Prevalence, Awareness, Treatment, and Control of Prediabetes and Diabetes Mellitus in Older Adults: Findings From Iranian Steps Surveys (2016 and 2021) Publisher Pubmed



A Nikkhah AMIRABBAS ; Y Farzi YOSEF ; Y Azizpour YOSRA ; N Rezaei NAZILA ; M Mirzad MINA ; S Keyvanloo Shahrestanaki SAHAR ; F Sharifi FARSHAD ; S Akbarpour SAMANEH ; O Tabatabaeimalazy OZRA ; M Payab MOLOUD
Source: BMC Public Health Published:2025

Abstract

Background: Diabetes mellitus (DM) is a significant public health concern, particularly among older adults who face an elevated risk of complications and increased mortality. This study assessed overtime changes in the prevalence, awareness, treatment coverage, and glycemic control of DM in Iranian adults aged 60 and older. Methods: This is a nationwide repeated cross-sectional study based on data from the 2016 and 2021 STEPwise Approach to Non-communicable Disease Risk Factor Surveillance (STEPS), the most recent surveys conducted across all provinces of Iran. We reported prevalence estimates as weighted percentages with 95% confidence intervals (CIs). Logistic regression was used to evaluate the association between selected demographic and health characteristics and diabetes mellitus (DM). All analyses were performed using R statistical software version 4.0.5. Results: From 2016 to 2021, the prevalence of prediabetes increased from 23.86 to 28.96% in males and from 22.86 to 30.86% in females, while DM prevalence rose from 19.37 to 25.43% in males and from 26.22 to 30.26% in females. In 2016, DM awareness was 74.47% in males and 82.19% in females, and in 2021, it was 71.20% in males and 78.73% in females. Treatment coverage was 60.18% in males and 67.63% in females in 2016, and 63.71% in males and 71.14% in females in 2021. Glycemic control was 59.77% in males and 57.98% in females in 2016, and 55.96% in males and 53.66% in females in 2021. Obesity significantly increased the odds of DM (odds ratio (OR) 1.97, p < 0.001), while being underweight (OR 0.21, p < 0.001) and having sufficient physical activity (OR 0.77, p = 0.02) were protective factors. Conclusion: The findings from the 2016 and 2021 STEPS surveys indicate a rising burden of prediabetes and DM among older adults in Iran, particularly among females. Although awareness and treatment coverage were high, optimal glycemic control remains a challenge, emphasizing the need to improve access to healthcare resources and develop tailored community-based interventions. © 2025 Elsevier B.V., All rights reserved.