Characteristics of Survey Respondents
6 Blood Presssure and Hypertension
6.2 Methods and Definitions Hypertension HistoryHypertension History
Hypertension history was evaluated by asking the question “Do you have hypertension (high blood pressure) diagnosed by a physician?” To the ones who stated that they had physician diagnosed hypertension, questions about whether they used medication regularly, if they had a chronic diseases report, and the brands of the medication they used were asked.
Measurements
Systolic and diastolic blood pressure values were obtained from 16893 individuals. The blood pressure values of the individuals were obtained with a single measurement after they rested at least 15 minutes.
A standard protocol was used for the measurement; it was ensured that the person is in a sitting position and the right arm of the person is naked as to allow for blood pressure; systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured using a stethoscope and a sphygmomanometer.
71 Blood Pressure and Hypertension
Definition of Hypertension
For the individuals who have not been diagnosed with hypertension before was diagnosed as “hypertension present” if average SBP ≥ 140 mmHg or average DBP ≥90 mmHg. Individuals who have been diagnosed with hypertension before and who have used antihypertensive medication were considered as “hypertension present” regardless of their blood pressure measurements. Individuals who have been diagnosed with hypertension but have not used any medication were diagnosed as “hypertension present” if average SBP≥140 mmHg or average DBP ≥ 90 mmHg (6).
Isolated systolic hypertension was defined as SBP ≥ 140 mmHg on average and DBP <90 mmHg on average; isolated diastolic hypertension was defined as SBP<140 mmHg on average and DBP ≥90 mmHg on average.
Definitions of Diagnosis, Treatment and Control
The blood pressure levels of the individuals were categorized into four groups by the systolic and diastolic blood pressure levels obtained by measurements and their condition of current use of medications due to hypertension (6).
Normal blood pressure levels – not receiving treatment: SBP <140 mmHg and DBP <90 mmHg, not diagnosed with hypertension and not using medications for hypertension.
Hypertensive-controlled: SBP<140 mmHg and DBP<90 mmHg, currently using medication due to hypertension
Hypertensive-uncontrolled: SBP≥140 mmHg or DBP ≥90 mmHg, currently using medication due to hypertension
Hypertensive-not receiving treatment: SBP ≥ 140 mmHg or DBP ≥90 mmHg, currently not using medication due to hypertension
Hypertension awareness, is defined for the individuals who declared hypertension based on physician diagnosis among the individuals who were diagnosed with hypertension after the measurements (1).
6.3 Findings
Systolic and Diastolic Blood Pressure Averages By Sex, Age and Area of Residence
Table 6.1 presents the SBP and DPB averages with % CI for the participants. Average measured SBP is as 117,9±17,5 (%95 CI: 117,6-118,2), average DBP is 74,1±11,3 (%95 CI: 73,9-74,3) in the study group. Average SBP is 118,8±16,1 mmHg in males and 117,0±18,5 mmHg in females. Average DBP is 74,7±10,9 in males and 73,5±11,5 in females. In both males and females the average systolic and diastolic blood pressures increase with age. SBP and DBP averages are higher in individuals who live in rural areas than the people living in urban areas (Table 6.1).
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Table 6.1 Systolic and Diastolic Blood Pressure Averages by sex, age and area of residence, Turkey 2011.
