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      Nationwide Prevalence of Diabetes and Prediabetes and Associated Risk Factors Among Iranian Adults: Analysis of Data from PERSIAN Cohort Study

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          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.

          Supplementary Information

          The online version contains supplementary material available at 10.1007/s13300-021-01152-5.

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          Most cited references49

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          WITHDRAWN: Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: results from the International Diabetes Federation Diabetes Atlas, 9th edition

          To provide global estimates of diabetes prevalence for 2019 and projections for 2030 and 2045.
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            IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045

            Since the year 2000, IDF has been measuring the prevalence of diabetes nationally, regionally and globally.
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              2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes—2020

              (2019)
              The American Diabetes Association (ADA) "Standards of Medical Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee (https://doi.org/10.2337/dc20-SPPC), a multidisciplinary expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations, please refer to the Standards of Care Introduction (https://doi.org/10.2337/dc20-SINT). Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
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                Author and article information

                Contributors
                h.poustchi@gmail.com
                malek@tums.ac.ir , dr.reza.malekzadeh@gmail.com
                Journal
                Diabetes Ther
                Diabetes Ther
                Diabetes Therapy
                Springer Healthcare (Cheshire )
                1869-6953
                1869-6961
                30 September 2021
                30 September 2021
                November 2021
                : 12
                : 11
                : 2921-2938
                Affiliations
                [1 ]GRID grid.411746.1, ISNI 0000 0004 4911 7066, Endocrine Research Center, Institute of Endocrinology and Metabolism, , Iran University of Medical Sciences (IUMS), ; Tehran, Iran
                [2 ]GRID grid.411705.6, ISNI 0000 0001 0166 0922, Digestive Disease Research Center, Digestive Diseases Research Institute, , Tehran University of Medical Sciences, ; Tehran, Iran
                [3 ]GRID grid.411874.f, ISNI 0000 0004 0571 1549, Gastrointestinal and Liver Diseases Research Center, , Guilan University of Medical Sciences, ; Rasht, Iran
                [4 ]GRID grid.412505.7, ISNI 0000 0004 0612 5912, Industrial Diseases Research Centre, , Shahid Sadoughi University of Medical Sciences, ; Yazd, Iran
                [5 ]GRID grid.412888.f, ISNI 0000 0001 2174 8913, Liver and Gastrointestinal Diseases Research Center, , Tabriz University of Medical Sciences, ; Tabriz, Iran
                [6 ]GRID grid.488433.0, ISNI 0000 0004 0612 8339, Health Promotion Research Center, , Zahedan University of Medical Sciences, ; Zahedan, Iran
                [7 ]GRID grid.411230.5, ISNI 0000 0000 9296 6873, Department of Biostatistics and Epidemiology, Hearing Research Center, School of Public Health, Clinical Sciences Research Institute, , Ahvaz Jundishapur University of Medical Sciences, ; Ahvaz, Iran
                [8 ]GRID grid.412571.4, ISNI 0000 0000 8819 4698, Colorectal Research Center, , Shiraz University of Medical Sciences, ; Shiraz, Iran
                [9 ]GRID grid.411135.3, ISNI 0000 0004 0415 3047, Noncommunicable Diseases Research Center, , Fasa University of Medical Sciences, ; Fasa, Iran
                [10 ]GRID grid.484406.a, ISNI 0000 0004 0417 6812, Social Determinants of Health Research Center, Research Institute for Health Development, , Kurdistan University of Medical Sciences, ; Sanandaj, Iran
                [11 ]GRID grid.412763.5, ISNI 0000 0004 0442 8645, Maternal and Child Obesity Research Center, , Urmia University of Medical Sciences, ; Urmia, Iran
                [12 ]GRID grid.412237.1, ISNI 0000 0004 0385 452X, Endocrinology and Metabolism Research Center, , Hormozgan University of Medical Sciences, ; Bandar Abbas, Iran
                [13 ]GRID grid.411623.3, ISNI 0000 0001 2227 0923, Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, , Mazandaran University of Medical Sciences, ; Sari, Iran
                [14 ]GRID grid.412328.e, ISNI 0000 0004 0610 7204, Non-Communicable Diseases Research Center, , Sabzevar University of Medical Sciences, ; Sabzevar, Iran
                [15 ]GRID grid.440801.9, ISNI 0000 0004 0384 8883, Modeling in Health Research Center, , Shahrekord University of Medical Sciences, ; Shahrekord, Iran
                [16 ]GRID grid.440801.9, ISNI 0000 0004 0384 8883, Epidemiology and Biostatistics Department, School of Health, , Shahrekord University of Medical Sciences, ; Shahrekord, Iran
                [17 ]GRID grid.412112.5, ISNI 0000 0001 2012 5829, Research Center for Environmental Determinants of Health (RCEDH), Health Institute, , Kermanshah University of Medical Sciences, ; Kermanshah, Iran
                [18 ]GRID grid.413020.4, ISNI 0000 0004 0384 8939, Social Determinants of Health Research Center, , Yasuj University of Medical Sciences, ; Yasuj, Iran
                [19 ]GRID grid.411426.4, ISNI 0000 0004 0611 7226, Digestive Disease Research Center, , Ardabil University of Medical Sciences, ; Ardabil, Iran
                [20 ]GRID grid.412653.7, ISNI 0000 0004 0405 6183, Non-Communicable Research Center, Clinical Forensic Medicine and Toxicology Specialist, , Rafsanjan University of Medical Sciences, ; Rafsanjan, Iran
                [21 ]GRID grid.412571.4, ISNI 0000 0000 8819 4698, Gastroenterohepatology Research Center, , Shiraz University of Medical Sciences, ; Shiraz, Iran
                [22 ]GRID grid.502998.f, ISNI 0000 0004 0550 3395, Healthy Ageing Research Centre, , Neyshabur University of Medical Sciences, ; Neyshabur, Iran
                [23 ]GRID grid.411705.6, ISNI 0000 0001 0166 0922, Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, , Tehran University of Medical Sciences, ; Tehran, Iran
                [24 ]GRID grid.411705.6, ISNI 0000 0001 0166 0922, Digestive Oncology Research Center, Digestive Diseases Research Institute, Shariati Hospital, , Tehran University of Medical Sciences, ; N. Karegar Ave, 14117-13014 Tehran, Iran
                Author information
                http://orcid.org/0000-0002-9820-6335
                Article
                1152
                10.1007/s13300-021-01152-5
                8521563
                34595726
                136dbb99-7085-452f-9ea4-ebf8941f2987
                © The Author(s) 2021

                Open Access This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 10 July 2021
                : 7 September 2021
                Funding
                Funded by: Tehran University of Medical Sciences and Health Services
                Award ID: 700/534
                Award Recipient :
                Categories
                Original Research
                Custom metadata
                © The Author(s) 2021

                Endocrinology & Diabetes
                diabetes,glycemic control,awareness,ethnic background,household wealth,education

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