Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2008

Open Access 01-12-2008 | Research article

High prevalence of undiagnosed diabetes and abnormal glucose tolerance in the Iranian urban population: Tehran Lipid and Glucose Study

Authors: Farzad Hadaegh, Mohammad Reza Bozorgmanesh, Asghar Ghasemi, Hadi Harati, Navid Saadat, Fereidoun Azizi

Published in: BMC Public Health | Issue 1/2008

Login to get access

Abstract

Background

To estimate the prevalence of diagnosed and undiagnosed diabetes mellitus, impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and combined IFG/IGT in a large urban Iranian population aged ≥ 20 years.

Methods

The study population included 9,489 participants of the Tehran Lipid and Glucose Study with full relevant clinical data. Age-standardized prevalence of diabetes and glucose intolerance categories were reported according to the 2003 American Diabetes Association definitions. Age-adjusted logistic regression models were used to estimate the numbers needed to screen (NNTS) to find one person with undiagnosed diabetes.

Results

The prevalence of diagnosed and undiagnosed diabetes, isolated IFG, isolated IGT, and combined IFG/IGT were 8.1%, 5.1%, 8.7%, 5.4% and 4.0% in men and 10%, 4.7%, 6.3%, 7.6%, and 4.5% in women respectively. Participants with undiagnosed diabetes had higher age, body mass index (BMI), waist circumference, systolic and diastolic blood pressures, triglycerides (all p values <0.001) and lower HDL-cholesterol (only in women, p < 0.01) compared to normoglycemic subjects. Undiagnosed diabetes was associated with family history of diabetes, increased BMI (≥ 25 kg/m2), abdominal obesity, hypertriglyceridemia, hypertension and low HDL-cholesterol levels. Among men, a combination of increased BMI, hypertension, and family history of diabetes led to a NNTS of 1.6 (95% CI: 1.57–1.71) and among women a combination of family history of diabetes and abdominal obesity, yielded a NNTS of 2.2 (95% CI: 2.1–2.4).

