Abstract
BackgroundThe Middle East is estimated to have the largest increase in prevalence of diabetes by 2030; yet there is lack of published data on the incidence of Type 2 diabetes in this region. This study aimed to estimate Type 2 diabetes incidence and its associated risk factors in an Iranian urban population.MethodsAmong 3307 non-diabetics ≥ 20 years (mean age 42 ± 13 years, 42% males), glucose tolerance test was performed at baseline in 1999–2001 and at two consecutive phases in 2001–2005 and 2005–2008. Diabetes and glucose tolerance status were defined according to the ADA 1997 criteria. Logistic regression was used to determine the independent variables associated with incident diabetes and their odds ratios (OR).ResultsAfter median follow-up of 6 years, 237 new cases of diabetes were ascertained corresponding to an age and sex standardized cumulative incidence of 6.4% (95%CI: 5.6–7.2) and incidence rate of 10.6 (9.2–12.1) per 1000 person years. Besides classical diabetes risk factors, female sex and low education level significantly increased risk of diabetes in age adjusted models. In full model, the independent predictors were age [OR, 95%CI: 1.2 (1.1–1.3)], family history of diabetes [1.8 (1.3–2.5)], body mass index ≥ 30 kg/m2 [2.3 (1.5–3.6)], abdominal obesity [1.9 (1.4–2.6)], high triglyceride [1.4 (1.1–1.9)], Isolated impaired fasting glucose (IFG) [7.4 (3.6–15.0)], Isolated impaired glucose tolerance (IGT) [5.9 (4.2–8.4)] and combined IFG and IGT [42.2 (23.8–74.9)].ConclusionMore than 1% of the Iranian urban population older than 20 years develops Type 2 diabetes each year. Combination of IFG and IGT was the strongest predictor of incident diabetes among the modifiable risk factors.
Highlights
The Middle East is estimated to have the largest increase in prevalence of diabetes by 2030; yet there is lack of published data on the incidence of Type 2 diabetes in this region
Comparison of responders and non-responders showed that the formers had higher baseline family history of diabetes, diastolic blood pressure, Body mass index (BMI), waist circumference (WC) and TG
Similar to the results of a recent Australian study [16], we found family history of diabetes to be an independent predictor of Type 2 diabetes in the full model
Summary
The Middle East is estimated to have the largest increase in prevalence of diabetes by 2030; yet there is lack of published data on the incidence of Type 2 diabetes in this region. Type 2 diabetes has reached epidemic levels in most populations and epidemiological evidence suggests that unless effective preventive measures are implemented, the prevalence continue to raise globally [1] It is estimated that by the 2030 the number of people with diabetes will increase to more than 366 million, more than twice the number in 2000 [2] Most of these new cases are from developing countries and it seems that the Middle East is among the regions that will have the largest increase in (page number not for citation purposes). The occurrence of rapid and major lifestyle changes in these countries has increased the prevalence of obesity and other non-communicable disease risk factors (like hypertension and dyslipidemia) which have been reported to be the major etiologic factors behind the rising incidence of type 2 diabetes around the globe [4]. We aimed to determine the incidence of type 2 diabetes and its associated risk factors by using standardized oral glucose tolerance test (OGTT) in a large population based study in a representative sample of the population of Tehran called the Tehran Lipid and Glucose Study (TLGS)
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