Najafipour Hamid, Farjami Maryam, Sanjari Mojgan, Amirzadeh Raheleh, Shadkam Farokhi Mitra, Mirzazadeh Ali
Cardiovascular Research Center, Institute of Basic and Clinical Physiology Sciences, and Department of Physiology and Pharmacology, Kerman University of Medical Sciences, Kerman, Iran.
Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran.
Front Public Health. 2021 Nov 1;9:611652. doi: 10.3389/fpubh.2021.611652. eCollection 2021.
Diabetes mellitus is among the most serious health challenges worldwide. We assessed the prevalence of pre-diabetes (pre-DM) and diabetes (DM), the effectiveness of diabetes management, the 5-year incidence rate, and associated variables in the adult population in southeastern Iran. In a random cluster household survey (2014-2018), 9,959 adult individuals aged 15-80 years were assessed for coronary artery disease risk factors, including diabetes mellitus in Kerman (KERCADRS, phase 2). Among these people, 2,820 persons had also participated in phase 1 of the study 5 years earlier (2009-2011). Univariable and multivariable survey logistic regression models were used to identify the potential predictors of diabetes and pre-diabetes. The prevalence of pre-DM was 12% (males 13.2% vs. females 11.1%), steadily increasing from 7.1% in the 15-24 years group to 18.4% in the 55-64 years group. The prevalence of DM was 10.2% (male and female, 7.9 and 10.8%, respectively), of which 1.9% were undiagnosed. DM was diagnosed in 10.6% of educated and 15.1% of illiterate people. The prevalence of diagnosed DM was lower in smokers (5.2 vs. 8.7%) and dependent opium users (5.4 vs. 8.8%). The prevalence of uncontrolled DM (HbA1c > 7%) was 48.8%, increasing with age. The frequency of uncontrolled DM among people without and with treatment was 32 and 55.9%, respectively. Illiterate people had worse uncontrolled DM (55.6 vs. 39.6%). The 5-year incidence rate (persons/100 person-years) was 1.5 for pre-DM and 1.2 for DM, respectively. The lowest and the highest incidence rate of DM belonged to the 15-34 years old group (0.5) and dependent opium users (2.4). The incidence rate was found to have a direct relationship with BMI and a reverse relationship with physical activity. Pre-DM and DM affected 22.2% of the population. One-third of patients with diabetes had undiagnosed DM, and in 55.9% of people with diagnosed DM, treatment had been ineffective. Appropriate health interventions are needed to reduce the prevalence and health consequences of diabetes in the region.
糖尿病是全球最严峻的健康挑战之一。我们评估了伊朗东南部成年人群中糖尿病前期（pre-DM）和糖尿病（DM）的患病率、糖尿病管理的有效性、5年发病率以及相关变量。在一项随机整群家庭调查（2014 - 2018年）中，对克尔曼（KERCADRS，第2阶段）9959名年龄在15 - 80岁的成年人进行了冠状动脉疾病风险因素评估，包括糖尿病。其中，2820人在5年前（2009 - 2011年）还参与了该研究的第1阶段。采用单变量和多变量调查逻辑回归模型来确定糖尿病和糖尿病前期的潜在预测因素。糖尿病前期的患病率为12%（男性为13.2%，女性为11.1%），从15 - 24岁组的7.1%稳步上升至55 - 64岁组的18.4%。糖尿病的患病率为10.2%（男性和女性分别为7.9%和10.8%），其中1.9%未被诊断出。在受过教育的人群中，糖尿病诊断率为10.6%，在文盲人群中为15.1%。吸烟者（5.2%对8.7%）和阿片类药物依赖者（5.4%对8.8%）中已诊断糖尿病的患病率较低。未控制的糖尿病（糖化血红蛋白>7%）患病率为48.8%，且随年龄增长而增加。未接受治疗和接受治疗人群中未控制糖尿病的发生率分别为32%和55.9%。文盲人群中未控制糖尿病的情况更严重（55.6%对39.6%）。糖尿病前期和糖尿病的5年发病率（每100人年发病数）分别为1.5和1.2。糖尿病发病率最低和最高的分别是15 - 34岁组（0.5）和阿片类药物依赖者（2.4）。发现发病率与体重指数呈正相关，与体力活动呈负相关。糖尿病前期和糖尿病影响了22.2%的人群。三分之一的糖尿病患者未被诊断出患有糖尿病，在55.9%已诊断糖尿病的人群中，治疗无效。需要采取适当的健康干预措施来降低该地区糖尿病的患病率及其对健康的影响。
