فهرست مطالب

Iranian Journal of Diabetes and Obesity
Volume:15 Issue: 4, Winter 2023

  • تاریخ انتشار: 1402/10/18
  • تعداد عناوین: 8
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  • Akram Mehrabbeik, Mohsen Mirzaei, Maryam Askari, Mohamad Ali Sahami, Mozhgan Minoosepehr, Nasim Namiranian* Pages 194-200
    Objective

    Diabetes mellitus is reported to be the third most prevalent comorbidity with COVID-19, after cardio‐cerebrovascular disease and hypertension. Furthermore, diabetes increases the likelihood of admission to the hospital and intensive care unit and death from COVID-19. The aim of the present study was to compare the clinical manifestations and outcomes of COVID-19 in diabetic versus non-diabetic inpatients.

    Materials and Methods

    The medical records of 6525 patients with definitive diagnosis of COVID-19 were obtained from the reference COVID-19 diagnosis laboratory from January to July 2021 in Yazd, Iran. Patients were investigated for data on onset, clinical history, and fatality rate. COVID-19-related death was defined as positive RT-PCR in at least one of three nasal samples. Data were analysed using SPSS 24.

    Results

    Among inpatients, 21.2% were diabetic. The mean ages of diabetic and non-diabetic patients were 64.45 (±13.87) and 52.98 (±20.36) years, respectively. Diabetics were more likely to be admitted to the intensive care unit (6.8% vs. 5%, P= 0.02) and the fatality rate was higher among them than non-diabetics (22.6% vs. 12%, P< 0.001). In diabetics, the mean age of non-survivors was lower than that of survivors (62.57 vs. 70.48, P= 0.0001) and the frequency of death was higher among men than women (53% vs. 47.5%, P= 0.045). Generally, diabetes has the strongest association with COVID-19 death (P= 0.0001).

    Conclusion

    Diabetic patients experience more adverse outcomes because of COVID-19. These findings indicate the need for special attention in relation to prevention treatment against COVID-19 in patients with diabetes.

    Keywords: COVID-19, Diabetes, Inpatients, Outcomes
  • Mehdi Behkar, Mojtaba Eizadi*, Saeid Sedaghaty, Yaser Kazemzadeh, Motahareh Moslehi Pages 201-207
    Objective

    Apart from hormonal factors and oxidative stress, insulin synthesis is strongly dependent on transcription factors in the pancreas. The aim of the present study was to assess the impact of high-intensity interval training (HIIT) on genes affecting insulin synthesis in diabetic obese rats.

    Materials and Methods

    Type 2 diabetes (T2D) was induced by a 6-week high-fat diet (HFD) and intraperitoneal injection of streptozotocin (25 mg /kg) in 14 male Wistar rats (10 week old, 220±10 g). Rats with fasting glucose levels between 400 and 150 were considered T2D. The diabetic rats were randomly assigned to exercise (HIIT: 6 weeks/5 sessions weekly, n= 7) or control (n= 7) groups. Forty-eight hours after the intervention, fasting GLP-1R and PKBα gene expression in pancreatic tissue and plasma insulin and glucose levels were compared between the groups. Data were compared by independent t-test used to compare variables, version 22 between groups. A P< 0.05 was considered significant.

    Results

    HIIT led to significant increase in PKBα gene expression (P: 0.001) and insulin (P: 0.031) and decreases in glucose concentration (P: 0.001) compared with the control group. No change was observed in the GLP-1R gene expression response to HIIT (P: 0.093).

    Conclusion

    HIIT is associated with increased serum insulin levels in T2D obese rats. Despite no change in GLP-1R, this improvement is probably rooted in increased expression PKBα in pancreas in response to this type of exercise training.

    Keywords: GLP-1R, PKBα, High fat diet, High intensity interval training, Diabetes
  • Ensieh Yazdkhasti, Farnaz Seifi Skishahr*, Reza Farzizadeh Pages 208-217
    Objective

    Adipose tissue-derived adipokines affect cardiometabolic health. This study aimed to evaluate the effect of interval resistance training with different intensities on leptin, adiponectin, and acrosin levels in obese males.

