مجله دیابت و متابولیسم ایران
سال پانزدهم شماره 1 (پیاپی 64، مهر و آبان 1394)

Diabetic foot ulcers are important topic in diabetes care. Diabetes is one of the most common metabolic diseases of endocrinology. Raspberry (Rubus fruticosus) has anti-inflammatory, anti-septic and anti-oxidant effects. The aim of present study is healing effects of raspberry extract on the regeneration process of skin wounds in control and diabetic rats. In this study, 48 adult male rats were divided into four groups (n=12 each) including: control group (non-treated and non-diabetic rats), sham (eucerin-treated diabetic rats), experimental1 (non-treated diabetic rats) and experimental 2 (raspberry-treated diabetic rats). Diabetes was induced by 55 mg/kg Streptozotocin (STZ) in three groups of rats. A wound with 3 cm length was created on the skin of back side of animals in all groups. The experimental 1 group was treated by eucerin and experimental 2 groups were treated by raspberry extract two times in a day. Microscopic and macroscopic studies were performed on wound healing process on days of 3, 5, 7, 14 and 21. The findings showed that sham and experimental 1 group had later healing effect comparing with control group. The speed of wound healing in raspberry extract-treated rats (experimental 2 groups) had significantly increased in comparison with control group and the wound surface area has been significantly decreased in comparison with all other groups (P ≤ 0.05). It seems that topical application of raspberry extract can accelerate the wound healing in diabetic rats and materials in raspberry extract stimulate the collagen synthesis, faster wound contraction and angiogenesis.

Glycogen synthase kinase 3 beta is a key regulator of many signaling pathways. It is reported that Inhibition of this kinase results neuronal survival. Accordingly in this study we investigated the effect of endurance training on the gene expression of GSK-3β in the sensory areas of the spinal cord of male Wistar rats with diabetic neuropathy. we randomly assigned 16 male Wistar rats into four groups: healthy control, healthy trained, neuropathy control, neuropathy trained. Intraperitoneal injection of a STZ (streptozotocin) solution (45 mg/kg) was used to induce diabetes. At two weeks after STZ injections, the mechanical allodynia and thermal hyperalgesia tests demonstrated the presence of diabetic neuropathy. A moderate endurance training protocol was performed for a six- week period. At 24 hours after the final training session, the rats were sacrificed and the L4-L6 sensory neurons of the spinal cord tissue were removed. GSK-3β mRNA expression was performed using real time-PCR. Statistical analysis shows that neuropathy trained experiences a decrease in gene expression in comparison to neuropathy control (P=0.02). On the other there was significant difference between healthy control and neuropathy control (P=0.02). However, there was no significant difference between healthy control and neuropathy trained. we claim that endurance training will effectively decrease the expression of GSK-3β in the sensory areas of spinal cord of male Wistar rats with diabetic neuropathy. Endurance training as a non- pharmacotherapy strategy can modulate and return GSK-3β to approximate normal levels.

Type 2 diabetes is a chronic disease that leads to many complications such as atherosclerosis. Matrix Metalloproteinase (MMPs) family plays a key role in atherosclerosis and remodeling of the vessel wall. The aim of this study was determination the Effect of eight weeks aerobic exercise with Portulaca oleracea seeds consumption on MMP-1, MMP-3 and MIP-1α in women with type 2 diabetes. In one Quasi-experimental study 28 women with type II diabetes (44 to 65 years old) selected and divided into 4 groups (Exercise, Supplement, Exercise-Supplement and Control groups) randomly. Exercise program included 8 weeks (3 sessions per week) with 50 to 70% of maximum heart rate. Supplemented groups received 7. 5 g Portulaca oleracea seeds every day. Blood samples were collected before and after the 8 weeks with 12 hours fasting conditions. P < 0. 05 considered statistically significant. Eight weeks of the aerobic training or portulacalo consumption cause a significant decrease in MMP-1، MMP-3 و MIP-1α levels, in comparison to pretest. However, the effectiveness of combination training and supplement is better in the above indicators. MMP-1 levels showed a significant difference between supplement, training, training- supplement group with control group (P = 0. 001) and between supplement exercise group with training- supplement (Respectively P = 0. 018, P =0. 039). MMP-3 levels showed a significant difference between supplement with training- supplement (P = 0. 007) and control group (P = 0. 011), exercise group with training- supplement (P = 0. 026) and control group (P = 0. 04). MIP-1α levels showed a significant difference between training- supplement and control group (P = 0. 001). The results showed both intervention exercise and purslane may be support from due to the effects of antioxidant and anti-inflammatory from oxidative stress induced diabetes and combination therapy was associated with synergistic effects.

