and attitudes related to hypertension in relation to demographic characteristics of FCHV. • A majority of FCHV agreed that smoking (69.8%), alcohol (77.8%), low physical activity (42.4%), high salt intake (65.4%), high fat intake (78.7%), and genetics (53.9%) are major risk factors for hypertension. |
• The study was conducted only among FCHV based in 1 municipality in Nepal |
| 51 | Neupane et al. (82) | • HTN was 29.6%, M = 55.4%; F = 24.1 • Pre-HTN was 20.6% • The mean systolic blood pressure at 1 year was significantly lower in the intervention group than in the control group for all cohorts: the difference was −2·28 mm Hg (95% CI −3·77 to −0·79, p = 0·003) for participants who were normotensive, −3·08 mm Hg (−5·58 to −0·59, p = 0·015) for participants who were prehypertensive, and −4·90 mm Hg (−7·78 to −2·00, p = 0·001) for participants who were hypertensive |
• First cluster-randomized controlled trial to report systolic blood pressure among normotensive, prehypertensive, and hypertensive populations through an existing network of community health workers |
| 52 | Neupane et al. (83) | • The age and sex adjusted prevalence of hypertension was 28% • Among hypertensive participants, 46% were aware of their preexisting hypertension, 31% were on hypertensive medication, and 15% met BP control targets • Increasing age (1.07, 95% confidence interval: 1.06; 1.08), higher body mass index (OR: 1.09, 95% CI: 1.06; 1.12), men (OR: 1.63, 95% CI: 1.25; 2.14), harmful alcohol intake (Or: 2.46; 95% CI: 1.73; 3.51), family history of hypertension (OR: 1.42; 95% CI: 1.14; 1.76), and diabetes (OR: 2.08, 95% CI: 1.30; 3.33) were independently associated with hypertension |
• High response rate, adequate representation of both sexes, utilizing average of two BP measurements preceded by a first disregarded measurement and detailed information on the history of hypertension, and pharmacological treatments. |
| 53 | Niraula et al. (84) | • Serum ADA levels (U/L) was significantly raised in Uncontrolled Diabetic patients (49.24 ± 16.89) compared to controlled population (35.74 ± 16.78) and healthy controls (10.55 ± 2.20), p-value < 0.001 • A significant positive correlation was obtained between Serum ADA and HbA1c, Fasting Plasma Glucose and Post-prandial Glucose respectively |
• Serum Adenosine deaminase (ADA) level can also be used as a biomarker in predicting glycemic control in diabetic patients • ADA level also indicates the presence of other diseases • Hospital based comparative cross-sectional study • Convenient sampling |