Fasting Hyperglycaemia and Diabetes-Related Risk Factors Among Schoolchildren in Kumasi, Ghana: A Community-Based Cross-Sectional Study

Abstract Background: Childhood dysglycaemia is an emerging public health concern, particularly in settings undergoing nutritional and lifestyle transitions. However, data on fasting hyperglycaemia and its associated factors among school-aged children in Ghana remain limited. This study assessed fasting glycaemic status and examined selected demographic, anthropometric, dietary, and familial factors associated with hyperglycaemia among pupils in a primary school in Kumasi, Ghana. Methods: A school-based cross-sectional study was conducted in June 2021 among 141 pupils aged 9–14 years at Kotei R/C Basic School in Kumasi, Ghana. Sociodemographic characteristics, family history, diabetes knowledge, and dietary practices were obtained using a structured questionnaire. Weight, height, and mid-upper arm circumference were measured, and body mass index-for-age was classified using WHO growth reference standards. Fasting capillary blood glucose was measured using a OneTouch Ultra 2 glucometer. Hyperglycaemia was operationalized as a mean fasting glucose concentration ≥5.6 mmol/L. Descriptive statistics were used to summarize participant characteristics, while associations with hyperglycaemia were examined using logistic regression. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were reported. Results: The mean age of participants was 10.6 ± 1.3 years, and 82 (58.2%) were female. Mean BMI was 16.8 ± 2.0 kg/m², while mean fasting blood glucose was 5.08 ± 0.69 mmol/L. Overall, 106 (75.2%) participants were classified as normoglycaemic, 32 (22.7%) as having hyperglycaemia, and 3 (2.1%) as hypoglycaemic. According to WHO BMI-for-age classification, 111 (78.7%) participants had normal weight, 10 (7.1%) were underweight, and 20 (14.2%) were overweight/obese. In multivariable analysis, age (aOR 1.14, 95% CI 0.82–1.56), male sex (aOR 1.68, 95% CI 0.74–3.83), BMI (aOR 0.89, 95% CI 0.71–1.10), family history of diabetes (aOR 0.87, 95% CI 0.18–3.10), and rare fruit and vegetable intake (aOR 0.61, 95% CI 0.25–1.56) were not significantly associated with hyperglycaemia. The model demonstrated acceptable calibration (Hosmer–Lemeshow p=0.688) but limited discrimination (AUC=0.609). Conclusion: A substantial proportion of pupils had fasting glucose concentrations meeting the study's screening definition of hyperglycaemia, despite most participants having normal BMI-for-age. No examined demographic, anthropometric, familial, or dietary factor was significantly associated with hyperglycaemia. These findings highlight the need for improved surveillance of childhood dysglycaemia and further investigation using larger, multi-school studies with standardized laboratory-based glucose assessment and longitudinal follow-up. The observed hyperglycaemia should be interpreted as a screening finding rather than a clinical diagnosis of diabetes.