Iranian Journal of

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The incidence and prevalence of type2 diabetes mellitus is increasing worldwide. Many believe that type 2 diabetes mellitus is a disease that can be prevented by appropriate interventions in individuals at high risk for the disease. A number of studies have therefore looked at primary prevention during the past decade. Iran’s diabetic population of approximately 2 million people and the warning by the World Health Organisation that diabetes is on the rise in developing countries make the primary prevention of diabetes mellitus in Iran doubly important. Researchers have been increasingly focusing on identifying the risk factors for type 2 diabetes and, through these, appropriate strategies to prevent the rapidly growing incidence of this disease in the population at risk. Genetic predisposition (a positive family history), insulin resistance, obesity, impaired glucose tolerance, a history of gestational diabetes mellitus, physical inactivity and an unsuitable diet are among the most important recognised risk factors for type 2 diabetes other factors have also been found to contribute. Most of the available research has evaluated the effect of behavioural or lifestyle modification, in the form usually of dietary education and increased physical activity, in the primary prevention of type 2 diabetes. The second most common approach has been pharmacological manipulation. The information available indicates that type 2 diabetes will come to be considered as a preventable disease within the next decade. The weight of research behind this problem will undoubtedly discover even more effective methods of preventing type 2 diabetes in the near future than behavioural/lifestyle modification.

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Diabetes among Eastern Mediterranean (EM) population above age of 20 years is around 10.5% and is ranked among the leading causes of blindness, renal failure and lower limb amputation. While 50% of EM people with diabetes will die of cardiovascular diseases. This means that in our region, there are pandemic trends in prevalence of diabetes and associated complications. Globally, people with diabetes are 25 times more likely to have a leg amputated than those without the condition, and up to 70% of all leg amputations happen to people with diabetes. Somewhere in the world, a leg is lost to diabetes every 30 seconds. Foot ulcer is the most common single precursor to lower extremity amputations among diabetics. Hyperglycemia, impaired immunologic responses, neuropathy, and peripheral arterial disease are the major predisposing factors leading to limb-threatening diabetic foot infections. Diabetic foot represents a health problem and economic burden among majority of EM Countries. Infection in a diabetic foot is limb-threatening and must be treated empirically and aggressively. Treatment of infected foot wounds is the most common reason for diabetes- related hospitalization. The good news is that up to 85 percent of diabetic amputations can be prevented. As to above challenge, the best approach for EMR is education, community awareness and prevention of diabetic foot. The public approach and education that emphasize on proper footwear and foot care are best preventive and cost-effective modalities that can be easily implemented among EM Countries. EM Countries need to strengthen national health services that promote the concept of prevention and tight control of diabetes in order to prevention diabetes complications. This also necessitates building/strengthening diabetes registry and complications.

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Background: Diabetes is a chronic disease that is increasing in the world that has a different outbreak in different societies. 90% to 95% of all types of diabetes include type 2 diabetes. This disease is spreading due to the Industrial life and urbanization .The Nationwide Program for Prevention and Control of Diabetes is already under way for controlling the disease and its side-effects. This study is intended to probe into the effects of the program in the country.
Methods: This study used a cross-sectional pre- and post-test design involving 100 elderly patients newly introduced to be suffering from diabetes who were selected by convenience sampling in Isfahan. The data collection methods were a questionnaire on demography and health, and another one on patients’ levels of fasting blood sugar (FBS) and hemoglobin glycosides (HbA1c(The data was gathered before and three months after the patients’ entrance into the program.
Results: The mean and standard deviation of the fasting blood sugar before the program were 172.73 and 71.68 and after the program 143.02 and 51.19, respectively (P<.001; t=5.30). And finally, glycated hemoglobin mean and standard deviation before the program were 8.24 and 1.9 and after the program 7.44 and 1.66, respectively (P<.001; t=4.79).
Conclusion: The results indicate the importance of the program for the prevention and control of the elderly patients’ diabetes by controlling their fasting blood sugar and glycated hemoglobin.It is recommended that this program be implemented in all health centers of the country.

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Non-Communicable Diseases (NCDs) are the major cause of premature death and disability due to diseased globally, imposing a heavy burden on the health systems. Four main categories of NCDs are cardiovascular diseases, neoplasms, diabetes, and chronic respiratory diseases. Iran, the second greatest country in the Middle East Region, has been through an important transition period of communicable diseases toward NCDs in the last decades. One of the effective approaches to control NCDs is implementation of population-based studies and interventions, trying to reduce risk factors and incidence of NCDs through investigations in the populations. Endocrinology and Metabolism Research Institute (EMRI) and Non-Communicable Diseases Research Center (NCDRC) are the pioneers trying to study and control various NCDs during the last decades in Iran. In this review, we are going to inspect some of the major completed and ongoing projects of this research institute to highlight valuable efforts to reduce burden of NCDs in Iran, and make a successful example for national and regional public health policy makers and authorities.

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