Glycemic control among Iranian people with type 2 diabetes: a systematic review and meta-analysis

Background Glycemic control reduces the risk of cardiovascular complications among people with diabetes. However, the current status of glycemic control is uncertain among Iranian people with diabetes. This study aims to systematically review the studies on the status of glycemic control among people with type 2 diabetes in Iran. Methods A systematic literature search was conducted in international databases including Medline database (PubMed), Web of Science, Google Scholar, and Scopus, as well as domestic databases such as Iran Medex, SID, Magiran, Irandoc, and Medlib, up to end of 2020. All observational studies (cross-sectional, case-control, and cohort) were included. Studies that reported the status of glycemic control among people with type 2 diabetes in Iran were selected. Good glycemic control was defined as glycated hemoglobin A1c (HbA1c) less than 7%. Results A total of 23 eligible studies (15,358 patients) were included in the quantitative analysis. Of 15,358 patients, 5882 had good glycemic control. The pooled prevalence of good glycemic control was 33.1% (95% CI, 25.6-41.1%). Meta-regression showed no significant improvement in glycemic control rate by year. Conclusion Despite the importance of good glycemic control in the prevention of micro- and macrovascular diabetic complications, the high proportion of Iranian people with type 2 diabetes remains poorly controlled. The result of this meta-analysis indicates the need for better approaches to diabetes management in Iran.