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The levels and trends of diabetes prevalence at national and sub-national levels in Iran (1990 – 2016)

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Abstract

Background

The increasing trends in Diabetes prevalence and its attributed burden emphasized as an important issue that needs serious and urgent attention, all over the word. We estimated the mean Fasting Plasma Glucose (FPG) and the prevalence of Diabetes in aged 25 years or older Iranian adults, by sex, age, province, and year through the time period of 1990 to 2016.

Methods

In order to access the most comprehensive relevant data at the same time the systematic data searched added to the data of 5 national surveys and 7 sub-national population based investigations. Two round of modeling, including the Age-Spatio-Temporal and Gaussian Process Regression were used for estimation of mean FPG trend and uncertainties. To estimate Diabetes estimations in target groups, a crosswalk model was applies to the FPG estimates. The model reiterated separately for women and men. All of estimations standardized based on the Iran national census population of 2016 by year, age groups and sexes at national and sub-national levels.

Results

In 2016, the number of the diabetic population was 4.43 (3.93–4.99) million (2.38 million women). Between 1990 and 2016, the age-standardized mean of FPG increased from 84.69 mg/dl (79.8–89.8) to 100.5 mg/dl (97.9–103.3) in women and from 82.7 mg/dl (78.3–87.5) to 98.8 mg/dl (96.2–101.4) in men. Simultaneously, with considerable difference, the Diabetes prevalence, has increased from 6.1% (4.7–7.8) to 9.8% (8.7–11.1) in women and from 5.0% 18 (3.8–6.3) to 8.1% (7.2–9.2) in men (75% attributed to population growth). Considering the geographical patterns, the greatest increment in the prevalence of Diabetes detected in the northwestern and the central provinces.

Conclusion

Significant increasing trends of Diabetes led to alarming threat, which can make the strategies and goals of our prevention programs out of control. We should plan for more effective communicative interventions for prevention and management of Diabetes, to be designed, implemented and monitored based on the updated scientific evidence.

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Data availability

The authors confirm that the data supporting the findings of this study are available within the article and its supplementary document.

References

  1. Worldwide trends in Diabetes since 1980: a pooled analysis of 751 population-based studies with 4.4 million participants. Lancet (London, England) 2016;387(10027):1513–30.

  2. Danaei G, Finucane MM, Lu Y, et al. National, regional, and global trends in fasting plasma glucose and Diabetes prevalence since 1980: systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2.7 million participants. Lancet (London, England) 2011;378(9785):31–40.

  3. Global Action Plan for the Prevention and Control of NCDs 2013–2020. Available in https://www.who.int/nmh/events/ncd_action_plan/en/. Accessed 15 Jan 2023.

  4. Sustainable Development Goal 3 Ensure healthy lives and promote well-being for all at all ages Available in https://sustainabledevelopment.un.org/sdg3. Accessed 10 Jan 2023.

  5. Bommer C, Sagalova V, Heesemann E, et al. Global Economic Burden of Diabetes in Adults: Projections 326 From 2015 to 2030. Diabetes Care. 2018;41(5):963–70.

    Article  PubMed  Google Scholar 

  6. Global Burden of Diseases, GBD compare. Available in https://vizhub.healthdata.org/gbd-compare/. Accessed 15 Jan 2023.

  7. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2015: a systematic analysis for the Global Burden of 342 Disease Study 2015. Lancet (London, England). 2016;388(10053):1659–724.

  8. NCD Risk Factor Collaboration (NCD-RisC), Diabetes. Available in http://ncdrisc.org/data-visualisations-Diabetes.html. Accessed 20 Dec 2022.

  9. Koon AD, Rao KD, Tran NT, Ghaffar A. Embedding health policy and systems research into decision- making processes in low- and middle-income countries. Health Res Policy Syst. 2013;11:30.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Esteghamati A, Etemad K, Koohpayehzadeh J, et al. Trends in the prevalence of Diabetes and impaired fasting glucose in association with obesity in Iran: 2005–2011. Diabetes Res Clin Pract. 2014;333 103(2):319–27.

  11. Naghavi M, Abolhassani F, Pourmalek F, et al. The burden of disease and injury in Iran 2003. Popul Health Metrics. 2009;7:9.