    Materials and Methods

    Fourty-four obese males (27.70± 3.02 years) were randomly allocated into four groups: high intensity (HI), moderate intensity (MI), low intensity (LI), and control (C). Subjects of the HI, MI, and LI groups implemented the training program for 12 weeks, three sessions a week with intensities corresponding 80% 1RM, 60% 1RM, and 40% 1RM,, respectively. Body composition and plasma levels of leptin, adiponectin, and asprosin were evaluated before and after interval resistance training at different intensities.

    Results

    Following exercise, serum levels of leptin and asporin were significantly reduced in all groups (P< 0.01). The greatest reduction of leptin and asporin levels was recorded in the HI group (P= 0.001, P= 0.01) for leptin and asporsin levels, respectively. The level of adiponectin significantly decreased after exercise in all groups (P< 0.001, F= 12.44). The greatest reduction was observed in the HI group compared with the MI and UI group (P= 0.001).

    Conclusion

    Interval resistance training with different intensities can cause significant changes in leptin, asprosin, and adiponectin levels in obese men, and this improvement was better at high intensities.

    Keywords: Obesity, Leptin, Adiponectin, Asprosin, Interval resistance training
  • Fatemeh Zargar, Ailin Salmani*, Neda Mostofizadeh, Reza Bagherian Sararoodi, Zahra Heydari Pages 218-227
    Objective

    Type 1 diabetes mellitus (T1DM) is one of the most common chronic diseases in childhood, and its management is associated with many problems. The study aimed to compare the effect of group self-care training and patient child play (PCP) on quality of life (QoL) in children with type 1 diabetes in Isfahan, Iran.

    Materials and Methods

    This randomized trial was done from January 2020 to October 2021 in Endocrine and Metabolism research center of Isfahan University of medical sciences. Seventy- five children aged 8 to 11 years with T1DM who did not have a severe behavioral problem based on the child behavior checklist (CBCL) were simple randomly assigned to three groups: self-care training, play therapy, and control. The self-care group received ten education sessions via the Skyroom and the playgroup performed PCP for ten sessions. The control group did not receive any psychological intervention. All participants received routine diabetes medication. They completed a health-related QoL questionnaire for children (KIDSCREEN-52) before and after the intervention. Data were analyzed using SPSS-23 software and analysis of covariance.

    Results

    A significant difference between the mean scores of the post-test subscales of physical well-being (P= 0.003), psychological well-being (P= 0.003), moods and emotions (P= 0.02), self-perception (P= 0.002), self-autonomy (P= 0.002), parental relationships and family life (P= 0.001), social and peers support (P= 0.04), school environment (P= 0.003) and social acceptance (P= 0.001) in PCP group.

    Conclusion

    Self-care training and PCP are effective in increasing the QoL, and can be used as a complementary treatment in children with T1DM.

    Keywords: Quality of life, Diabetes mellitus, Play therapy, Children
  • Tamer Addissouky*, Majeed Ali, Ibrahim El Tantawy El Sayed, Yuliang Wang Pages 228-242

    Diabetes mellitus is a chronic metabolic disease characterized by hyperglycemia resulting from inadequate insulin signaling. Current management relies on biomarkers such as hemoglobin A1c (HbA1c) to guide therapy, but emerging tools offer opportunities to transform care through more personalized approaches. Molecular biomarkers, including microRNAs, metabolites, and proteins, may enable better prediction of disease course and risk of complications in individuals. Genomic medicine leverages knowledge of genetic architecture to guide tailored prevention and treatment based on an individual’s genomic profile. Stem cell research differentiates functional insulin-secreting cells for transplantation into patients as an alternative to exogenous insulin. Gene silencing techniques such as RNA interference can restore defective insulin production and secretion pathways by inhibiting dysregulated gene expression. Artificial intelligence applications automate glucose monitoring, insulin delivery, diagnostic screening for complications, and digital health coaching. Despite barriers to translation, these technologies have disruptive potential for predictive, preventive, precise, and participatory care paradigms in diabetes management. Continued research on molecular biomarkers, pharmacogenomics, stem cell therapies, gene editing, and artificial intelligence (AI) aims to improve patient outcomes through more personalized approaches tailored to the specific biological vulnerabilities underlying each individual’s diabetes.

