Nikkhah Amirabbas, Farzi Yosef, Azizpour Yosra, Rezaei Nazila, Mirzad Mina, Shahrestanaki Sahar Keyvanloo, Sharifi Farshad, Akbarpour Samaneh, Tabatabaei-Malazy Ozra, Payab Moloud, Ebrahimpur Mahbube
Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
BMC Public Health. 2025 Aug 5;25(1):2658. doi: 10.1186/s12889-025-23654-8.
Diabetes mellitus (DM) is a significant public health concern, particularly among older adults who face an elevated risk of complications and increased mortality. This study assessed overtime changes in the prevalence, awareness, treatment coverage, and glycemic control of DM in Iranian adults aged 60 and older.
This is a nationwide repeated cross-sectional study based on data from the 2016 and 2021 STEPwise Approach to Non-communicable Disease Risk Factor Surveillance (STEPS), the most recent surveys conducted across all provinces of Iran. We reported prevalence estimates as weighted percentages with 95% confidence intervals (CIs). Logistic regression was used to evaluate the association between selected demographic and health characteristics and diabetes mellitus (DM). All analyses were performed using R statistical software version 4.0.5.
From 2016 to 2021, the prevalence of prediabetes increased from 23.86 to 28.96% in males and from 22.86 to 30.86% in females, while DM prevalence rose from 19.37 to 25.43% in males and from 26.22 to 30.26% in females. In 2016, DM awareness was 74.47% in males and 82.19% in females, and in 2021, it was 71.20% in males and 78.73% in females. Treatment coverage was 60.18% in males and 67.63% in females in 2016, and 63.71% in males and 71.14% in females in 2021. Glycemic control was 59.77% in males and 57.98% in females in 2016, and 55.96% in males and 53.66% in females in 2021. Obesity significantly increased the odds of DM (odds ratio (OR) 1.97, p < 0.001), while being underweight (OR 0.21, p < 0.001) and having sufficient physical activity (OR 0.77, p = 0.02) were protective factors.
The findings from the 2016 and 2021 STEPS surveys indicate a rising burden of prediabetes and DM among older adults in Iran, particularly among females. Although awareness and treatment coverage were high, optimal glycemic control remains a challenge, emphasizing the need to improve access to healthcare resources and develop tailored community-based interventions.
糖尿病（DM）是一个重大的公共卫生问题，在面临并发症风险升高和死亡率增加的老年人中尤为突出。本研究评估了伊朗60岁及以上成年人中糖尿病的患病率、知晓率、治疗覆盖率和血糖控制情况随时间的变化。
这是一项基于2016年和2021年非传染性疾病风险因素监测逐步方法（STEPS）数据的全国性重复横断面研究，这是伊朗所有省份进行的最新调查。我们将患病率估计值报告为加权百分比，并给出95%置信区间（CIs）。使用逻辑回归评估选定的人口统计学和健康特征与糖尿病（DM）之间的关联。所有分析均使用R统计软件版本4.0.5进行。
从2016年到2021年，男性糖尿病前期患病率从23.86%升至28.96%，女性从22.86%升至30.86%，而男性糖尿病患病率从19.37%升至25.43%，女性从26.22%升至30.26%。2016年，男性糖尿病知晓率为74.47%，女性为82.19%；2021年，男性为71.20%，女性为78.73%。2016年治疗覆盖率男性为60.18%，女性为67.63%；2021年男性为63.71%，女性为71.14%。2016年血糖控制情况男性为59.77%，女性为57.98%；2021年男性为55.96%，女性为53.66%。肥胖显著增加患糖尿病的几率（优势比（OR）1.97，p<0.001），而体重过轻（OR 0.21，p<0.001）和有足够的体育活动（OR 0.77，p=0.02）是保护因素。
2016年和2021年STEPS调查结果表明，伊朗老年人中糖尿病前期和糖尿病的负担在增加，尤其是女性。尽管知晓率和治疗覆盖率较高，但最佳血糖控制仍然是一个挑战，这强调了需要改善医疗资源的可及性并制定针对性的社区干预措施。
