Prevalence and Determinants of Diabetes and Prediabetes in Southwestern Iran: The Khuzestan Comprehensive Health Study (KCHS)

Abstract

Background: The 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.Methods: This 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 fasting blood sugar (FBS) ≥ 126 mg/dl and/or taking oral anti-diabetic medications. Prediabetes was defined as FBS ≥ 100 but ≤ 125 mg/dl. Multinomial logistic regression models were used to examine the association of multiple risk factors that attained significance on the outcome.Results: Overall, 30,500 participants were recruited; the mean (±SD) age was 41.6 (±11.9) years. The prevalence of prediabetes and diabetes were 30.8% and 15.2%, respectively. We found a comparable prevalence of diabetes in both sexes, although it was higher among illiterates, urban residents, married people, and smokers. Participants aged ≥ 50 and those with Body Mass Index (BMI) ≥ 30 kg/m2 were more likely to be affected by diabetes [RR: 18.5 (16.4,21.0) and 3.2 (2.9,3.5)]. Hypertension [RR: 5.1 (4.7,5.4)], waist circumference (WC) ≥ 90 cm [RR: 3.6 (3.3,3.9)], and family history [RR: 2.4 (2.2,2.6)] were also significantly associated with diabetes. For prediabetes, the main risk factors were age ≥ 50 [RR: 2.4 (2.3,2.6)], BMI ≥ 30 kg/m2 [RR: 1.9 (1.7 ,2.0)], hypertension and WC ≥ 90 cm [RR: 1.7 (1.6 ,1.8)]. Conclusions: Prediabetes 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.