    Keywords: Diabetes mellitus, Molecular biomarkers, Genomic medicine, pharmaceutical advances, gene therapy, Artificial intelligence
  • Sachini M Thennakoon*, Niroshima D Withanage Pages 243-255

    The relationship between gamma-glutamyl transferase (GGT) levels and risk factors for type 2 diabetes mellitus (T2DM) and the risk of incident T2DM was assessed using a narrative review of available evidence. Higher circulating levels of GGT are associated with an increased risk of type 2 diabetes mellitus, suggesting GGT as a risk predictor of T2DM. The incidence of type 2 diabetes and its association with GGT elevation could be explained by oxidative stress in cells followed by subclinical inflammation and fatty liver, leading to impaired insulin secretion and insulin resistance. A strong correlation is evident between BMI and GGT, in which hepatic steatosis and insulin resistance are proposed to be the intermediate connecting characteristics.

    Keywords: Gamma-glutamyl transferase, Type 2 diabetes mellitus, Body mass index
  • Mohammad Mehdi Hakimian, Najmeh Sedrpoushan*, Farid Abolhassani Shahreza Pages 256-260
    Objective

    The purpose of this study was to investigate the effectiveness of acceptance and commitment based group therapy (ACT) with the Islamic approach to reduce anxiety and depression in patients with type II diabetes referent to the Yazd Diabetes Research Center.

    Materials and Methods

    The study method was the semi experimental. Forty diabetic patients were simple randomly divided into two equal experimental and control groups. The study was done in the patients referent to the Yazd diabetes center (n= 5000), using a purposeful sampling method. So, all of the patients did completed the beck anxiety (BAI) and depression (BDI-II) questionnaire for diabetic patients. Then, the experimental group received ACT with an Islamic approach every other week during 16 weeks and 120 minutes for each time, and the control group continued their normal plan. The population of both groups performed the anxiety (BAI) and depression (BDI-II) questionnaire again after performing the instructional plan.

    Results

    In this research, the covariance analysis test was used to analyze the results. The findings of the research showed that ACT with an Islamic approach effects on the anxiety (P: 0.001) and depression (P: 0.001) in type II diabetes people.

    Conclusion

    The results showed that ACT with Islamic approach is effective on reducing anxiety rate and depression of type 2 diabetic people. Scores of post-test confirmed the effect of treatment method ACT with Islamic approach on reducing of anxiety and depression rate.

    Keywords: Type II diabetes, Acceptance, commitment based therapy, Islamic approach, Anxiety, Depression
  • Mohammad Mehdi Hakimian, Najmeh Sedrpoushan*, Farid Abolhassani Shahreza Pages 261-265
    Objective

    The purpose of this study was to investigate the effectiveness of acceptance and commitment based group therapy (ACT) with the Islamic approach to diabetes control, increasing self-care behaviors in patients with type II diabetes mellitus (T2DM) referent to the Yazd Diabetes Research Center.

    Materials and Methods

    The study method was semi experimental with control group. For this purpose, 40 diabetic patients were randomly divided into two experimental and control groups. The study was in Yazd diabetes research center. The purposeful sampling method was done. So, all of the patients did the A1C hemoglobin test, and completed the self-care questionnaire for diabetic patients (SDSCA). Then, the experimental group received ACT with an Islamic approach during 16 weeks. The population of both groups performed the A1C Hemoglobin test and completed the self-care questionnaire again after performing the instructional plan. In this research, the covariance analysis test was done to analyze the results.

    Results

    The findings of the research showed that ACT group therapy with an Islamic approach effects on HbA1c decreasing (P: 0.001) and self-care behaviors improvement (P: 0.001) in T2DM patients.

    Conclusion

    This study showed that the treatment group based on commitment resulted in a significant reduction of HbA1 and a significant increase in self-care activities in patients with T2DM.

    Keywords: Type II diabetes, Acceptance, commitment based therapy, Islamic approach, Self-care, Diabetes control