Conclusion

In conclusion, about one third of Tehranian adults had disturbed glucose tolerance or diabetes. One- third of total cases with diabetes were undiagnosed. Screening individuals with BMI ≥ 25 kg/m2 (men), hypertension (men), abdominal obesity (women) and family history of diabetes may be more efficient.
Literature
1.
Wild S, Roglic G, Green A, Sicree R, King H: Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes care. 2004, 27 (5): 1047-1053. 10.2337/diacare.27.5.1047.CrossRefPubMed
2.
Franse LV, Di Bari M, Shorr RI, Resnick HE, van Eijk JT, Bauer DC, Newman AB, Pahor M: Type 2 diabetes in older well-functioning people: who is undiagnosed? Data from the Health, Aging, and Body Composition study. Diabetes care. 2001, 24 (12): 2065-2070. 10.2337/diacare.24.12.2065.CrossRefPubMed
3.
Harris MI, Flegal KM, Cowie CC, Eberhardt MS, Goldstein DE, Little RR, Wiedmeyer HM, Byrd-Holt DD: Prevalence of diabetes, impaired fasting glucose, and impaired glucose tolerance in U.S. adults. The Third National Health and Nutrition Examination Survey, 1988-1994. Diabetes care. 1998, 21 (4): 518-524. 10.2337/diacare.21.4.518.CrossRefPubMed
4.
Wilson PW, Cupples LA, Kannel WB: Is hyperglycemia associated with cardiovascular disease? The Framingham Study. Am Heart J. 1991, 121 (2 Pt 1): 586-590. 10.1016/0002-8703(91)90729-2.CrossRefPubMed
5.
Haffner SM, Lehto S, Ronnemaa T, Pyorala K, Laakso M: Mortality from coronary heart disease in subjects with type 2 diabetes and in nondiabetic subjects with and without prior myocardial infarction. N Engl J Med. 1998, 339 (4): 229-234. 10.1056/NEJM199807233390404.CrossRefPubMed
6.
Unwin N, Shaw J, Zimmet P, Alberti KG: Impaired glucose tolerance and impaired fasting glycaemia: the current status on definition and intervention. Diabet Med. 2002, 19 (9): 708-723. 10.1046/j.1464-5491.2002.00835.x.CrossRefPubMed
7.
Lawrence JM, Bennett P, Young A, Robinson AM: Screening for diabetes in general practice: cross sectional population study. Bmj. 2001, 323 (7312): 548-551. 10.1136/bmj.323.7312.548.CrossRefPubMedPubMedCentral
8.
Amini M, Afshin-Nia F, Bashardoost N, Aminorroaya A, Shahparian M, Kazemi M: Prevalence and risk factors of diabetes mellitus in the Isfahan city population (aged 40 or over) in 1993. Diabetes Res Clin Pract. 1997, 38 (3): 185-190. 10.1016/S0168-8227(97)00099-5.CrossRefPubMed
9.
Esteghamati A, Gouya MM, Abbasi M, Delavari A, Alikhani S, Alaedini F, Safaie A, Forouzanfar M, Gregg EW: Prevalence of diabetes and impaired fasting glucose in the adult population of Iran: National Survey of Risk Factors for Non-Communicable Diseases of Iran. Diabetes care. 2008, 31 (1): 96-98. 10.2337/dc07-0959.CrossRefPubMed
10.
Azizi F, Rahmani M, Emami H, Mirmiran P, Hajipour R, Madjid M, Ghanbili J, Ghanbarian A, Mehrabi Y, Saadat N, Salehi P, Mortazavi N, Heydarian P, Sarbazi N, Allahverdian S, Saadati N, Ainy E, Moeini S: Cardiovascular risk factors in an Iranian urban population: Tehran lipid and glucose study (phase 1). Soz Praventivmed. 2002, 47 (6): 408-426.CrossRefPubMed
11.
Standards of medical care in diabetes--2007. Diabetes care. 2007, 30 Suppl 1: S4-S41.
12.
Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). Jama. 2001, 285 (19): 2486-2497. 10.1001/jama.285.19.2486.
13.
Genuth S, Alberti KG, Bennett P, Buse J, Defronzo R, Kahn R, Kitzmiller J, Knowler WC, Lebovitz H, Lernmark A, Nathan D, Palmer J, Rizza R, Saudek C, Shaw J, Steffes M, Stern M, Tuomilehto J, Zimmet P: Follow-up report on the diagnosis of diabetes mellitus. Diabetes care. 2003, 26 (11): 3160-3167. 10.2337/diacare.26.11.3160.CrossRefPubMed
14.
Ahmad OB, Boschi-Pinto C, Lopez AD, Murray CJL, Lozano R, Inoue M: Age standardization of rates: a new WHO standard. Global Programme on Evidence for Health Policy Discussion Paper Series. 2002
