Trends in the prevalence of diabetes and impaired fasting glucose in association with obesity in Iran: 2005–2011 Alireza Esteghamati a, *, Koorosh Etemad b , Jalil Koohpayehzadeh b , Mehrshad Abbasi a , Alipasha Meysamie c , Sina Noshad a , Fereshteh Asgari b , Mostafa Mousavizadeh a , Ali Rafei b , Elias Khajeh a , MohamadrezaNeishaboury a , SaraSheikhbahaei a ,Manouchehr Nakhjavani a a Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran b Center for Disease Control, Tehran, Iran c Department of Preventive Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran d i a b e t e s r e s e a r c h a n d c l i n i c a l p r a c t i c e x x x ( 2 0 1 4 ) x x x – x x x a r t i c l e i n f o Article history: Received 11 August 2013 Received in revised form 8 November 2013 Accepted 21 December 2013 Available online xxx Keywords: Diabetes mellitus Impaired fasting glucose Obesity Trends Population attributable fraction Surveillance of Risk Factors of Non- communicable Diseases a b s t r a c t Aims: To estimate the prevalence and trends of diabetes mellitus (DM) and impaired fasting glucose (IFG), 2005–2011, and to determine the contribution of obesity to DM prevalence. Patients and methods: Data from Surveillance of Risk Factors of Non-communicable Diseases (SuRFNCD) conducted in 2005, 2007, and 2011 were gathered. DM was defined as presence of self-reported previous diagnosis or a fasting plasma glucose (FPG)  7 mmol/L. IFG was diagnosed with FPG levels between 5.6 and 6.9 mmol/L. Prevalence rates for 2011 and trends for 2005–2011 were determined by extrapolating survey results to Iran’s adult population. Population attributable fraction (PAF) of obesity was also calculated. Results: In 2011, IFG and total DM prevalence rates were 14.60% (95%CI: 12.41–16.78) and 11.37% (95%CI: 9.86–12.89) among 25–70 years, respectively. DM was more common in older age (p < 0.0001), in women (p = 0.0216), and in urban-dwellers (p = 0.0001). In 2005–2011, trend analysis revealed a 35.1% increase in DM prevalence (OR: 1.04, 95%CI: 1.01–1.07, p = 0.011); albeit, IFG prevalence remained relatively unchanged (OR: 0.98, 95%CI: 0.95– 1.00, p = 0.167). In this period, DM awareness improved; undiagnosed DM prevalence decreased from 45.7% to 24.7% ( p < 0.001). PAF analysis demonstrated that 33.78%, 10.25%, and 30.56% of the prevalent DM can be attributed to overweight (BMI  25 kg/m 2 ), general obesity (BMI  30 kg/ m 2 ), and central obesity (waist circumference  90 cm), respectively. Additionally, the DM increase rate in 2005–2011, was 20 times higher in morbidly obese compared with lean individuals. Conclusion: More than four million Iranian adults have DM which has increased by 35% over the past seven years, owing in large part, to expanding obesity epidemic. # 2013 Elsevier Ireland Ltd. All rights reserved. * Corresponding author at: Endocrinology and Metabolism Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, Tehran University of Medical Sciences, P.O. Box 13145-784, Tehran, Iran. Tel.: +98 21 88417918; fax: +98 21 64432466. E-mail addresses: Esteghamati@tums.ac.ir, esteghamati@sina.tums.ac.ir (A. Esteghamati), Etemad@Health.gov.ir (K. Etemad), J-koohpayezadeh@sina.tums.ac.ir (J. Koohpayehzadeh), Meabbasi@sina.tums.ac.ir (M. Abbasi), Meysamie@tums.ac.ir (A. Meysamie), Sina.noshad@gmail.com (S. Noshad), Asgarifcdc@yahoo.com (F. Asgari), S.m.mousavizadeh@gmail.com (M. Mousavizadeh), Rafei@health.gov.ir (A. Rafei), Elyas.khajeh@gmail.com (E. Khajeh), M.neishaboury@gmail.com (M. Neishaboury), Shb.sara@yahoo.com (S. Sheikhbahaei), Nakhjavanim@tums.ac.ir (M. Nakhjavani). DIAB-5945; No. of Pages 9 Please cite this article in press as: Esteghamati A, et al. Trends in the prevalence of diabetes and impaired fasting glucose in association with obesity in Iran: 2005–2011. Diabetes Res Clin Pract (2014), http://dx.doi.org/10.1016/j.diabres.2013.12.034 Contents available at ScienceDirect Diabetes Research and Clinical Practice journal homepage: www.elsevier.com/locate/diabres 0168-8227/$ – see front matter # 2013 Elsevier Ireland Ltd. All rights reserved. http://dx.doi.org/10.1016/j.diabres.2013.12.034