The diabetes cascade of care through the 14 years in Iran: findings of nationwide STEPS surveys 2007-2021

Aslan Ameli; Ali Sheikhy; Ozra Tabatabaei-Malazy; Naser Ahmadi; Mahbube Ebrahimpur; Aida Fallahzadeh; Mohammad-Mahdi Rashidi; Ali Golestani; Moein Yoosefi; Yosef Farzi; Arezou Dilmaghani-Marand; Negar Rezaei; Bagher Larijani; Farshad Farzadfar

doi:10.1007/s40200-023-01308-z

The diabetes cascade of care through the 14 years in Iran: findings of nationwide STEPS surveys 2007-2021

J Diabetes Metab Disord. 2023 Sep 28;22(2):1731-1743. doi: 10.1007/s40200-023-01308-z. eCollection 2023 Dec.

Authors

Aslan Ameli^#¹, Ali Sheikhy^#¹, Ozra Tabatabaei-Malazy^#^{1

2}, Naser Ahmadi¹, Mahbube Ebrahimpur³, Aida Fallahzadeh¹, Mohammad-Mahdi Rashidi¹, Ali Golestani¹, Moein Yoosefi^{1

4}, Yosef Farzi¹, Arezou Dilmaghani-Marand¹, Negar Rezaei^#^{1

5}, Bagher Larijani^#², Farshad Farzadfar^{1

2}

Affiliations

¹ Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
² Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
³ Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
⁴ Department of Mathematics and Statistics, Memorial University of Newfoundland, St. John's, NL Canada.
⁵ Digestive Disease Research Center (DDRC), Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran.

^# Contributed equally.

Abstract

Background: Diabetes as the leading cause of mortality and morbidity, have been increased by about 35% from 2011 to 2015 worldwide. The objective of this study was to assess the trend and pattern of diabetes and prediabetes prevalence in Iran and also evaluate the diagnosis and status of diabetes management.

Methods: The results of this study are extracted from the National Stepwise approach to non-communicable disease risk factor surveillance (STEPS), conducted in 2007, 2011, 2016, and 2021 in Iran. We evaluated all obtained data by questionnaires (demographic, epidemiologic, risk-related behavioral data), physical measurements, and laboratory measures.

Results: The prevalence of diabetes almost doubled from 2007 to 2021 among adults 25 years old and above. Diabetes prevalence increased from 10.85% (95% CI:10.30-11.40) in 2016 to 14.15% (13.42-14.87) in 2021. Prediabetes prevalence increased from 18.11% (17.46- 18,76) in 2016 to 24.81% (23.88-25.74) in 2021. Diabetes diagnosis stayed constant hence; diabetes coverage improved from 56.87% (54.21-59.52) to 65.04% (62.40- 67.69). Despite an enhancement in diabetes diagnosis and coverage, diabetes effective care did not improve significantly during 2016 and 2021, with a number of 35.98% (32.60- 39.36) in 2016 and 31.35% (28.20- 34.51) in 2021.

Conclusion: The prevalence of diabetes and prediabetes in Iran is almost doubled during the past 14 years. Although, several health policies had been developed to improve the screening and quality of diabetes care; there are still significant gaps in the effective control of diabetes. Accordingly, the current care plan should be reviewed.

Supplementary information: The online version contains supplementary material available at 10.1007/s40200-023-01308-z.

Keywords: Diabetes; STEPS; Survey study; Trend.

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