15.
Rathmann W, Haastert B, Icks A, Lowel H, Meisinger C, Holle R, Giani G: High prevalence of undiagnosed diabetes mellitus in Southern Germany: target populations for efficient screening. The KORA survey 2000. Diabetologia. 2003, 46 (2): 182-189.PubMed
16.
King H, Aubert RE, Herman WH: Global burden of diabetes, 1995-2025: prevalence, numerical estimates, and projections. Diabetes care. 1998, 21 (9): 1414-1431. 10.2337/diacare.21.9.1414.CrossRefPubMed
17.
Al-Lawati JA, Al Riyami AM, Mohammed AJ, Jousilahti P: Increasing prevalence of diabetes mellitus in Oman. Diabet Med. 2002, 19 (11): 954-957. 10.1046/j.1464-5491.2002.00818.x.CrossRefPubMed
18.
Gokcel A, Ozsahin AK, Sezgin N, Karakose H, Ertorer ME, Akbaba M, Baklaci N, Sengul A, Guvener N: High prevalence of diabetes in Adana, a southern province of Turkey. Diabetes care. 2003, 26 (11): 3031-3034. 10.2337/diacare.26.11.3031.CrossRefPubMed
19.
Mohan V, Deepa M, Deepa R, Shanthirani CS, Farooq S, Ganesan A, Datta M: Secular trends in the prevalence of diabetes and impaired glucose tolerance in urban South India--the Chennai Urban Rural Epidemiology Study (CURES-17). Diabetologia. 2006, 49 (6): 1175-1178. 10.1007/s00125-006-0219-2.CrossRefPubMed
20.
Azizi F, Salehi P, Etemadi A, Zahedi-Asl S: Prevalence of metabolic syndrome in an urban population: Tehran Lipid and Glucose Study. Diabetes Res Clin Pract. 2003, 61 (1): 29-37. 10.1016/S0168-8227(03)00066-4.CrossRefPubMed
21.
Zabetian A, Hadaegh F, Azizi F: Prevalence of metabolic syndrome in Iranian adult population, concordance between the IDF with the ATPIII and the WHO definitions. Diabetes Res Clin Pract. 2007, 77 (2): 251-257. 10.1016/j.diabres.2006.12.001.CrossRefPubMed
22.
Azadbakht L, Mirmiran P, Shiva N, Azizi F: General obesity and central adiposity in a representative sample of Tehranian adults: prevalence and determinants. Int J Vitam Nutr Res. 2005, 75 (4): 297-304. 10.1024/0300-9831.75.4.297.CrossRefPubMed
23.
Azizi F, Azadbakht L, Mirmiran P: Trends in overweight, obesity and central fat accumulation among Tehranian adults between 1998-1999 and 2001-2002: Tehran lipid and glucose study. Ann Nutr Metab. 2005, 49 (1): 3-8. 10.1159/000084171.CrossRefPubMed
24.
Mooy JM, Grootenhuis PA, de Vries H, Valkenburg HA, Bouter LM, Kostense PJ, Heine RJ: Prevalence and determinants of glucose intolerance in a Dutch caucasian population. The Hoorn Study. Diabetes care. 1995, 18 (9): 1270-1273. 10.2337/diacare.18.9.1270.CrossRefPubMed
25.
Will new diagnostic criteria for diabetes mellitus change phenotype of patients with diabetes? Reanalysis of European epidemiological data. DECODE Study Group on behalf of the European Diabetes Epidemiology Study Group. Bmj. 1998, 317 (7155): 371-375.
26.
Glumer C, Jorgensen T, Borch-Johnsen K: Prevalences of diabetes and impaired glucose regulation in a Danish population: the Inter99 study. Diabetes care. 2003, 26 (8): 2335-2340. 10.2337/diacare.26.8.2335.CrossRefPubMed
27.
Dunstan DW, Zimmet PZ, Welborn TA, De Courten MP, Cameron AJ, Sicree RA, Dwyer T, Colagiuri S, Jolley D, Knuiman M, Atkins R, Shaw JE: The rising prevalence of diabetes and impaired glucose tolerance: the Australian Diabetes, Obesity and Lifestyle Study. Diabetes care. 2002, 25 (5): 829-834. 10.2337/diacare.25.5.829.CrossRefPubMed
28.
Cowie CC, Rust KF, Byrd-Holt DD, Eberhardt MS, Flegal KM, Engelgau MM, Saydah SH, Williams DE, Geiss LS, Gregg EW: Prevalence of diabetes and impaired fasting glucose in adults in the U.S. population: National Health And Nutrition Examination Survey 1999-2002. Diabetes care. 2006, 29 (6): 1263-1268. 10.2337/dc06-0062.CrossRefPubMed
29.
Ramachandran A, Snehalatha C, Satyavani K, Vijay V: Impaired fasting glucose and impaired glucose tolerance in urban population in India. Diabet Med. 2003, 20 (3): 220-224. 10.1046/j.1464-5491.2003.00904.x.CrossRefPubMed
