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Diabetes Mellitus · Journal article
Journal of Diabetes and Metabolic Disorders · August 25, 2026
Reinforces what was already believed, rather than introducing something new.
This nationally representative surveillance study documents a sustained increase in unhealthy lifestyle behaviors among Iranian adults with diabetes over 14 years. Prevalence of ≥2 unhealthy lifestyle behaviors rose from 55.57% to 65.39%, with worsening physical inactivity and obesity; the finding confirms established epidemiologic concerns and identifies women and those on diabetes treatment as priority groups for intervention.
Repeated cross-sectional surveillance study (STEPS surveys). Iranian adults aged ≥25 years with diabetes identified in four nationally representative STEPS surveys; stratified analysis by sex, residence, and diabetes treatment status.. n = 7,674. Iran (national level across four survey waves).
Prevalence of ≥2 ULBs increased from 55.57% in 2007 to 65.39% in 2021 (APC = 1.17%) Prevalence of ≥3 ULBs increased from 13.02% to 19.29% (APC = 2.86%) Smoking prevalence declined from 18.6% to 10.5%
No direct clinical outcome data (complications, mortality); findings based on risk factor prevalence alone.
These trends underscore the need for strengthened lifestyle interventions in diabetes care, particularly targeting women and individuals on diabetes medication. The worsening physical inactivity and obesity despite declining smoking suggest that current public health efforts may be insufficient to reverse modifiable risk factors in this population.
A large, nationally representative surveillance study documenting worsening temporal trends in established risk factors for diabetes outcomes, confirming and quantifying a known public health concern without introducing novel interventions or mechanisms.
As stated by the source record.
Quoted from the source exactly as published.
These trends underscore the need for strengthened lifestyle interventions in diabetes care, particularly targeting women and individuals on diabetes medication. The worsening physical inactivity and obesity despite declining smoking suggest that current public health efforts may be insufficient to reverse modifiable risk factors in this population.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Purpose. Unhealthy lifestyle behaviors (ULBs) contribute substantially to poor outcomes among individuals with diabetes. This study examined temporal trends in ULBs among Iranian adults with diabetes between 2007 and 2021.Methods. Data were obtained from four nationally representative STEPwise approach to noncommunicable disease risk factor surveillance (STEPS) surveys conducted in 2007, 2011, 2016, and 2021. Adults aged ≥ 25 years with diabetes were included. ULBs comprised current smoking, insufficient physical activity, inadequate fruit and vegetable intake, and obesity. Each participant received a ULB score ranging from 0 to 4, and temporal trends were evaluated across the thresholds of ≥ 1, ≥2, and ≥ 3 ULBs, with ≥ 2 ULBs as the primary outcome. Age-standardized prevalence estimates were calculated overall and by sex, residence, and diabetes treatment status.Results. A total of 7,674 adults with diabetes were included. The prevalence of ≥ 2 ULBs increased from 55.57% in 2007 to 65.39% in 2021 (annual percent change [APC] = 1.17%), while the prevalence of ≥ 3 ULBs increased from 13.02% to 19.29% (APC = 2.86%). Obesity and inadequate fruit and vegetable intake remained highly prevalent throughout the study period. Smoking prevalence declined from 18.6% to 10.5%, whereas insufficient physical activity increased from 59.6% to 70.4%. ULBs were consistently more prevalent among females than males and remained common among individuals receiving diabetes treatment.Conclusion. Unhealthy lifestyle behaviors increased among Iranian adults with diabetes from 2007 to 2021. These findings highlight the need for sustained lifestyle interventions, particularly for women and other high-risk groups, to improve diabetes management and reduce future complications.Supplementary information. The online version contains supplementary material available at 10.1007/s40200-026-02053-9.
Taken from the source record, never inferred. Follow any of these and new work involving them reaches your briefing.