Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts, USA.
Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Arch Iran Med. 2022 Sep 1;25(9):591-599. doi: 10.34172/aim.2022.94.
Using the WHO STEPwise approach to NCD risk factor surveillance (STEPS), first round of Iran's STEPS completed in 2005. It has been repeated six times afterward. Here we report the results of 2016 round on the population characteristics and prevalence of diabetes and prediabetes, along with an assessment of the country-level performance on diabetes care in Iran.
Using a proportional-to-size cluster random sampling method, the STEPS 2016 included 18947 subjects aged≥25 years who matched the criteria (non-missing information on diabetes self-report, and biomarkers). For the analyses, survey design methods with weighted samples were employed. Different definitions of diabetes (biomarker-based, self-report, anti-diabetes medication use, or a combination) and prediabetes (different cutpoints of the biomarker) were calculated and presented.
An estimated 5171035 persons aged≥25 years or 10.6% (95% CI: 10.0%-11.1%) had diabetes according to the serologic diagnosis of diabetes (FPG≥126 mg/dL) or the use of at least one anti-diabetes medication (1896 out of 18947). Employing the serologic diagnosis of diabetes among those who responded no to the self-reported question, 2.7% (2.5%-3.0%) of the population were not aware of their diabetes compared to 11.5% (10.9%-12.0%) who were diabetics according to the just self-reported question. Defining prediabetes as 100≤FPG<126 mg/dL or 5.7≤HbA1c<6.5%, an estimated 15244299 persons had prediabetes (5885 out of 18947). Overall, 52.1% (49.4%-54.7%) of patients with self-reported diabetes were under strict glycemic control (HbA1c<7%). Poor diabetes control (HbA1c>9%) was found in 18.4% (16.3%-20.6%) of the patients with self-reported diabetes.
Since 2005, the prevalence of diabetes in Iran has been on a gradual increase in both genders with an increasing gap between females and males.
伊朗采用世界卫生组织（WHO）的 STEP 式非传染性疾病危险因素监测方法（STEPS），于 2005 年完成了首轮 STEPS 调查。此后，该调查已重复进行了六次。在此，我们报告 2016 年一轮调查的结果，内容涉及伊朗人口特征、糖尿病和糖尿病前期的流行情况，并评估了该国的糖尿病护理水平。
采用按大小比例分组的随机抽样方法，纳入了年龄≥25 岁且符合条件（糖尿病自我报告和生物标志物检测结果无缺失信息）的 18947 名参与者。对分析采用加权样本的调查设计方法。计算并报告了不同的糖尿病定义（基于生物标志物的诊断、自我报告、使用抗糖尿病药物或以上方法的任意组合）和糖尿病前期（生物标志物不同切点）。
根据血清学诊断（FPG≥126mg/dL）或至少使用一种抗糖尿病药物（18947 人中的 1896 人），估计有 5171035 名年龄≥25 岁的人患有糖尿病，占比为 10.6%（95%CI：10.0%-11.1%）。在对自我报告问题回答为否的人群中采用血清学诊断方法，与根据自我报告问题确诊的 11.5%（10.9%-12.0%）糖尿病患者相比，有 2.7%（2.5%-3.0%）的人群不知道自己患有糖尿病。如果将糖尿病前期定义为 100≤FPG<126mg/dL 或 5.7≤HbA1c<6.5%，则估计有 15244299 人患有糖尿病前期（18947 人中的 5885 人）。总的来说，有自我报告糖尿病的患者中，有 52.1%（49.4%-54.7%）的患者血糖控制严格（HbA1c<7%）。在有自我报告糖尿病的患者中，有 18.4%（16.3%-20.6%）的患者血糖控制不佳（HbA1c>9%）。
自 2005 年以来，伊朗的糖尿病患病率在两性中呈逐渐上升趋势，女性和男性之间的差距不断扩大。