Systolic Blood Pressure
(mmHg) Diastolic Blood Pressure
(mmHg)
mean+SD %95 CI mean+SD %95 CI
Sex
Male 118,8±16,1 118,5-119,2 74,7±10,9 74,5-75,0
Female 117,0±18,5 116,5-117,4 73,5±11,5 73,3-73,7
Age Groups
15-24 109,3±12,2 108,9-109,7 69,2±9,7 68,9±69,6
25-34 111,2±12,5 110,8-111,6 71,2±9,9 70,9±71,6
35-44 115,4±14,4 114,9-115,9 74,1±10,5 73,8±74,5
45-54 121,7±16,9 121,2-122,4 76,9±11,2 76,5±77,4
55-64 127,9±18,4 127,1-128,7 78,3±11,4 77,9±78,9
65-74 132,1±21,3 130,9-133,4 78,9±12,6 78,2±79,7
75 + 134,4±21,7 132,8-135,9 69,3±9,8 68,9-69,6
Area of Residence
Rural 120,0±18,4 119,4-120,5 74,9±11,5 74,6-75,2
Urban 116,9±17,0 116,7-117,3 73,7±11,1 73,5-73,9
Total* 117,9±17,5 117,6-118,2 74,1±11,3 73,9-74,3
* was calculated based on the sex
Hypertension Prevalence Defined by Blood Pressure Measurements and Medical History
The prevalence of hypertension based on medical history is 17% in the participants (12% in males and 20% in females). In total 85% of the participants who reported hypertension also declared that they regularly used medication for this disease and 63% had chronic disease prescriptions. Medication use rates are 84% for males and 86% for females and 65% of males and 62% of females have chronic disease prescriptions.
In the study population, the blood pressure was categorized into five groups using to the results obtained from the blood pressure measurements and medical histories. According to this, 76% of the study population had normal blood pressure levels, 10% of the individuals do not use medication although they have hypertension (untreated individuals). Almost all (88%) of the untreated individuals are not aware of their disease or have not been diagnosed with hypertension before. The rate of individuals with hypertension diagnosis and controlled blood pressure is 7% (Table 6.2, Figure 6.1).
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Table 6.2 Distribution of blood pressure categories defined by the measurements and medical history, Turkey 2011.
Distribution of blood pressure categories defined by
measurements and medical history n %
Normotensive, no known diagnosis, not using medication 12533 76,3
Hypertensive, no known diagnosis, not using medication a 1450 8,8
Hypertension diagnosed,using medication, normotensive*,b 1167 7,1
Hypertension diagnosed, using medication, hypertensive**, c 1083 6,6
Hypertension diagnosed,not using medication, hypertensive d 197 1,2
Total 16430 100,0
* Hypertension Controlled,
** Hypertension not controlled
a, d Without treatment a,b,c,d Hypertensive group(%23,7)
0,9 1,5 1,2
Figure 6.1 Distribution of blood pressure categories defined by the results obtained in the measurements and medical history, Turkey 2011.
Hypertension Prevalence By Sex and Age
The prevalence of hypertension is 24%. This rate is 21% in males and 26% in females. TURKSTAT 2010 population standardized Hypertension prevalence is 22%; 19% for males and 25% females (Table 6.3),(Figure 6.2).
Hypertension prevalence increases in both males and females with age. While hypertension prevalence for 15-24 age group is 3%, it increases to 14% for 34-44 age group; almost one of two people in 55-64 age group is hypertensive (53%). Hypertension prevalence in geriatric population (≥ 65 years) is 68%
(59% for males, and 76% for females) (Table 6.3) (Figure 6.3).
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Table 6.3 Hypertension prevalence by age, NUTS1 Regions and area of residence in male and female, Turkey 2011.
35-44 224 14,6 233 14,0 457 14,3
45-54 362 28,0 560 37,3 922 33,0
55-64 412 43,6 615 62,1 1028 53,1
65-74 302 58,4 422 75,1 724 67,1
75+ 178 60,3 304 77,6 482 70,3
NUTS1 Regions
İstanbul 324 22,3 405 24,9 729 23,7
Western Marmara 117 30,3 160 40,0 277 35,2
Aegean 199 19,6 334 27,1 534 23,7
Eastern Marmara 160 20,4 233 27,6 394 24,2
Western Anatolia 147 21,0 198 22,3 345 21,7
Mediterranean 201 19,9 228 21,5 428 20,7
Central Anatolia 86 21,4 142 29,9 227 25,9
Western Black Sea 128 26,0 189 34,7 317 30,6
Eastern Black Sea 84 29,9 100 32,7 185 31,5
North Eastern Anatolia 51 22,7 57 26,4 108 24,5
Middle Eastern Anatolia 60 15,5 71 21,3 131 18,2
South Eastern Anatolia 90 13,4 132 19,0 222 16,3
Area of residence
Rural 503 21,4 745 30,7 1248 26,2
Urban 1118 20,9 1460 24,1 2579 22,6
Total
* Standardized using Turkey 2010 population
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Figure 6.2 Crude and standardized hypertension prevalence, Turkey 2011.
