Volume 36, Issue 261 (10-2026)
J Mazandaran Univ Med Sci 2026, 36(261): 335-346 |
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Moosazadeh M, Shirzad R, Kheradmand M. Undiagnosed Diabetes in Adults: The Need for Targeted Screening of High-Risk Populations in Mazandaran Province, Iran - A Policy Brief. J Mazandaran Univ Med Sci 2026; 36 (261) :335-346
URL: http://jmums.mazums.ac.ir/article-1-23056-en.html
URL: http://jmums.mazums.ac.ir/article-1-23056-en.html
Abstract: (19 Views)
Diabetes is one of the major non-communicable diseases and poses a significant challenge to the health system in Iran. A proportion of individuals with diabetes, particularly during the early stages of the disease, remain asymptomatic and unaware that they have the condition. This issue is particularly important in Mazandaran Province. According to the 2021 STEPS survey, the prevalence of diabetes based on fasting blood glucose was 19.84% in Mazandaran, compared with 14.15% nationally. In addition, the Tabari Cohort Study reported a 4.7% prevalence of undiagnosed diabetes among adults aged 35–70 years, and 27.5% of people with diabetes were unaware of their condition.
This policy brief aims to propose an approach to reducing the burden of undiagnosed diabetes in Mazandaran. Evidence indicates that, in addition to individuals with high cardiovascular-kidney-metabolic risk, certain groups, including men, younger adults, urban residents, and people who use health services infrequently, may be more likely to be overlooked by routine diagnostic pathways. Therefore, reliance solely on voluntary attendance or conventional risk-factor-based screening may fail to identify all individuals with undiagnosed diabetes.
The proposed approach combines population-level measures with stepwise, risk-based screening integrated into the existing primary healthcare system. At the population level, emphasis is placed on raising awareness, conducting active outreach, and facilitating access to initial risk assessment, particularly among individuals who make limited use of health services. Individuals would then be prioritised according to age, clinical and metabolic risk factors and, where appropriate, validated diabetes risk-assessment tools, with those at higher risk referred for laboratory testing.
Individuals with abnormal results should be linked to a clearly defined pathway for diagnostic confirmation, registration, and follow-up. Rather than establishing a parallel programme, this approach focuses on strengthening existing primary healthcare services and IraPEN capacity to identify individuals who are currently missed by routine care and connect them with ongoing care and follow-up.
This policy brief aims to propose an approach to reducing the burden of undiagnosed diabetes in Mazandaran. Evidence indicates that, in addition to individuals with high cardiovascular-kidney-metabolic risk, certain groups, including men, younger adults, urban residents, and people who use health services infrequently, may be more likely to be overlooked by routine diagnostic pathways. Therefore, reliance solely on voluntary attendance or conventional risk-factor-based screening may fail to identify all individuals with undiagnosed diabetes.
The proposed approach combines population-level measures with stepwise, risk-based screening integrated into the existing primary healthcare system. At the population level, emphasis is placed on raising awareness, conducting active outreach, and facilitating access to initial risk assessment, particularly among individuals who make limited use of health services. Individuals would then be prioritised according to age, clinical and metabolic risk factors and, where appropriate, validated diabetes risk-assessment tools, with those at higher risk referred for laboratory testing.
Individuals with abnormal results should be linked to a clearly defined pathway for diagnostic confirmation, registration, and follow-up. Rather than establishing a parallel programme, this approach focuses on strengthening existing primary healthcare services and IraPEN capacity to identify individuals who are currently missed by routine care and connect them with ongoing care and follow-up.
Type of Study: Policy Brief |
Subject:
Epidemiology
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