The prevalence of Diabetes Mellitus (DM) has undergoes a growing trend in recent decades in Iran and imposed a lot of economic burden on the community. The present study aimed to evaluate the prevalence of diabetes and prediabetes, along with an assessment of the country-level performance on diabetes care, as well as, socioeconomic-related inequality in the prevalence of diabetes and prediabetes in south-east Iran.

Using a proportional-to-size cluster random sampling method, the STEPS included 7947 subjects aged ≥ 25 years who met the criteria (no missing information on diabetes self-report and biomarkers) were used for the analyses. Different definitions of diabetes (based on biomarkers, self-report, use of diabetes medication, or a combination) and prediabetes (different cut-off values for the biomarker) were calculated and presented.

An estimated 11.2% persons aged ≥ 25 years (95% CI: 11.0%–12.1%) had diabetes according to the serologic diagnosis of diabetes (FPG ≥ 126 mg/dL) or the use of at least one anti-diabetes medication. Employing the serologic diagnosis of diabetes among those who responded no to the self-reported question, 3.7% (3.5%–4.0%) of the population were not aware of their diabetes compared to 11.4% (10.7%-12.1%) who were diabetics according to the just self-reported question. Defining prediabetes as 100 ≤ FPG < 126 mg/dL or 5.7 ≤ HbA1c < 6.5%, an estimated 28.8% persons had prediabetes. Overall, 57.1% (49.8%–61.4%) of patients with self-reported diabetes were under strict glycemic control (HbA1c < 7%). Poor diabetes control (HbA1c > 9%) was found in 19.4% (16.9%-20.5%) of the patients with self-reported diabetes. The high prevalence of prediabetes and diabetes, which is affected by socioeconomic inequality and combined with low levels of glycemic control, may place a greater burden on the health system.

The prevalence of diabetes in south-east Iran has gradually increased in both sexes, with a widening gap between females and males. The awareness, management and control of blood glucose levels in people with diabetes, and the socioeconomic status of people have become increasingly important in south-east Iran.