15-24
25-34 35-44 45-54 55-64 65-74 75+
90
Figure 6.3 Hypertension prevalence by sex and age groups, Turkey 2011.
Hypertension prevalence is higher in females than males in each age group starting from 45-54 age group (Table 6.3). The prevalence in people living in rural areas is higher (26%) than the ones living in urban areas (22%). As it is so in general population, both in rural and in urban areas, hypertension prevalence is higher in females than in males (Table 6.3, Figure 6.4).
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35
Figure 6.4 Hypertension prevalence by sex and area of residence, Turkey 2011.
Hypertension Prevalence By NUTS1 Region
Hypertension prevalence varies between 16% (South-eastern Anatolia) and 35% (Western Marmara) by NUTS1 regions. Hypertension prevalence is higher in females than in males in each of the 12 geographical regions (Figure 6.5).
E. MarmaraW. Anatolia
MediterraneanC. AnatoliaW. Black SeaE. Black SeaNE. Anatolia ME. Anatolia
SE. Anatolia
Figure 6.5 Hypertension prevalence by sex and NUTS1 regions, Turkey 2011
Isolated systolic hypertension (systolic BP≥ 140 mmHg, diastolic BP < 90 mmHG) prevalence is 6%.
Isolated systolic hypertension prevalence increases with age, and the prevalence reaches to 22% in 65-and-above age group. Isolated diastolic hypertension is 3.9% (approximately 4% in both males and females).
77 Blood Pressure and Hypertension
Hypertension Diagnosis, Treatment and Control Rates
In total 17% of the participants (3059 individuals) declared that they had hypertension based on physician diagnosis, 85% of these participants were currently using medication for this diagnosis, and 63% of the one who are on medication have got chronic disease prescriptions. Hypertension awareness rate is 48%
in general; 36% in males and 58% in females.
Treatment and Control Rates in Hypertensive Group
Only 30% of the people with hypertensive had blood pressures under control. 42% of the patients do not use any medication although they have been diagnosed with hypertension; namely without treatment. 28%
of the patients using medication have their blood pressure not controlled. In females with hypertension, the rates for the ones not using medications, the ones with controlled blood pressure and the ones with not-controlled blood pressure are nearly the same (34%, 33% and 32% respectively). On the other hand, more than half of males (53.0%) are not receiving treatment currently; the rate for the ones with controlled hypertension is 25% (Table 6.4.), (Figure 6.6).
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Table 6.4 Treatment and control rates for hypertensive individuals by sex, age groups, area of residence and NUTS1 regions, Turkey 2011.
