Abstract
BackgroundThe Middle East and North Africa (MENA) is postulated to have the highest increase in the prevalence of diabetes by 2030; however, studies on the epidemiology of diabetes are rather limited across the region, including in Iran.MethodsThis study was conducted between 2016 and 2018 among Iranian adults aged 20 to 65 years residing in Khuzestan province, southwestern Iran. Diabetes was defined as the fasting blood glucose (FBG) level of 126 mg/dl or higher, and/or taking antidiabetic medications, and/or self-declared diabetes. Prediabetes was defined as FBG 100 to 125 mg/dl. Multinomial logistic regression models were used to examine the association of multiple risk factors that attained significance on the outcome.ResultsOverall, 30,498 participants were recruited; the mean (±SD) age was 41.6 (±11.9) years. The prevalence of prediabetes and diabetes were 30.8 and 15.3%, respectively. We found a similar prevalence of diabetes in both sexes, although it was higher among illiterates, urban residents, married people, and smokers. Participants aged 50–65 and those with Body Mass Index (BMI) 30 kg/m2 or higher were more likely to be affected by diabetes [RR: 20.5 (18.1,23.3) and 3.2 (3.0,3.6)]. Hypertension [RR: 5.1 (4.7,5.5)], waist circumference (WC) equal or more than 90 cm [RR: 3.6 (3.3,3.9)], and family history [RR: 2.3 (2.2,2.5)] were also significantly associated with diabetes. For prediabetes, the main risk factors were age 50 to 65 years [RR: 2.6 (2.4,2.8)], BMI 30 kg/m2 or higher [RR: 1.9 (1.8,2.0)], hypertension and WC of 90 cm or higher [RR: 1.7 (1.6,1.8)]. The adjusted relative risks for all variables were higher in females than males, with the exception of family history for both conditions and waist circumference for prediabetes.ConclusionsPrediabetes and diabetes are prevalent in southwestern Iran. The major determinants are older age, obesity, and the presence of hypertension. Further interventions are required to escalate diabetes prevention and diagnosis in high-risk areas across Iran.
Highlights
The Middle East and North Africa (MENA) is postulated to have the highest increase in the prevalence of diabetes by 2030; studies on the epidemiology of diabetes are rather limited across the region, including in Iran
We found a similar prevalence of diabetes in both sexes, it was higher among illiterates, urban residents, married people, and smokers
Participants aged 50– 65 and those with Body Mass Index (BMI) 30 kg/m2 or higher were more likely to be affected by diabetes [relative risks (RR): 20.5 (18.1,23.3) and 3.2 (3.0,3.6)]
Summary
The Middle East and North Africa (MENA) is postulated to have the highest increase in the prevalence of diabetes by 2030; studies on the epidemiology of diabetes are rather limited across the region, including in Iran. The Middle East and North Africa (MENA) region holds the highest prevalence of diabetes mellitus (DM) worldwide, and is estimated to have the most significant increase in diabetes prevalence in the coming years [1]. There are limited population-based studies on the epidemiology and determinants of diabetes in MENA countries, including Iran [2]. The MENA region is estimated to have an over 95% increase in the number of people with diabetes by 2035 [4]. Identifying the main traditional and non-traditional diabetes risk factors is crucial for developing preventive strategies and early diagnosis in such countries [2]
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