Diabetic patients need to be followed for glycemic index regularly and HbA1c test is one of the most important biochemical markers for patient monitoring. HbA1c should be standardized based on international standards, but using internationally accepted assays are expensive. This study aimed to evaluate cost effectiveness of different assays which are currently used in Iran. In this economic evaluation study, five HbA1c assays (Pars Azmoon, NycoCard, DS5, Biosystems and CERA STAT 2000) have been evaluated for cost, sensitivity and specificity, true score and also incremental cost-effectiveness ratios. Tosoh G8 has been considered as reference method. Although none of the assays can be a good alternative for reference method, DS5 and pars azmoon had better cost effectiveness results compared to other assays. The quality of HbA1c assays need to be improved by using real tariff or the establishment of referral labs.

Diabetes mellitus is regarded as a major health problem due to its complications that these, nonetheless could be prevented or delayed with changes and modifications in the patients’ behavior and diet by understanding their beliefs.. The objective of this study was to explore the utility of the Theory of Planned Behavior (TPB) and complications of diabetes perceived risk to find modifiable diabetes-related believes in order to make behavior changes feasible. The present descriptive-analytical cross sectional study was conducted in Semirom Diabetes Clinic based on the TPB and complications of diabetes perceived risk, using a self-administered questionnaire. A total of 154 diabetic patients without complications of diabetes were participated in the study. Measured variables were patients’ attitude, subjective norm, perceived behavioral control, complications of diabetes perceived risk, intention to eat a healthful diet and nutritional style. Structural equation modeling was used to analyze data. The results revealed that the TPB and complications of diabetes perceived risk fitted the data acceptably well among the Type 2 diabetes and within dietary behavior. Perceived behavioral control, subjective norm, complications of diabetes perceived risk and intention to eat a healthy diet were related to healthy diet behavior. No relation was found between attitude and intention to eat a healthy diet. The TPB and complications of diabetes perceived risk is a useful theory in determining intentions of diabetic patients’ and their adherence to healthy diets. TPB and complications of diabetes perceived risk forms a framework for promoting dietary practice among Type 2 diabetic patients

The scavenger receptor class B type I (SR-BI), as the high density lipoprotein cholesterol (HDL-C) receptor, is a key component in the reverse cholesterol transportation. The objective of this study was to assess the association between exon1 (G→A) polymorphism of SR-BI gene and lipid profiles among the Tehran Lipid and Glucose Study (TLGS) population. This cross-sectional study included 774 adults (322 males and 452 females) aged 20–70 years, who were randomly selected from among TLGS population. Anthropometrical and biochemical variables for participants were measured. Selected SR-BI gene polymorphism was determined with restriction fragment length polymorphism (RFLP) using the Alu restriction enzyme. according to the results of current study, in the Tehran population, the allele frequency of SR-BI (G→A) polymorphism was 0.159 for an allele (minor allele) and 0.841 for G allele. Allele frequencies were in conformity with Hardy–Weinberg equilibrium. The result of this study showed that Subjects with the less common allele (allele A), after adjusting for age, have lower HDL-CandHDL3concentrations (p=0.046, p=0.041 respectively). lipid disorders are caused by the interaction of environmental and genetic factors; therefore, exon1 (G→A) polymorphism of SR-BI gene could not be the only cause for the abnormality in the HDL-C levels. In future, this polymorphism may be use as a molecular marker for diagnosis.

This study was designed to assess the effects of calcium and vitamin D supplementation on the metabolic status of pregnant women with gestational diabetes mellitus (GDM). This randomized placebo-controlled trial was performed at maternity clinics affiliated to Kashan University of Medical Sciences, Kashan, Iran. Participants were 56 women with GDM at 24–28 weeks gestation (18 to 40 years of age). Subjects were randomly assigned to receive calcium plus vitamin D supplements or placebo. All study participants were blinded to group assignment. Individuals in the calcium–vita- min D group (n = 28) received 1,000 mg calcium per day and a 50,000 U vitamin D3 pearl twice during the study (at study baseline and on day 21 of the intervention), and those in the placebo group (n = 28) received two placebos at the mentioned times. Fasting blood samples were taken at study baseline and after 6 weeks of intervention. The study was completed by 51 participants (calcium–vitamin D n = 25, placebo n =26). However, as the analysis was based on an intention-to-treat approach, all 56 women with GDM (28 in each group) were included in the final analysis. After the administration of calcium plus vitamin D supplements, we observed a significant reduction in fasting plasma glucose (p < 0.001), serum insulin levels (p = 0.02) and HOMA-IR (p = 0.001) and a significant increase in QUICKI (p = 0.003) compared with placebo. In addition, a significant reduction in serum LDL-cholesterol (P=0.02) and total cholesterol: HDL-cholesterol ratio (p = 0.003) and a significant elevation in HDL-cholesterol levels (p = 0.01) was seen after intervention in the calcium–vitamin D group compared with placebo. In addition, calcium plus vitamin D supplementation resulted in a significant increase in GSH (p =0.03) and prevented a rise in MDA levels (p = 0.03) compared with placebo. Calcium plus vitamin D supplementation in women with GDM had beneficial effects on their metabolic profile.