Not controlled Without
treatment Controlled Total
Sex n % n % n % n %
Male 355 21,5 874 53,0 419 25,4 1648 100,0
Female 729 32,4 773 34,4 748 33,2 2250 100,0
Age Groups
15-24 2 1,9 98 94,2 4 3,8 104 100,0
25-34 10 5,5 153 84,5 18 9,9 181 100,0
35-44 56 12,3 308 67,4 93 20,4 457 100,0
45-54 203 22,0 431 46,7 288 31,2 922 100,0
55-64 347 33,8 320 31,1 361 35,1 1028 100,0
65-74 282 39,0 195 26,9 247 34,1 724 100,0
75+ 185 38,3 142 29,4 156 32,3 483 100,0
NUTS1 regions
İstanbul 188 25,8 323 44,3 218 29,9 729 100,0
Western Marmara 83 30,0 120 43,3 74 26,7 277 100,0
Aegean 151 28,3 210 39,4 172 32,3 533 100,0
Eastern Marmara 116 29,4 160 40,6 118 29,9 394 100,0
Western Anatolia 95 27,6 124 36,0 125 36,3 344 100,0
Mediterranean 113 26,4 191 44,6 124 29,0 428 100,0
Central Anatolia 64 28,1 97 42,5 67 29,4 228 100,0
Western Black Sea 88 27,8 124 39,1 105 33,1 317 100,0
Eastern Black Sea 61 33,2 70 38, 53 28,8 184 100,0
North Eastern Anatolia 34 31, 56 51,4 19 17,4 109 100,0
Middle Eastern Anatolia 35 26,5 64 48,5 33 25,0 132 100,0
South Eastern Anatolia 55 24,7 108 48,4 60 26,9 223 100,0
Area of residence
Rural 379 30,4 555 44,5 314 25,2 1248 100,0
Urban 689 26,7 1056 40,9 834 32,3 2579 100,0
Total 1083 27,8 1647 42,3 1167 29,9 3898 100,0
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Figure 6.6 Treatment and control rates for hypertensive individuals by sex, Turkey 2011.
Among the hypertensive group, the proportion of individuals without treatment in rural areas in higher than in urban areas (44% for rural and 41% for urban areas). The proportion of controlled hypertension is lower in individuals in rural areas than the ones in urban areas (25% for rural areas, and 32% for urban areas) (Figure 6.7)(Table 6.4).
When NUTS1 regions are evaluated, the rate for hypertensive people without treatment is highest in North-Eastern Anatolia region (51%). The highest rate for controlled hypertension is Western Anatolia with 36%. On the other hand, the rate for uncontrolled hypertension is highest in Eastern Black Sea with 33% and North-eastern Anatolia with 31% (Table 6.4) (Figure 6.7).
45
E. MarmaraW. Anatolia
MediterraneanC. AnatoliaW. Black SeaE. Black SeaNE. Anatolia ME. Anatolia
SE. Anatolia
Figure 6.7 Treatment and control for hypertensive individuals by NUTS1 regions and area of residence, Turkey 2011.
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Hypertension Treatment-Control Rates in the Study Population
In this section, hypertension treatment-control rates were presented in the total study group.
The percentage of hypertensive males who are not on medication is 11%, and it is also seen that the rate for without treatment group increases in the hypertensive population as the age group increases: 17% of males in 45-54 age group, 19% of 55-64 age group, 19% of 65-74 age group, and 21% of the 75-and-above group do not use medication although they are hypertensive (Table 6.5) (Figure 6.8).
Table 6.5 Blood pressure categories by age groups, NUTS regions and area of residence in males, Turkey 2011.
55-64 534 56,4 107 11,3 179 18,9 127 13,4
65-74 215 41,6 105 20,3 100 19,3 97 18,8
75+ 117 39,8 49 16,7 62 21,1 66 22,4
NUTS1 regions
İstanbul 1131 77,7 63 4,3 177 12,2 84 5,8
Western Marmara 269 69,9 30 7,8 63 16,4 23 6,0
Aegean 818 80,4 42 4,1 108 10,6 50 4,9
Eastern Marmara 623 79,6 34 4,3 75 9,6 51 6,5
Western Anatolia 552 79,0 38 5,4 69 9,9 40 5,7
Mediterranean 809 80,2 39 3,9 109 10,8 52 5,2
Central Anatolia 315 78,6 15 3,7 49 12,2 22 5,5
Western Black Sea 364 74,1 26 5,3 63 12,8 38 7,7
Eastern Black Sea 197 70,1 27 9,6 37 13,2 20 7,1
North Eastern Anatolia 174 77,3 10 4,4 34 15,1 7 3,1
Middle Eastern Anatolia 327 84,5 21 5,4 31 8, 8 2,1
South Eastern Anatolia 581 86,5 8 1,2 58 8,6 25 3,7
Area of residence
Rural 1845 78,6 112 4,8 282 12,0 109 4,6
Urban 4221 79,1 239 4,5 574 10,8 305 5,7
Total 6160 78,9 355 4,5 874 11,2 419 5,4
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0,1 25-34 35-44 45-54 55-64 65-74 75+
Controlled Without treatment Not controlled
Figure 6.8 Hypertension prevalence and control-treatment rates for males by age groups, Turkey 2011.
