• Vol. 36 No. 3, 175–180
  • 15 March 2007

Diabetes and Associated Cardiovascular Risk Factors in Iran: The Isfahan Healthy Heart Programme

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ABSTRACT

Introduction: Diabetes mellitus (DM) is one of the major health problems worldwide. The aim of this study was to detect the prevalence of DM and its associated risk factors in Iran. Materials and Methods: This cross-sectional study was performed in 3 cities in the central part of Iran on participants over the age of 19 years. Sampling was conducted by multi-stage randomised cluster method. Initially, a questionnaire consisting of demographic information, drug intake and smoking status was filled out. Later, a physical examination was performed, including the measurement of systolic blood pressure (SBP) and diastolic blood pressure (DBP), body mass index (BMI) and waist-to-hip ratio (WHR). Fasting blood sample was drawn and analysed for sugar, total cholesterol (TC), triglyceride (TG) and 2-hour postprandial glucose. A fasting blood sugar (FBS) of >126 mg/dL or a 2-hour plasma glucose of over 200 mg/dL was considered an indication of diabetes. The impaired glucose tolerance test (IGTT) was defined with 2-hour plasma glucose of 140 to 200 mg/dL and FBS <126 mg/dL. The collected data were analysed with Student’s t-test, chi-square test and multiple logistic regression analysis. Results: This study was performed on 12,514 subjects (48.9% males and 51.1% females). The total prevalence of DM was 6.7% and 5.3% in urban and rural areas and 5.4% and 7.1% in males and females, respectively. The mean blood glucose rose with age in both sexes, and blood glucose was higher in females and in urban areas. IGTT, known and new DM heightens as age increased and more than half of the diabetes cases in all age groups were newly diagnosed. The mean blood pressure, age, BMI, waist circumference and serum lipids were higher in people with DM and IGTT especially in females. Obesity, a family history of DM, high blood pressure, high WHR and ageing were associated with a higher probability of DM, but sex had no effect on this probability. Discussion and Conclusion: Considering the high prevalence of DM in the central regions of Iran, providing vast educational programme to prevent this disease is essential and screening FBS tests, especially for obese subjects and those with a family history of DM, should be taken into account.


The incidence and prevalence of diabetes mellitus (DM) worldwide is increasing, due almost exclusively to an increase in non-insulin-dependent (type 2) DM, which represents more than 90% of all cases of diabetes.1 Presently, there is a global pandemic of type 2 DM and its clinical sequelae. The World Health Organization (WHO) estimates that there will be 300 million people with diabetes worldwide by the year 2025, which is more than twice the estimated prevalence reported in 1995.2 These figures are most likely a gross underestimation of the problem, given that as many as half of affected patients remain undiagnosed.3 Historically, type 2 diabetes has been a public health problem principally in developed countries due to its close association with the “Western” lifestyle, though the greatest anticipated threat of diabetes over the next several decades belongs to developing countries.2 Modernisation has resulted in increased rates of diabetes, primarily because of a decrease in physical activity, an increasing prevalence of obesity, and an increasing consumption of high-caloric diets in these nations.4 In addition, increases in life expectancy will most likely translate into an increasing prevalence of DM in developing countries. DM is strongly associated with cardiovascular disease (CVD) risk, which is the primary cause of morbidity and mortality among patients with diabetes, accounting for more than 80% of deaths in this population.5

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