The assessment of downward Trend in Diabetic Nephropathy prevalence among Diabetic mellitus patients using Piecewise regression during 1992-2010 in Isfahan, Iran

Diabetes mellitus is a metabolic disorder which its subsequent complications such as retinopathy, nephropathy, ulcers, disability, and amputation increase the burden of the disease. Patient-knowledge-improving programs are employed to prevent disease progression and to improve the patients’ quality of life. In this way, we need to characterize the groups of patients with urgent need for more and rich in content programs. In the present study, we used Piecewise regression to evaluate the trends in diabetic nephropathy prevalence among patients registered in Sedigheh-Tahereh Research Center and also identify patients needing more attention. This retrospective study was conducted on 1935 registered patients in the center during 1992-2010.Piecewise regression was fitted using Joinpoint program 3.5.3 to identify change points. The results showed an upward trend with 2 change points in females (p-value= 0.06). There was 1 change point with an increased trend in recent years in elderly patients, older than 70 years (p-value=0.038).The prevalence of diabetic nephropathy was in rise without any change point among patients with academic education. In addition, patients with family history of diabetes showed the decreased trend with 2 change points (p-value= 0.040). Hypertensive patients experienced a fall in the trend up to 1997 and then this reminded stable. Evaluating of a disease trend and its complications can lead to developing new theory and innovation. However, this is suggested to conduct further studies to exploring other subgroups and discovering the reasons for increased trend of disease in some subgroups.