In females the rate for individuals without controlled blood pressure increases in the hypertensive group which also increases with age. In general, the rate for the non controlled hypertension in females is 8%;
however this rate increases to 9% in 45-54 age group, 24% in 55-64 age group, and reaches to 34% in 75 and over age group. (Table 6.6) (Figure 6.9).
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Table 6.6 Blood Pressure categories by age groups, NUTS regions and area of residence in females, Turkey 2011.
Normal blood
Pressure HT-not
controlled HT-without
treatment HT-controlled
Age Groups n % n % n % n %
15-24 1665 97,9 - - 31 1,8 4 0,2
25-34 1731 95,6 5 0,3 63 3,5 12 0,7
35-44 1433 86,1 32 1,9 147 8,8 53 3,2
45-54 941 62,6 140 9,3 216 14,4 205 13,6
55-64 375 37,8 240 24,2 142 14,3 234 23,6
65-74 140 24,9 177 31,5 95 16,9 150 26,7
75+ 88 22,4 135 34,4 80 20,4 89 22,7
NUTS1 regions
İstanbul 1222 75,1 125 7,7 146 9,0 134 8,2
Western Marmara 240 59,9 53 13,2 57 14,2 51 12,7
Aegean 897 72,9 110 8,9 102 8,3 122 9,9
Eastern Marmara 612 72,3 82 9,7 85 10,0 67 7,9
Western Anatolia 690 77,7 57 6,4 56 6,3 85 9,6
Mediterranean 832 78,5 74 7,0 82 7,7 72 6,8
Central Anatolia 333 70,1 49 10,3 48 10,1 45 9,5
Western Black Sea 356 65,3 62 11,4 61 11,2 66 12,1
Eastern Black Sea 206 67,3 34 11,1 33 10,8 33 10,8
North Eastern Anatolia 160 74,1 23 10,6 21 9,7 12 5,6
Middle Eastern Anatolia 262 78,7 14 4,2 32 9,6 25 7,5
South Eastern Anatolia 563 81,1 46 6,6 50 7,2 35 5,0
Area of residence
Rural 1678 69,3 268 11,1 273 11,3 204 8,4
Urban 4591 75,9 450 7,4 482 8,0 529 8,7
Total 6372 73,9 729 8,4 773 9,0 748 8,7
83
25-34 35-441,9 45-54 55-64 65-74 75+
Controlled Without treatment Not controlled
Figure 6.9 Hypertension prevalence and control-treatment rates for females by age groups, Turkey 2011.
6.4 Discussion
In this study, the prevalence for hypertension in individuals of 15 years of age was found as 24%, with regard to hypertension history, medication status, and systolic-diastolic blood pressure values. Prevalence in females is 26%, and 24% in males. In the TEKHARF study in 1990, the high blood pressure frequency in Turkey was found 38% in females and 28% in males (3). In the TURDEP-I study conducted in 1998, hypertension prevalence in the individuals who are above 20 years of age was found 29% (7), and it was found as 32% in the Turkish Hypertension Prevalence Study (PatenT) conducted in 2003 among individuals who are 18 years of age and above (1). In this study, if the age group is taken as 20 and above as in TURDEP-I; hypertension prevalence would be 26 %, if the age group is taken as 18 and above as in PatenT, prevalence would be 25%.
According to the preliminary results of the TURDEP-II in 2010 hypertension prevalence rate is 31% and the difference between males-females and rural areas-urban areas disappeared (5) (Table 6.7).
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Table 6.7 Three previous HT prevalence studies conducted between 1998 and 2011 in Turkey, and comparative results.