    Article  Google Scholar 

  12. American Diabetes Association. Diabetes Care. 2017;40(Supplement 1):S11-S24.

  13. Peykari N, Sepanlou SG, Djalalinia S, et al. National and sub-national prevalence, trend, and burden of metabolic risk factors (MRFs) in Iran: 1990 - 2013, study protocol. Arch Iran Med. 2014;17(1):54-339 61.

  14. Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19.2 million participants. Lancet (London, England). 2016;345 387(10026):1377–96.

  15. Palermo A, Maggi D, Maurizi AR, Pozzilli P, Buzzetti R. Prevention of type 2 Diabetes mellitus: is it feasible? Diabetes Metab Res Rev. 2014;30(Suppl 1):4–12.

    Article  PubMed  Google Scholar 

  16. Yazdanpanah L, Shahbazian HB, Moravej Aleali A, Jahanshahi A, Ghanbari S, Latifi SM. Prevalence, awareness and risk factors of Diabetes in Ahvaz (South West of Iran). Diabetes Metab Syndrome. 2016;10(2 350 Suppl 1):S114–8.

  17. Katibeh M, Hosseini S, Soleimanizad R, et al. Prevalence and risk factors of Diabetes mellitus in a central district in Islamic Republic of Iran: a population-based study on adults aged 40–80 years. East Mediterr Health J. 2015;21(6):412–9.

  18. Rashedi V, Asadi-Lari M, Delbari A, Fadayevatan R, Borhaninejad V, Foroughan M. Prevalence of Diabetes type 2 in older adults: Findings from a large population-based survey in Tehran, Iran (Urban HEART-2). Diabetes Metab Syndrome. 2017;11(Suppl 1):S347–50.

    Article  Google Scholar 

  19. Peykari N, Saeedi MS, Djalalinia S, et al. High Fasting Plasma Glucose Mortality Effect: A Comparative Risk Assessment in 25–64 Years Old Iranian Population. Int J Prev Med. 2016;7:75.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Djalalinia S, Moghaddam SS, Peykari N, et al. Mortality Attributable to Excess Body Mass Index in Iran: Implementation of the Comparative Risk Assessment Methodology. Int J Prev Med. 2015;6:107.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Peykari N, Djalalinia S, Qorbani M, Sobhani S, Farzadfar F, Larijani B. Socioeconomic inequalities and Diabetes: A systematic review from Iran. J Diabetes Metab Disord. 2015;14:8.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: a systematic analysis from the Global Burden of Disease Study 2016. Lancet (London, England). 2018;391(10136):2236–71.

  23. Peykari N, Hashemi H, Asghari G, et al. Scientometric Study on Non-communicable Diseases in Iran: A Review Article. Iran J Public Health. 2018;47(7):936–43.

    PubMed  PubMed Central  Google Scholar 

  24. Peykari N, Hashemi H, Dinarvand R, et al. National action plan for non-communicable diseases prevention and control in Iran; a response to emerging epidemic. J Diabetes Metab Disord. 2017;16:3.

    Article  PubMed  PubMed Central  Google Scholar 

  25. The General Assembly United Nations. Political declaration of the high-level meeting of the general assembly on the prevention and control of non-communicable diseases. New York: United Nations; 2011.

  26. Lindstrom J, Ilanne-Parikka P, Peltonen M, et al. Sustained reduction in the incidence of type 2 Diabetes by lifestyle intervention: follow-up of the Finnish Diabetes Prevention Study. Lancet (London, England). 2006;378 368(9548):1673–9.

  27. Sussman JB, Kent DM, Nelson JP, Hayward RA. Improving Diabetes prevention with benefit based tailored treatment: risk based reanalysis of Diabetes Prevention Program. BMJ (Clin Res ed). 2015;350(381):h454.

    Google Scholar 

  28. Asante E. Interventions to promote treatment adherence in type 2 Diabetes mellitus. Br J Community Nurs. 2013;18(6):267–74.

    Article  PubMed  Google Scholar 

  29. Farzadfar F, Murray CJ, Gakidou E, et al. Effectiveness of Diabetes and hypertension management by rural primary health-care workers (Behvarz workers) in Iran: a nationally representative observational study. 386 Lancet (London, England). 2012;379(9810):47–54.

