Evaluation of the diabetes care cascade and compliance with WHO global coverage targets in Iran based on STEPS survey 2021

Abstract

This study aimed to investigate the diabetes mellitus (DM) and prediabetes epidemiology, care cascade, and compliance with global coverage targets. We recruited the results of the nationally representative Iran STEPS Survey 2021. Diabetes and prediabetes were two main outcomes. Diabetes awareness, treatment coverage, and glycemic control were calculated for all population with diabetes to investigate the care cascade. Four global coverage targets for diabetes developed by the World Health Organization were adopted to assess the DM diagnosis and control status. Among 18,119 participants, the national prevalence of DM and prediabetes were 14.2% (95% confidence interval 13.4–14.9) and 24.8% (23.9–25.7), respectively. The prevalence of DM treatment coverage was 65.0% (62.4–67.7), while the prevalence of good (HbA1C < 7%) glycemic control was 28.0% (25.0–31.0) among all individuals with diabetes. DM diagnosis and statin use statics were close to global targets (73.3% vs 80%, and 50.1% vs 60%); however, good glycemic control and strict blood pressure control statistics, were much way behind the goals (36.7% vs 80%, and 28.5% vs 80%). A major proportion of the Iranian population are affected by DM and prediabetes, and glycemic control is poorly achieved, indicating a sub-optimal care for diabetes and comorbidities like hypertension.

Glycemic control and associated factors among type 2 diabetes mellitus patients: a cross-sectional study of Azar cohort population

“…Consistent with our findings, Babaniamansour et al [ 31 ] also found that 49% of the 562 subjects diagnosed with T2DM exhibited inadequate glycemic control. Recently, based on STEPS survey in Iran, poor glycemic control has been reported in 51.4% of diabetic patients [ 23 ] that was roughly the same as our study. Alzaheb et al conducted a study on adult patients with T2DM in Saudi Arabia and reported a higher prevalence of poor glycemic control compared to the results of our study [ 32 ].…”

“…Moreover, studies on the association of multimorbidity and blood glucose control are very limited; while, the majority of studies examining the correlation between multimorbidity and glycemic control have primarily concentrated on hypoglycemia [ 20 , 21 ]. However, prior research suggests that uncontrolled diabetes, leading to hyperglycemia, remains the primary concern in developing countries [ 22 , 23 ]. Thus, despite the growing prevalence of diabetes and its complications, there is a dearth of data regarding factors associated with glycemic control [ 16 ].…”

Implications of cognitive and daily living capabilities on early type 2 diabetes management: a preliminary case–control study

“…Controls were T2DM patients with the same criteria as above who had an HbA1c measurement equal to or less than 8%, i.e. fairly controlled T2DM [ 15 , 16 ]. Patients were recruited from the Imam-Reza University Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.…”