Epidemiology of diabetes mellitus, pre-diabetes, undiagnosed and uncontrolled diabetes and its predictors in general population aged 15 to 75 years: A community-based study (KERCADRS) in southeastern Iran;

Background The goal of this research was to measure the age-sex standardized prevalence of pre-diabetes (pre-DM) and diabetes (DM), and the effectiveness of diabetes management (using HbA1C as the indicator) in an urban area in Iran. Methods Using a randomized cluster household survey, we recruited 5900 individuals whose age ranged from 15 to 75 from Kerman for assessing coronary artery disease risk factors (KERCADRS) including diabetes. In 2010 and 2011, all of the participants were interviewed by trained staff for medical history and physical activities, and were then examined for blood pressure and anthropometric measures. Venus blood sample was also collected for fasting plasma glucose and HbA1c. Results The age-sex standardized prevalence of pre-diabetes, diagnosed and undiagnosed was 18.7%, 6.3% and 2.7%, respectively. Diabetes increased by age (from 14.7% in the 15–24 years old group to 28.4% in the 65–75 years old group), particularly after 40 years. Occasional opium users had the highest prevalence of Pre-DM (34.6%). Seventy-nine percent of the depressed and 75.5% of the anxious participants with diagnosed-DM were identified as uncontrolled-DM. More than 60% of diagnosed diabetic cases had impaired HbA1c. Overweight and obesity (adjusted odds ratio (AOR) 1.6) and low physical activity (AOR 1.5) were the most preventable risk factors associated with diabetes. Conclusion Considerable prevalence of diabetes, susceptibility in progressing to diabetes and uncontrolled diabetes among individuals living in Kerman, suggested ineffective prevention and treatment of diabetes in urban areas in Iran. Successful experience regarding primary health-care in rural areas should be expanded to urban settings. 摘要 背景： 这项研究的目的是在伊朗市区调查经过年龄-性别标准化后的糖尿病前期（pre-DM）以及糖尿病（DM）的患病率，并且调查了糖尿病的治疗效果（用HbA1c作指标）。 方法： 使用随机聚类家庭调查法，我们招募了5900名来自克尔曼的受试者，他们的年龄为15至75岁，评估了包括糖尿病在内的冠心病危险因素（Kerman for assessing coronary artery disease risk factors，KERCADRS）。在2010与2011年，所有的参与者都由受过训练的医务人员来接诊，记录他们的医疗史以及体力活动情况，接着进行血压与人体测量学的检查。还要搜集静脉血样用来测定空腹血糖与HbA1c。 结果： 年龄-性别标准化后的糖尿病前期、已诊断的以及未诊断的糖尿病患病率分别为18.7%、6.3%与2.7%。糖尿病患病率随着年龄增长而增加（从15–24岁年龄组的14.7%至65-75岁年龄组的28.4%），特别是40岁以后。偶尔吸食鸦片的人群的Pre-DM患病率最高（34.6%）。在合并已诊断DM的患者中，79%的抑郁症以及75.5%的焦虑症参与者被判定为未控制的DM。60%以上的已诊断糖尿病病例的HbA1c异常。超重与肥胖（校正后的优势比[AOR]为1.6）以及低体力活动（AOR为1.5）是最有可能得到预防的糖尿病相关危险因素。 结论： 生活在克尔曼的人群的糖尿病患病率、容易进展为糖尿病以及未控制的糖尿病患病率相当高，这提示伊朗市区的糖尿病预防与治疗工作效果不佳。应该将农村地区有关初级卫生保健的成功经验扩展到城市环境中。