  30. Qorbani M, Farzadfar F, Majdzadeh R, Mohammad K, Motevalian A. Technical efficiency of rural primary health care system for Diabetes treatment in Iran: a stochastic frontier analysis. J Diabetes Metab Disord. 2017;16:33.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Cleveringa FG, Gorter KJ, van den Donk M, van Gijsel J, Rutten GE. Computerized decision support systems in primary care for type 2 Diabetes patients only improve patients’ outcomes when combined with feedback on performance and case management: a systematic review. Diabetes Technol Ther. 2013;15(2):180–92.

    Article  PubMed  Google Scholar 

  32. BEST BUYS’ And other recommend intervention for the prevention and control of noncommunicable diseases, the updated Appendix 3 of the WHO Global NCD Action Plan 2013–2020.http://apps.who.int/gb/ebwha/pdf_files/WHA70/A70_R11-en.pdf.

Download references

Acknowledgements

This study has been sponsored by Iran’s Ministry of Health and Medical Education and the National Institute for Health Research. The authors would like to express their appreciation for the collaboration of the Deputy for Health and Deputy for Research and Technology of the Ministry of Health and Medical Education. We also thank for cooperation of all of participants who made this experience possible. Research reported in this publication was supported by NIMAD Grant No. 973048 from the National Institutes for Medical Research Development (NIMAD), Tehran, Iran.

NASBOD Risk Collaborating Group: Fereydoun Azizi (Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran) Majid Ghayour-Mobarhan (Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran), Davood Khalili (Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran) Masoud Khoshnia (Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran) Jalil Kouhpayehzadeh (Center for Educational Research in Medical Sciences (CERMS), Iran University of Medical Sciences, Tehran, Iran), Reza Malekzadeh (Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran), Shahin Merat (Liver and Pancreaticobiliary Disease Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran) Ali Mirzazadeh (Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, United States) Kazem Mohammad (Department of Biostatistics and Epidemiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran) Noushin Mohammadifard (Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran) Iraj Nabipour (The Persian Gulf Marine Biotechnology Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran) Mahboubeh Parsaeian (Department of Biostatistics and Epidemiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran) Akram Pourshams (Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran) Hossein Poustchi (Liver and Pancreaticobiliary Disease Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran) Nizal Sarrafzadegan (Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran)

Funding

The funder had no role in the development and running the study or interpretation of results. As the corresponding author, FF had full access to the data in the study and had the final responsibility to decide whether or not to submit the resultant article for publication.

Author information

Authors and Affiliations

  1. Deputy for Education, Ministry of Health and Medical Education, Tehran, Iran

    Niloofar Peykari

  2. Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Second Floor, No.10, Jalal Al-E-Ahmad Highway, Tehran, Iran

    Parinaz Mehdipour, Shirin Djalalinia & Farshad Farzadfar

  3. Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran

    Bagher Larijani & Farshad Farzadfar

  4. Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran

    Sadaf G. Sepanlou & Reza Malekzadeh

  5. Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran

    Shirin Djalalinia

  6. Hematology, Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran

    Amir Kasaeian

  7. Department of Biostatistics and Epidemiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

    Mahboubeh Parsaeian

  8. School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Australia

    Alireza Ahmadvand

  9. Deputy for Public Health, Ministry of Health and Medical Education, Tehran, Iran

    Ardeshir Khosravi

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  1. Niloofar Peykari
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Contributions

Paper Design: FF, NP, SD, PM, and SGS.

Systematic review: NP, SD, FF.

Data gathering and data refinement: NP, AK, PM, SD, AA, and FF.

Data analysis: FF, PM. NP.

Drafting the paper: NP, PM, SD, FF.

The remaining co-authors participated in revising the manuscript. All co– authors had contribution and participated in the revision of the manuscript.

Corresponding author

Correspondence to Farshad Farzadfar.

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Ethical Statement

Study approved by institutional research board committee of Iran Ministry of Health and Medical Education (MoHME) (Code: IR.NIMAD.REC.1397.513).

Competing Interests

The authors declare that they have no competing interests.

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Peykari, N., Mehdipour, P., Larijani, B. et al. The levels and trends of diabetes prevalence at national and sub-national levels in Iran (1990 – 2016). J Diabetes Metab Disord 22, 743–752 (2023). https://doi.org/10.1007/s40200-023-01197-2

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