فصلنامه پرستاری دیابت
سال دوم شماره 3 (پاییز 1393)

Momordica charantia (karela) has been used for alleviating the damaging effects of metabolic disorders in Indian traditional medicine. In this study، we aimed to study the effects of karela extracts on serum glucose، lipid and malondialdehyde (MDA) levels in streptozotocin-diabetic rats. In this study، 40 male rats were divided into four groups. The control group received a normal diet، and diabetes was induced in the other three groups، using streptozotocin. One week after diabetes induction، the first and second groups were fed a normal diet. The third and fourth groups received karela leaf extracts (100 and 200 mg/kg) for 6 weeks via gavage. Serum glucose، lipoprotein، and MDA levels were evaluated in the groups. One-way analysis of variance (ANOVA) and Tukey’s test were performed for data analysis. Serum glucose level was significantly higher in the diabetic and karela-treated diabetic groups during the sixth week of intervention، compared to the previous week; in other words، treatment with karela extracts significantly reduced serum glucose level (P<0. 05). Administration of different doses of karela extracts decreased MDA level، compared to the non-treated diabetic group. Serum HDL level also significantly increased in the karela-treated group، compared to the non-treated diabetic group (P<0. 05); however، the extracts had no significant impacts on other serum lipids. The results indicated that karela leaf extracts may be effective for the treatment of diabetes in rats. This effect can be due to the presence of flavonoids and antioxidant compounds in this plant.

Diabetes mellitus is a chronic disease with significant effects on an individual’s mental، social and personal functioning. The aim of the present study was to compare coping styles and mental health in patients with type II diabetes and non-diabetic individuals. This causal-comparative study was conducted on all patients with type II diabetes، referring to the Diabetes Clinic of Taleghani Hospital in Kermanshah in 2014. The two groups were selected via available sampling. In total، 55 men and 55 women were enrolled in each group. Coping styles and mental health questionnaires were distributed among the participants. Data were analyzed using one-way analysis of variance (ANOVA) and independent sample t-test. There was a significant difference between the two groups in the subscales of coping styles (avoidant، emotional، cognitive، behavioral، and problem-focused styles) and mental health (physical function، agitation، social function and depression) (P<0. 01). Psychological features are among important factors، which are closely related to physical disorders، and should not be neglected in the treatment process.

Peripheral neuropathy occurs in about 50% of people with long-term type I and II diabetes mellitus. In this study, we aimed to evaluate the prevalence of neuropathy in type II diabetic patients at Ahwaz Petroleum Industry Healthcare Center, based on Michigan Neuropathy Screening Instrument and signs of neuropathy in 2012-2013. In this cross-sectional study, 325 patients with type II diabetes were randomly enrolled. Demographic characteristics were collected using a demographic questionnaire. The patients were evaluated in terms of mental symptoms, using UK questionnaire. The neuropathic symptoms of patients were evaluated, using Michigan standard table (Monofilament testing and diapason of 128Hz). In total, out of 221 patients participating in this study, 118 cases (53.4%) were female and 103 cases (46.6%) were male. The mean age of patients was 57±7.9 years. In terms of treatment method, 179 cases (81%) received oral medications, 21 patients (9.5%) received drug injections, and 21 cases (9.5%) used both methods. In terms of educational level, most of the studied samples had less than a high school diploma (65.6 %). Based on the patients’ statements and UK questionnaire, the prevalence of neuropathy was 58.8 %. According to the Michigan Screening Instrument and assessment of patients by physicians (using Monofilament testing and diapason), the prevalence of neuropathy was estimated at 33.5%. Based on the findings, in order to prevent diabetic foot ulcerations, it is necessary to screen diabetic patients regarding the probability of neuropathy (without considering the signs of neuropathy).

