Noncommunicable diseases (NCDs) are responsible for the death of 41 million people each year, equivalent to 71% of all deaths globally. The most common causes of death are cardiovascular diseases (17.9 million), cancer (9 million), respiratory diseases (3.9 million), and diabetes (DM) (1.6 million) in the world. Diabetes is associated with a high rate of early death in some countries (1, 2). Diabetes Mellitus (T2DM) is ranked third or fourth in disability-adjusted life years; And therefore, it's essential from the aspect of public health (3, 4).
T2DM is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both (5). Part of the increasing prevalence of diabetes is factors such as rapid industrialization and urbanization and changes in lifestyle factors (6, 7). The most important risk factors for type 2 diabetes are Race, family history of diabetes, previous gestational diabetes with increasing age, overweight and obesity, high-calorie intake, unhealthy diet, physical inactivity, and smoking. Overweight and obesity, along with physical inactivity, form a large part of the global burden of diabetes. (8, 9).
The prevalence of type 2 diabetes has increased over the past decade. And often associated with obesity (10). According to the International Diabetes Federation (IDF), the number of people with diabetes, from 382 million people worldwide in 2013, will rise to 592 million in 2035. Eighty percent of people with diabetes live in low-income and middle-income countries, and more than 60 percent live in Asia (11). In 2011, impaired fasting glucose and total DM prevalence rates were 14.60% and 11.37% among 25–70 years, respectively (12). There were 4,985.5 cases of diabetes in Iran in 2017and the prevalence of diabetes in adults was 8.9 % (13).
In 2012, the prevalence of type 2 diabetes mellitus in Yazd City was 16.3%, which is twice more than the overall prevalence of diabetes in Iranian adults. One percent of the urban population over the age of 20 years old is suffering from type 2 diabetes .(14) Risk factors for diabetes, including Race, family history of diabetes, previous gestational diabetes with increasing age, overweight and obesity, unhealthy diet, physical inability, and smoking increase the risk of developing diabetes. Overweight, obesity, and physical inactivity are a big part of the enormous global burden of diabetes (9)
Obesity increases the incidence of various diseases such as cardiovascular disease, diabetes, certain cancers, hypertension, and lipid disorders and is associated with their risk factors (15).
Because the prevalence of diabetes is increasing in Iran, And Since the health system, politicians need to be aware of the impact of a risk factor on the burden of disease. The results of this study can be used as a basis for preventing diabetes interventions. The definition of Population Attributable Fraction (PAF) is that disease or mortality is reduced if exposure to the risk factor is ideal (16).
The objective of this study was to calculate PAF of abnormal body mass index (BMI) for diabetes mellitus in the 20-74-year-old Population of Yazd during a 10-year Longitudinal Cohort