Hamid NAJAFIPOUR,1 Mojgan SANJARI,1,2 Mostafa SHOKOOHI,3 Ali-Akbar HAGHDOOST,3
Mehdi AFSHARI,3 Mitra SHADKAM,1 Koorosh ETEMAD4 and Ali MIRZAZADE1,5


Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran

1Physiology Research Center, Institute of Neuropharmacology,

2Department of Endocrinology, Afzalipour Hospital,

3Research Center for Modeling in Health, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman,

4Center for Non-Communicable Diseases, Ministry of Health and Medical Education, Tehran, Iran,

5Institute for Health Policy Studies, University of California, San Francisco, CA, USA


Background: The goal of this research was to measure the age-sex standardized prevalence of pre-diabetes (pre-DM) and diabetes (DM), and the effectiveness of diabetes management (using HbA1C as the indicator) in an urban
area in Iran.
Methods: Using a randomized cluster household survey, we recruited 5900
individuals whose age ranged from 15 to 75 from Kerman for assessing
coronary artery disease risk factors (KERCADRS) including diabetes. In
2010 and 2011, all of the participants were interviewed by trained staff for
medical history and physical activities, and were then examined for blood
pressure and anthropometric measures. Venus blood sample was also collected for fasting plasma glucose and HbA1c.
Results: The age-sex standardized prevalence of pre-diabetes, diagnosed and
undiagnosed was 18.7%, 6.3% and 2.7%, respectively. Diabetes increased by
age (from 14.7% in the 15–24 years old group to 28.4% in the 65–75 years old
group), particularly after 40 years. Occasional opium users had the highest
prevalence of Pre-DM (34.6%). Seventy-nine percent of the depressed and
75.5% of the anxious participants with diagnosed-DM were identified as
uncontrolled-DM. More than 60% of diagnosed diabetic cases had impaired
HbA1c. Overweight and obesity (adjusted odds ratio (AOR) 1.6) and low
physical activity (AOR 1.5) were the most preventable risk factors associated
with diabetes.
Conclusion: Considerable prevalence of diabetes, susceptibility in progressing to diabetes and uncontrolled diabetes among individuals living in
Kerman, suggested ineffective prevention and treatment of diabetes in urban
areas in Iran. Successful experience regarding primary health-care in rural
areas should be expanded to urban settings.
Keywords: diabetes mellitus, diabetes treatment, HbA1c, Iran, pre-diabetes,
uncontrolled diabetes, undiagnosed diabetes