# Prevalence and factors associated with comorbidities in Iranian patients with type 2 diabetes: A national study

## TL;DR

This study examines how often Iranian adults with type 2 diabetes also have other health conditions and identifies factors that increase the risk of having multiple conditions.

## Contribution

The study provides new national data on comorbidities in Iranian T2DM patients and identifies socio-demographic factors linked to these comorbidities.

## Key findings

- Over 70% of Iranian T2DM patients have at least one comorbidity, with hypertension being the most common.
- Older age, male gender, rural residence, and obesity are linked to higher comorbidity prevalence.
- Education, employment, and physical activity are associated with lower odds of comorbidities.

## Abstract

Type 2 diabetes (T2DM) is often accompanied by comorbidities such as hypertension (HTN), cardiovascular disease (CVD), and chronic kidney disease (CKD), which increase the disease burden and complicate its management. In Iran, where diabetes prevalence is growing, understanding the extent and determinants of these comorbidities is crucial for improving clinical care and informing national public health strategies.

We used data from the WHO STEPwise approach to non-communicable diseases risk factor surveillance (STEPS) 2021 to assess the prevalence of comorbidities among Iranian patients with T2DM. Comorbidity was defined as ≥ 2 of: HTN, CKD, history of CVD, or cancer. Multivariable logistic regression was done to identify the potential socio-demographic factors associated with comorbidities.

Of a total of 2,900 participants aged 25-70 years with T2DM (56.24% women), 27.00% (95% confidence interval (CI): 24.74–29.40) had no comorbidity, 39.82% (95% CI: 37.26–42.43) had one comorbidity (HTN: 79.62%, CKD: 10.66%, CVD: 8.64%, cancer: 1.09%), and 33.18% (95% CI: 30.58–35.89) had ≥ 2 comorbidities. The prevalence of comorbidity was significantly associated with male gender, age ≥ 60 years, living in a rural area, body mass index >30 kg/m2 (all p-values < 0.05). However, higher years of schooling, being employed, and physical activity ≥ 150 min/week were associated with lower odds of comorbidities.

Over 70% of Iranian adults have additional health conditions alongside diabetes, which significantly impact public health and underscore the need for personalized and multi-faceted preventive approaches.