Prevalence of Diabetes and Impaired Fasting Glucose in the Adult Population of Iran

Abstract

OBJECTIVE -Despite concerns regarding a diabetes epidemic in the Middle East, internationally published data on national estimates of prevalent type 2 diabetes in Iran do not exist. With this article, we document a dramatically high prevalence of diabetes in Iran. RESULTS -We found that 7.7% of adults aged 25-64 years, or 2 million adults, have diabetes, among whom one-half are undiagnosed. An additional 16.8%, or 4.4 million, of Iranian adults have impaired fasting glucose. RESEARCH DESIGN AND METHODSCONCLUSIONS -The high prevalence of diabetes in working-age adults is an ominous sign for this developing nation. As the relatively young Iranian population ages in the future and urbanization continues or accelerates, the prevalence of diabetes will likely escalate. Diabetes Care 31:96-98, 2008T he Middle East is expected to bear one of the world's greatest increases in the absolute burden of diabetes in the coming decades. Most of this increase is anticipated to affect the economically productive 45-to 64-year-old age segment in contrast with most developed countries, where the increase in diabetic patients will occur in those aged Ն65 years (1). Although national estimates of the diabetes burden in Iran do not exist, the most recent study reported a high prevalence of diabetes in the highly urbanized population of Tehran, Iran's capital. (2) Here, we report the diabetesrelated results of the national Survey of Risk Factors of Non-Communicable Diseases (SURFNCD) of Iran. As a population-based sample of over 89,000 Iranians, this study provides an opportunity to estimate the national prevalence and burden of impaired fasting glucose (IFG) and diabetes. As such, it provides a valuable basis for public health planning.RESEARCH DESIGN AND METHODS -The first Iran SUR-FNCD, a nationally representative crosssectional health survey, was conducted in January and February 2005 using guidelines of the stepwise approach to noncommunicable disease risk factor surveillance of the World Health Organization (3,4). In brief, a multistage probability cluster sampling scheme was used to randomly sample 89,400 adults aged 15-64 years from the urban and rural noninstitutionalized population of all 28 provinces of Iran.Participants were interviewed and examined to determine demographic characteristics and medical conditions, including history of diabetes. Participants who reported a history of physician-or health care professional-diagnosed diabetes were classified to have known diabetes. Subsequently, all participants aged 25-64 years (70,981 individuals) were asked to attend a health facility or laboratory for collection of blood samples following a 12-h fast. The departments of laboratory and medical diagnoses of each corresponding medical university in the provinces selected the laboratories based on standard instructions. The laboratories measured fasting plasma glucose (FPG) with coefficients of variation Ͻ3%. Of the 89,440 respondents, 18,459 individuals were aged Ͻ25 years, and of the remaining 70,981 individuals, 53,508 (75.4...

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