Continuous care is a regular and continuous process for establishing an interactive and effective communication between clients (as the receivers of continuous care) and health care providers (nurses) for identifying the clients’ needs and problems, sensitizing them to accept and perform continuous health behaviors, and improving their health status. This study aimed to compare the perception of patients with type 2 diabetes and their families regarding continuous care at hospitals affiliated to Isfahan University of Medical Sciences. This descriptive-analytical study included 140 patients with type 2 diabetes and 140 family members at Isfahan hospitals (Alzahra, Amin, khorshid, and Isa Ibn Maryam hospitals). The subjects were admitted to the hospitals in 2014 and received continuous care during their hospital stay and after hospital discharge. A questionnaire was used for data collection after confirming its reliability and validity. Descriptive and inferential statistics (Friedman and correlation coefficient) were applied, using SPSS. The findings of this study showed that the mean score of familiarization (54.32±14.74) and sensitization (17.57±8.61) were higher in family members than patients. However, the mean perception of control (104.62±23.39) and evaluation (33.49±7.03) were higher in patients than family members. Patient and family involvement in the implementation of continuous care and identification of short- and long-term complications of the disease lead to a greater understanding of the disease and the accurate implementation of healthcare plan. Therefore, nurses should run training programs for patients and their family members.

Sleep is an indispensable part of one’s lifestyle. On the other hand, sleep disorders may lead to many health problems. Changes in sleep duration are associated with cardiovascular diseases, metabolic disorders, weight gain and obesity. The present study aimed to evaluate the relationship between sleep duration and changes in serum glucose level in type II diabetic patients. This cross-sectional study was conducted on 108 patients with type II diabetes. A researcher-made questionnaire was used for data collection. T-test, Chi-square and one-way analysis of variance (ANOVA) were performed for data analysis. The obtained results showed a significant correlation between fasting blood glucose and sleep duration (P=0.0001, r=0.33). According to the results, the mean sleep duration was 6.2±1.8 hours. Body mass index was significantly higher in diabetic women than diabetic men (P=0.007). Also, serum glucose level in diabetic patients, who slept more than 8 hours, was higher than that reported in other diabetic patients (P=0.01). In this study, diabetic patients with longer sleep duration had high fasting blood glucose level. Therefore, prevention of sleep disturbances, with an emphasis on sleep health and normal sleeping time, seems necessary for inhibiting serum glucose variations.

This study was performed with regard to the concerns of World Health Organization about diabetes mellitus, high prevalence of diabetes mellitus and the associated complications during pregnancy, and the absence of information about risk perception for developing diabetes in women with a prior history of gestational diabetes. This cross-sectional study was conducted on a random sample of 315 women with a previous history of gestational diabetes mellitus. Data were collected using Risk Perception Survey for Developing Diabetes (RPS-DD). In this study, we evaluated risk perception for developing diabetes from different aspects and examined its correlation with other variables. The mean age of participants was 30.36±6.3 years. The majority of participants (69%) referred to a prior history of gestational diabetes as a risk factor for developing diabetes mellitus. More than 90% of participants believed that they were greatly at risk of developing diabetes mellitus. Moreover, 33% of subjects considered themselves to be at a higher risk of diabetes mellitus, compared to their same-age counterparts. Moreover, more than 90% of mothers had a high perceived risk of diabetes mellitus. Despite the high perceived risk of developing diabetes mellitus among the participants and changes these individuals had made in their lifestyle for avoiding diabetes, the evaluation of different factors (e.g., use of vegetables and fruits, physical activity, and body mass index) indicated unsatisfactory results. These findings imply the importance of patient follow-up, home-based care and counseling, along with educational programs for these hwomen.

Diabetes is a major cause of morbidity, mortality and increased health care costs, worldwide. In case of co-occurrence with stress, depression and anxiety, the extent and severity of diabetes may be intensified. The high prevalence of psychological problems in diabetic individuals has negatively affected the prognosis of diabetes. Accordingly, the present retrospective study was performed to evaluate the comorbidity of diabetes and certain psychological problems such as stress, depression and anxiety. In this study, literature search method was applied to review the published research. Online databases were searched to find relevant articles and studies. The obtained results showed that the comorbidity of psychological problems and diabetes reduced metabolic control and quality of life, decreased adherence to an appropriate diet and medical regimens, increased healthcare costs and use of insulin, and gave rise to the adverse side-effects of diabetes, morbidities, and mortality. According to the results, screening diabetic patients for common psychological problems such as stress, depression and anxiety and implementing strategies such as stress-management training and depression/anxiety treatment seem necessary for enhancing patients’ adaptation and quality of life.