Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Aug 5;25(1):2658.
doi: 10.1186/s12889-025-23654-8.

Prevalence, awareness, treatment, and control of prediabetes and diabetes mellitus in older adults: findings from Iranian STEPS surveys (2016 and 2021)

Amirabbas Nikkhah  1 , Yosef Farzi  2 , Yosra Azizpour  2 , Nazila Rezaei  2 , Mina Mirzad  2 , Sahar Keyvanloo Shahrestanaki  3 , Farshad Sharifi  4 , Samaneh Akbarpour  2   5 , Ozra Tabatabaei-Malazy  2 , Moloud Payab  2 , Mahbube Ebrahimpur  6
Affiliations

Prevalence, awareness, treatment, and control of prediabetes and diabetes mellitus in older adults: findings from Iranian STEPS surveys (2016 and 2021)

Amirabbas Nikkhah et al. BMC Public Health. .

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.

Keywords: Aged; Awareness; Control; Diabetes; Prevalence; Risk factors; Treatment.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study received approval from the Research Ethics Committees of the Endocrine & Metabolism Research Institute, Tehran University of Medical Sciences (IR.TUMS.EMRI.REC.1403.053) and was conducted in accordance with the Declaration of Helsinki. All participants were informed about the survey’s methods and objectives, and written informed consent was obtained prior to their enrollment in the survey. No personally identifiable information was included in the research data, ensuring the privacy and confidentiality of all participants. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Geographical distribution of prediabetes prevalence in Iranian older adults, 2016 and 2021
Fig. 2
Fig. 2
Geographical distribution of diabetes mellitus prevalence in Iranian older adults, 2016 and 2021
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Almigbal TH. Association between knowledge of hypoglycemia and likelihood of experiencing hypoglycemia among patients with Insulin-Treated diabetes mellitus. Diabetes Metab Syndr Obes. 2021;14:3821–9. - PMC - PubMed
    1. Ameli A, Sheikhy A, Tabatabaei-Malazy O, Ahmadi N, Ebrahimpur M, Fallahzadeh A, et al. The diabetes cascade of care through the 14 years in iran: findings of nationwide STEPS surveys 2007–2021. J Diabetes Metabolic Disorders. 2023;22(2):1731–43. - PMC - PubMed
    1. Namazi N, Moghaddam SS, Esmaeili S, Peimani M, Tehrani YS, Bandarian F, et al. Burden of type 2 diabetes mellitus and its risk factors in North Africa and the middle east, 1990–2019: findings from the global burden of disease study 2019. BMC Public Health. 2024;24(1):98. - PMC - PubMed
    1. Bandarian F, Sharifnejad Tehrani Y, Peimani M, Namazi N, Saeedi Moghaddam S, Esmaeili S, et al. National and sub-national burden and trend of type 1 diabetes in 31 provinces of iran, 1990–2019. Sci Rep. 2023;13(1):4210. - PMC - PubMed
    1. Azadnajafabad S, Ahmadi N, Rezaei N, Rashidi MM, Saeedi Moghaddam S, Mohammadi E, et al. Evaluation of the diabetes care cascade and compliance with WHO global coverage targets in Iran based on STEPS survey 2021. Sci Rep. 2023;13(1):13528. - PMC - PubMed

LinkOut - more resources