Estimating the Proportion of Diabetes to the Attributable Burden of Cardiovascular Diseases in Iran

BACKGROUND This study aimed at estimating the proportion of diabetes as a risk factor to the attributable burden of cardiovascular diseases in Iran. METHODS Comparative Risk Assessment methodology was used to calculating Potential Impact Fraction (PIF). To calculate PIF, data on the prevalence of newly diagnosed diabetes mellitus (NDM) and known diabetes mellitus (KDM) were obtained from 3rd Iranian surveillance of risk factors of non-communicable diseases and data on corresponding measures of effect were derived from a cohort study. PIF were estimated on both theoretical minimum and feasible minimum risk. Uncertainty for the attributable burden was estimated by Monte Carlo simulation-modeling techniques incorporating sources of uncertainty. RESULTS According to multivariate-adjusted hazard ratios, by reducing the prevalence of Iranian women with diabetes from 10.05 percent to the feasible minimum risk level i.e. 5 percent, 6.8% (95% uncertainty intervals: 3.5-9.8) of attributable Disability Adjusted Life Years (DALYs) to CVD are avoidable and the corresponding value for men were 3.1% (95% uncertainty intervals: 1.4-4.8). CONCLUSION Although data on the prevalence of diabetes and corresponding measures of associations were obtained from an updated and country-specific source, but to better priority setting, PIF should be applied to updated and revised burden of CVDs.