Related factors to disparity of diabetes care in Iran

We determined, in Iranian patients with diabetes mellitus, the prevalence of inadequate glycemic control and its predictors. The data from a national population-based survey that included a random sample of 89 404 Iranian individuals in 2005 were analyzed. In that sample, 2923 diabetic subjects (age range, 25-64 years) were identified. We linked the results of their fasting plasma glucose levels with demographic and behavioral variables to determine predictors of poor glycemic control. About 57% of the subjects had a fasting plasma glucose level of > or =130 mg/dL. That percentage was comparable in male and female subjects and in literate and illiterate subjects. However, inhabitants in rural areas controlled their fasting plasma glucose level about 11% better than did subjects who lived in an urban area. We also found that control of the fasting plasma glucose level was much better in relatively younger diabetic patients. Diabetic subjects with a family history of type 2 diabetes mellitus exhibited a higher uncontrolled fasting plasma glucose level than those without positive family history of diabetes. The percentage of uncontrolled type 2 diabetes found in our study suggests that the Iranian healthcare system should devote more attention to that disorder, particularly in elderly individuals, who are more vulnerable to the complications of diabetes and control their disorder less well than do younger diabetic patients. The recent integration of diabetic care in primary healthcare systems in Iranian rural areas was found to have a promising effect on community health.