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Diabetes and Vascular Disease

MON-594 - Burden of Diabetes in Low- and Middle-Income Countries' Prison Populations: A Systematic Review and Meta-Analysis

Monday, June 15, 2026
9:00 AM - 2:00 PM CT
Location: ENDOExpo; Poster Floor


Introduction: Diabetes mellitus (DM) is a global health concern, and poses substantial challenges in resource constrained settings. Incarcerated populations in low- and middle-income countries (LMICs) face significant healthcare risks and limited management accesses, yet are understudied and underrepresented in diabetes prevalence research. To date, no systematic review has synthesized evidence specific to this context.

Objective: To estimate the prevalence of diabetes in the general prisoner population of LMICs.

Methods: We conducted a systematic review and meta-analysis following PRISMA and GATHER guidelines. PubMed, Scopus, Embase, Web of Science and regional databases were searched from inception to May 2025 for studies reporting diabetes prevalence in prisoners of LMICs. Random-effects models with Freeman-Tukey double arcsine transformation were used to pool prevalence estimates in R version (version 4.5.1). Publication bias was assessed using the DOI plot. The Joanna Briggs Institute (JBI) tool was used for assessment of study quality. Certainty of evidence was appraised using an adapted-GRADE approach.

Results: Twenty-three studies, comprising a total of 107,473 participants, were included. Mean participant ages varied from 29 ± 9.6 to 40.5 ± 9.8 years. Pooled diabetes prevalence was 3.7% (95% CI: [2.5%-5.1%], Prediction Interval [0%-12.2%]), with high heterogeneity (I2 = 95.4%). Prevalence was highest in Asia (5.2%), particularly Pakistan (9.8%), and lowest in South America (2.3%). The DOI plot revealed major asymmetry, indicating high possibility of publication bias. Overall certainty of evidence was rated as low for diabetes prevalence due to risk of bias and publication bias.

Conclusion: Diabetes is a substantial but underdiagnosed health concern amongst the incarcerated LMIC population, with high geographic variations. Findings from this review highlight the need for standardized screening, and diabetes management in correctional facilities.

*Unless otherwise noted, all abstracts presented at ENDO must not be released to the press or the public until the date and time of presentation. For oral presentations, the abstracts are embargoed until the session begins. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO.*