TURDEP I Turkish
Hypertension Prevalence Study
(PatenT)
TURDEP II Chronic Diseases and Risk Factors
Study
Age group 20-and-above 18 and above 20-and-above 15-and-above
Year 1998 2003 2010 2011
HT definition History+BP
* Considering PatenT age group,
** Considering TURDEP age group
In this study, hypertension prevalence increases with age just as in the previous studies; hypertension prevalence for 34-44 age group is 14%, in 45-54 age group one of three people has hypertension. In the Turkish Hypertension Prevalence study, hypertension prevalence in geriatric population (≥ 65) was found 75% (67% for males, and 82% for females) (1). In this study, however, hypertension prevalence for the same age group is 68% (59% for males, and 76% for females.
It has been shown, in almost all of the previous studies, that hypertension is more frequent in females (1, 2). Similarly, this study, too, found that hypertension rate is higher in females than males in country general, in both rural and urban areas and also in each of the twelve NUTS1 regions. Again, starting from 45-54 age group, in each age group, prevalence in females is higher than males. It is thought that the reason for this high hypertension prevalence in females is obesity. Hypertension prevalence of the people living in rural areas was found higher than the ones in urban areas. In the Turkish Hypertension Prevalence study any difference between urban (31%) and rural (33%) areas was not found. However, it was reported that there were statistically meaningful differences between geograpical regions; the region with highest hypertension prevalence was Central Anatolia (38.5%) and the lowest was Eastern Anatolia (25%) (1). In this study, however, these regions are defined as NUTS1 regions and the lowest prevalence is in South-eastern Anatolia (16%) and the highest is in Western Marmara (35%).
According to the Turkish Hypertension Prevalence study, the rate for hypertension awareness was 41%
and this rate was higher in females than in males (48% vs. 28%) (1). In this study, however, hypertension awareness rate is found 48%; similarly awareness in females is higher than males (58% vs. 36%).
According to the results of TURDEP-II, hypertension awareness rate was 58%, and again the rate was higher in females than males (68% vs. 48%) (5). According to the study conducted in Kocaeli in 2009, hypertension awareness rate was 59% (8), is higher than the results of a previous study which had been
85 Blood Pressure and Hypertension
conducted in the same region 10 years ago (49% awareness rate in the previous study) (9).
In this study, the ratio of the patients who have hypertension but not using medication due to hypertension/
or patients without treatment is 42%. The rate for without treatment group is higher in males significantly.
In males, the rate for without treatment group increases as hypertension prevalence increases with age.
In this study, the rate for controlled blood pressure is found 7% in the study population. The same rate was 8% in PatenT study, 9% in Kocaeli study (1, 8).
According to the results of the study, only 30% of the hypertensive participants’ blood pressures are under control. The rate for not-controlled hypertension is higher in females than males (32% for females, and 21% for males). In the Turkish Hypertension Prevalence study, the rate for controlled hypertension was found 21%; similarly this rate is higher in males than females (31% in males and 17,4%in females) (1).
In conclusion, hypertension seems to be a significant chronic health condition and risk factor for our country with its 24% prevalence rate. Hypertension increases with age, and is higher in rural and in females.
Although there is an increase in hypertension awareness, compared to the previous years, unawareness is still high. Almost one third of the individuals in the hypertensive group have not-controlled blood pressure; being not-controlled in females and unawareness in males are seen as significant issues.
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References
1. Altun B and ark. Prevalence, awareness, treatment and control of hypertension in Turkey (the PatenT 1study).
Turkish Society of Hypertension and Renal Diseases. Journal of Hypertension 23(10):1817-1823, 2005 2. Ulusal Kalp Sağlığı Politikası. Türk Kardiyoloji Derneği, 2008. http://www.tkd-online.org/UKSP/TKD_
UlusalKalpSagligiPolitikasi_Taslak.pdf
3. Onat A. Türkiye’de erişkinlerde Kalp Hastalığı and Risk Faktörleri Sıklığı Taraması (TEKHARF). Türk Kardiyoloji Derneği Arşivi. 1991, 19 (169-171).
