Diabetes in Iran: Prospective Analysis from First Nationwide Diabetes Report of National Program for Prevention and Control of Diabetes (NPPCD-2016) (original) (raw)

We estimated proportions of different types of diabetes, comorbidities, treatment (the use of oral glucose-lowering agents and insulin), control (hyperglycemia, dyslipidemia and hypertension) and chronic microvascular and macrovascular complications among people with diabetes presenting to the tertiary-care academic diabetes outpatient clinics in Iran. This study is the prospective analysis of data (n = 30,202) from the registry of university-affiliated adult outpatient diabetes clinics in the country during 2015-2016. The proportions of type 1 diabetes, types 2 diabetes, and other types of diabetes were 11.4%, 85.5%, and 1.3%, respectively. The frequencies of drug-naivety, use of oral agents, insulin monotherapy and insulin combination therapy were 2.9%, 60.5%, 11.5%, and 25.1%, respectively. Around 13.2%, 11.9% and 43.3% of patients with diabetes had controlled hyperglycemia, hyperlipidemia and hypertension, respectively. The proportions of retinopathy, nephropathy, peripheral neuropathy, diabetic foot, and ischemic heart disease were 21.9%, 17.6%, 28.0%, 6.2%, and 23.9%, respectively. Despite the wide availability of medications and insulin coverage in Iran, the estimated national control of hyperglycemia, hyperlipidemia and hypertension (especially for young men and old women) remains subpar. The present study further suggests that the frequencies of chronic vascular complications among patients with diabetes are relatively high in Iran. In 2013, at least 382 million adults had diabetes (all types) worldwide 1 , and this number rose to 422 million by 2014 2. The United States (US) witnessed a 4.5% annual growth rate of patients with diabetes during 1998-2008, before the prevalence of diabetes leveled off with no significant change from 2008 to 2012 3. The 2013 International Federation of Diabetes (IDF) Atlas for Diabetes ranked the Middle East and North Africa (MENA) with the highest worldwide prevalence of diabetes at 10.9% 1. The MENA region is projected to have the second highest global growth rate in terms of the number of affected individuals with diabetes, with 96.2% by 2035 1. In Iran, the fourth round of the periodic National Survey of Risk Factors for Non-communicable Diseases project in 2011 (SuRFNCD-2011) estimated the national prevalence of diabetes at 11.4% of the adult population in Iran, showing