30.
Jaber LA, Brown MB, Hammad A, Nowak SN, Zhu Q, Ghafoor A, Herman WH: Epidemiology of diabetes among Arab Americans. Diabetes care. 2003, 26 (2): 308-313. 10.2337/diacare.26.2.308.CrossRefPubMed
31.
Ozdemir L, Topcu S, Nadir I, Nur N, Arslan S, Sumer H: The prevalence of diabetes and impaired glucose tolerance in Sivas, Central Anatolia, Turkey. Diabetes care. 2005, 28 (4): 795-798. 10.2337/diacare.28.4.795.CrossRefPubMed
32.
Ramachandran A, Snehalatha C, Kapur A, Vijay V, Mohan V, Das AK, Rao PV, Yajnik CS, Prasanna Kumar KM, Nair JD: High prevalence of diabetes and impaired glucose tolerance in India: National Urban Diabetes Survey. Diabetologia. 2001, 44 (9): 1094-1101. 10.1007/s001250100627.CrossRefPubMed
33.
Geiss LS, Pan L, Cadwell B, Gregg EW, Benjamin SM, Engelgau MM: Changes in incidence of diabetes in U.S. adults, 1997-2003. Am J Prev Med. 2006, 30 (5): 371-377. 10.1016/j.amepre.2005.12.009.CrossRefPubMed
34.
Harris MI, Eastman RC: Early detection of undiagnosed diabetes mellitus: a US perspective. Diabetes Metab Res Rev. 2000, 16 (4): 230-236. 10.1002/1520-7560(2000)9999:9999<::AID-DMRR122>3.0.CO;2-W.CrossRefPubMed
35.
Lorenzo C, Williams K, Hunt KJ, Haffner SM: The National Cholesterol Education Program - Adult Treatment Panel III, International Diabetes Federation, and World Health Organization definitions of the metabolic syndrome as predictors of incident cardiovascular disease and diabetes. Diabetes care. 2007, 30 (1): 8-13. 10.2337/dc06-1414.CrossRefPubMed
36.
Satman I, Yilmaz T, Sengul A, Salman S, Salman F, Uygur S, Bastar I, Tutuncu Y, Sargin M, Dinccag N, Karsidag K, Kalaca S, Ozcan C, King H: Population-based study of diabetes and risk characteristics in Turkey: results of the turkish diabetes epidemiology study (TURDEP). Diabetes care. 2002, 25 (9): 1551-1556. 10.2337/diacare.25.9.1551.CrossRefPubMed
37.
Huxley R, Barzi F, Lee CM, Lear S, Shaw J, Lam TH, Caterson I, Azizi F, Patel J, Suriyawongpaisal P, Oh SW, Kang JH, Gill T, Zimmet P, James PT, Woodward M: Waist circumference thresholds provide an accurate and widely applicable method for the discrimination of diabetes. Diabetes care. 2007, 30 (12): 3116-3118. 10.2337/dc07-1455.CrossRefPubMed
38.
Hadaegh F, Zabetian A, Harati H, Azizi F: Waist/height ratio as a better predictor of type 2 diabetes compared to body mass index in Tehranian adult men--a 3.6-year prospective study. Exp Clin Endocrinol Diabetes. 2006, 114 (6): 310-315. 10.1055/s-2006-924123.CrossRefPubMed
Metadata
Title
High prevalence of undiagnosed diabetes and abnormal glucose tolerance in the Iranian urban population: Tehran Lipid and Glucose Study
Authors
Farzad Hadaegh
Mohammad Reza Bozorgmanesh
Asghar Ghasemi
Hadi Harati
Navid Saadat
Fereidoun Azizi
Publication date
01-12-2008
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2008
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-8-176

Other articles of this Issue 1/2008

BMC Public Health 1/2008 Go to the issue

Research article

Obesity prevalence from a European perspective: a systematic review

Correspondence

Vouchers for scaling up insecticide-treated nets in Tanzania: Methods for monitoring and evaluation of a national health system intervention

Research article

Identification of patients for clinical risk assessment by prediction of cardiovascular risk using default risk factor values

Research article

Relationship between multimorbidity and physical activity: Secondary analysis from the Quebec health survey

Debate

Efficacious, effective, and embedded interventions: Implementation research in infectious disease control

Research article

Malaria treatment in the retail sector: Knowledge and practices of drug sellers in rural Tanzania