Nationwide Prevalence of Diabetes and Prediabetes and Associated Risk Factors Among Iranian Adults: Analysis of Data from PERSIAN Cohort Study
Authors
Mohammad E. Khamseh,#1 Sadaf G. Sepanlou,#2 Nahid Hashemi-Madani,1 Farahnaz Joukar,3Amir Houshang Mehrparvar,4 Elnaz Faramarzi,5 Hassan Okati-Aliabad,6 Zahra Rahimi,7 Abbas Rezaianzadeh,8Reza Homayounfar,9 Farhad Moradpour,10 Neda Valizadeh,11 Masoumeh Kheirandish,12 Ehsan Zaboli,13Alireza Moslem,14 Ali Ahmadi,15,16 Behrooz Hamzeh,17 Javad Harooni,18 Farhad Pourfarzi,19Mohammad Reza Abolghasemi,20 Ali Reza Safarpour,21 Nayyereh Aminisani,22 Zahra Mohammadi,23 Sareh Eghtesad,23Hossein Poustchi,
23 and Reza Malekzadeh24
Affiliations
Abstract
Introduction
Over the past decades prevalence of diabetes has increased in Iran and other countries. This study aimed to update the prevalence of diabetes and prediabetes in Iran and to determine associated sociodemographic risk factors, as well as diabetes awareness and control.
Methods
This is a nationally representative cross-sectional survey that included 163,770 Iranian adults aged 35–70 years, from different ethnic backgrounds, between 2014 and 2020. Diabetes was diagnosed at fasting blood sugar of ≥ 6.99 mmol/L (126 mg/dL), or receiving blood glucose-lowering treatment. Multivariable logistic regression was applied to detect determinants associated with prevalence of diabetes and prediabetes, as well as predictors of diabetes awareness and glycemic control.
Results
Sex- and age-standardized prevalence of diabetes and prediabetes was 15.0% (95% CI 12.6–17.3) and 25.4% (18.6–32.1), respectively. Among patients with diabetes, 79.6% (76.2–82.9) were aware of their diabetes. Glycemic control was achieved in 41.2% (37.5–44.8) of patients who received treatment. Older age, obesity, high waist to hip ratio (WHR), and specific ethnic background were associated with a significant risk of diabetes and prediabetes. Higher awareness of diabetes was observed in older patients, married individuals, those with high WHR, and individuals with high wealth score. Moreover, glycemic control was significantly better in women, obese individuals, those with high physical activity, educational attainment, and specific ethnic background.
Conclusions
The prevalence of diabetes and prediabetes is increasing at an alarming rate in Iranian adults. High proportion of uncontrolled patients require particular initiatives to be integrated in the health care system.
