Department of Epidemiology, School of Public Health, Iran University of Medical Sciences (IUMS), Tehran, Iran.
National Institute of Health Research (NIHR), Tehran University of Medical Sciences, Tehran (TUMS), No 70, Bozorgmehr St. Vesale Shirazi St., Tehran, Iran.
BMC Public Health. 2022 Jun 18;22(1):1216. doi: 10.1186/s12889-022-13627-6.
Diabetes as a leading cause of death imposes a heavy burden on health systems worldwide. This study investigated the trends in prevalence, awareness, treatment and control of diabetes among Iranian population aged 25 to 65 years over 12 years (2004-2016).
Secondary data analysis was performed using data from a national population-based survey, STEPwise approach to surveillance (STEPS) for non-communicable diseases (NCDs) in four rounds (2004, 2007, 2011, 2016). The sample sizes were 89,404, 29,991, 12,103 and 30,541 individuals, respectively across the country in both rural and urban areas. Data were analyzed using descriptive statistics and a logistic regression model with odds ratio at a significance level of less than 5% with no adjustment for age and sex. Logistic regression was used to identify socio-demographic factors associated with the levels of awareness, treatment and control of diabetes mellitus.
The prevalence of diabetes in four rounds was 8.4, 9, 11.1 and 13.2%, respectively. Among people with diabetes, 53.5, 65.6, 70.5 and 82.2% were aware of their condition and 35.9, 42, 46 and 39.6% were treated for this condition, respectively. In four rounds of study, 14.5, 20.8, 20.4 and 18.5% of all diabetic patients had adequate glycemic control, respectively. In the multivariable logistic regression analysis, there was a significant relationship between female gender, age over 40, living in the urban area, being in the third wealth quintile and having health insurance with diabetes prevalence. Female participants were more likely to be aware of the disease. Older participants were more likely to receive treatment and had adequate glycemic control.
The prevalence of diabetes in Iran has been increasing and despite the great awareness of the disease, receiving treatment and effective control of the disease are suboptimal. While several national policies to improve diabetes screening and care have been passed in recent years, it seems large gaps remain in disease detection and treatment. It is suggested that more attention be paid to the treatment and control of diabetes by NCDs national policies to prevent the growing burden associated with the disease.
糖尿病作为主要死因，给全球卫生系统带来了沉重负担。本研究旨在调查 12 年间（2004-2016 年）伊朗 25-65 岁人群糖尿病的患病率、知晓率、治疗率和控制率趋势。
使用全国性人群为基础的调查（STEPwise 方法监测非传染性疾病（NCDs），简称 STEPS）的数据进行二次数据分析。共纳入 4 轮调查数据，研究人群分别为 89404、29991、12103 和 30541 人，样本覆盖全国城乡地区。采用描述性统计和 logistic 回归模型分析数据，比值比（OR）的显著性水平为 5%，未对年龄和性别进行调整。采用 logistic 回归分析识别与糖尿病知晓率、治疗率和控制率相关的社会人口学因素。
四轮调查中糖尿病的患病率分别为 8.4%、9%、11.1%和 13.2%。在确诊糖尿病的患者中，分别有 53.5%、65.6%、70.5%和 82.2%知晓自身病情，分别有 35.9%、42%、46%和 39.6%接受了治疗。在四轮研究中，分别有 14.5%、20.8%、20.4%和 18.5%的糖尿病患者血糖控制达标。多变量 logistic 回归分析显示，女性、年龄＞40 岁、居住在城区、处于第三财富五分位组和有医疗保险与糖尿病患病率相关。女性患者更有可能知晓自身疾病，年龄较大的患者更有可能接受治疗和血糖控制达标。
伊朗的糖尿病患病率呈上升趋势，尽管患者对疾病的认知度较高，但治疗和有效控制率并不理想。近年来，伊朗通过了多项改善糖尿病筛查和管理的国家政策，但在疾病检出和治疗方面仍存在较大差距。建议国家非传染性疾病政策更加关注糖尿病的治疗和控制，以防止与该疾病相关的负担不断增加。