4. Arici M. for the Turkish Society of Hypertension and Renal Diseases. Hypertension incidence in Turkey (HinT): a population-based study. J Hypertens. 2009.
5. Satman I and ark. Türkiye Diyabet, Hipertansiyon, Obezite and Endokrinolojik Hastalıklar Prevalans Çalışması-II (TURDEP-II) Sonuçları. http://www.turkendokrin.org/files/file/TURDEP_II_2011.pdf
6. National Institute for Health and Clinical Excellence (NICE and British Hypertension Society).
7. Hypertension: Management of Hypertension in Adults in Primary Care: pharmacological update. Royal College of Physicians, London, 2006. www.nice.org.uk/CG034
8. Satman I. and ark. Population-Based Study of Diabetes and Risk Characteristics in Turkey. Results of the Turkish Diabetes Epidemiology Study(TURDEP-I). Diabetes Care 25:1551–1556, 2002.
9. Sarıışık A, Aytekin O, Uzunlulu M. Control of hypertension in Turkey – is it improving? The Kocaeli 2 study. Türkiye’de hipertansiyon kontrolü: Düzelme var mı? Kocaeli 2 çalışması. Türk Kardiyol Dern Arş - Arch Turk Soc Cardiol 2009;37 Suppl 6:13-16
10. Gundogmus A, Oguz A, Cinar Y, Gundogmus U, Seref B. Prevalence, awareness, treatment, and control of hypertension in Turkey: The Kocaeli study. J Hypertens 2000;18(Suppl 2):S166.
Diabetes
7
89 Diabetes
7 Diabetes
Professor Sibel KALAÇA Key Findings
• This section presents the diabetes prevalence in individuals above 15 years of age. Awareness, treatment and control rates were also evaluated bysex, age groups, area of residence and NUTS1 regions.
• 28% of the participants stated that at least one person had diabetes in their families.
• The rate for the individuals who stated that they had diabetes is approximately 8%, this rate is slightly higher in females (9%) than males (7%).
• Approximately 84% of the individuals who mentioned diabetes diagnosis use regular medication.
• The diabetes awareness rate is 74% and it is lower in males (69%) than females (78%).
• 16% of the population is prediabetic, there is no difference between males and females.
• The prevalence of newly diagnosed diabetes is 3%. According to the diabetes diagnosis which was determined using diabetes and medication history, and fasting plasma glucose measurement, diabetes prevalence in the 15-and-above age group is 11% (95% CI 10,6-11,6). There are not any differences between males and females; and between rural areas and urban areas.
• Diabetes prevalence increases with age, both in males and females.
• In terms of NUTS1 regions, diabetes prevalence varies between 9% (Eastern Central Anatolia region) and 14% (Western Marmara and Western Anatolia regions).
• The percentage of individuals with controlled diabetes is 29%, with uncontrolled diabetes is 40%, and the rate for individuals who has diabetes but are not receiving any treatment is 31%.
• The rate for uncontrolled diabetes is higher in females (41%) than males (38%); however, the rate for individuals who do not receive any treatment is higher in males (36%) than females (30%).
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7.1 Introduction
With the rapid change in life style, diabetes, especially type II diabetes prevalence is gradually increasing in developed and developing countries. While the population with diabetes around the world is 285 millions, by the end of 2009, this number is expected to reach 438 millions, by 2030 (1). The main reasons for this are population increase, aging and the increased obesity and physical inactivity caused by changing life style as a result of urbanization. According to estimations, diabetes prevalence in the adult population (20-79 age group) in Europe is 8.5% by 2010, and it is estimated that this rate would be 10%
in 2030, with a 18% increase (1). In other words, the current diabetes population in Europe, which is 55 million, is expected to exceed 66 million in 20 years. According to the results of the “Turkey Diabetes
in 2030, with a 18% increase (1). In other words, the current diabetes population in Europe, which is 55 million, is expected to exceed 66 million in 20 years. According to the results of the “Turkey Diabetes