مجله غدد درون ریز و متابولیسم ایران
سال هفدهم شماره 5 (پیاپی 83، آذر و دی 1394)

Diabetes and its complications have a significant impact on patient's quality of life and spirituality can help improve the quality of life in such patients. The purpose of this study was to determine the relationship of spirituality with quality of life in patients with Type 2 diabetes. This was a descriptive-correlation study. Participants were 145 individuals with type 2 diabetes, patients of rural health clinics and the Valiasr hospital in Khorramshahr city, selected via stratified random and sampling methods. Data collection tools were a version of 29-item of the spiritual questionnaire (Parsian and Dunning) and a version of 26-item of the Quality of Life Questionnaire (World Health Organization), both questionnaires with previously confirmed validity and reliability in numerous studies. Data were analyzed using SPSS version 16 software and Pearson's correlation, T-test, ANOVA, Post Hoc and Stepwise Regression analytical statistics. There was a significant positive relationship between spirituality and quality of life (p<0.0001). The results show a statistically significant relationship between spirituality and quality of life with both education and age. A strong correlation between spirituality and quality of life in patients with type II diabetes, demonstrates the roles and responsibilities of healthcare providers, including physicians, nurses and patient's families in meeting the varied spiritual and religious needs of patients along with their therapeutic management. Focusing on improving spiritual health is also important in education programs for these patients.

Diabetes mellitus is associated with a wide range of kidney and liver disorders. The aim of this study was to compare the effect of alcoholic extract of aerial parts of Melissa officinalis on indicators of liver function and kidney in diabetic rats. Thirty-five wistar rats were divided into 5 groups (n=7 each) as follows: Control, diabetic control and three diabetic groups, which received alcoholic extract of Melissa officinalis at doses of 100, 200 mg/kg body weight respectively through gastric gavage and glibenclamide 10 mg/ kg, for a period of 3 weeks. Diabetes was induced by streptozotocin (STZ). At the end of this period (21 days), blood samples were collected for measurement of liver enzymes and factors for data analysis. Amounts of enzyme levels of alanine transaminase (ALT) and aspartate aminotran­sferase (AST) in the group treated with the extract, compared to the diabetic control group showed no significant changes, whereas serum levels of alkaline phosphatase (ALP) and gamma glutamyl transferase (GGT) were significantly reduced (P<0.05), which declined most in the group receiving the minimum dose of the extract. Serum creatinine and urea in the group receiving the highest dose showed a significant decrease compared to other groups (P<0.05). The extract Melissa officinalis with lower levels of liver enzymes, particularly ALP and GGT and renal markers, urea and creatinine was effective in improving liver function and treatment of diseases of the liver and kidneys.

Physical activity has beneficial effects in the prevention of metabolic syndrome components. The purpose of this study was to investigate the effects of circuit resistance training on changes in fasting blood glucose, blood fat and blood pressure in females with type II diabetes. In this study, twenty females volunteers with diabetes Type II (aged 50.2±4.8yr, BMI 30.16±3.6 kg/m2) participated and were randomly divided into a circuit resistance training and a control group aged 51.3±6.63yr, BMI 30.5±4.8 kg/m2. Circuit resistance training included of leg extensions, lying leg curl, bench press, cable triceps pushdown, frontarm, leg press, cable Row and sit-ups with 40-65 % 1RM for 3 days a week. Blood pressure and body composition was measured before starting the training protocol and after the last training session. Changes from baseline were assessed using the paired sample t-test. In addition, pre-and-post comparisons between groups were analyzed, using the independent student t-test. Results showed significant changes in glycosylated hemoglobin (HbA1c) (P<0.03) and total cholesterol (TC)(P<0.02) between these two groups after intervention, whereas no significant changes occurred in fasting blood sugar, triglycerides (TG), highdensity lipoprotein (HDL-C), low-density lipoprotein (LDL-C), levels or in systolic or diastolic blood pressure, or waist to hip ratio (WHR). Circuit resistance training with 40-65%1RM can decrease glycosylated hemoglobin and total cholesterol in patients and plays an important role in improving symptoms of metabolic syndrome in patients.

The general aim of this study was to evaluate and compare the effects of 12 weeks of moderate and heavy intensity exercise training and determine the optimal intensity level/rate for maximum weight loss in obese and overweight women. Forty one subjects were randomly assigned into the moderate (16 subjects with 64-76% of maximum heart rate), heavy intensity (15 subjects with 80-90% of maximum heart rate) exercise and control (10 subjects groups). Following two stages blood sampling at rest, and fasting, subjects completed appetite questionnaires. In addition, subjects exercised three times a week, one and a half hour after breakfast. Results showed that calorie expenditure in the moderate intensity group was significantly higher than in the heavy intensity group. The results showed decreased weight (P=0.004) and body fat (P=0.001) in both exercise groups compared to the control group. Exercise had no effect on appetite and plasma acylated ghrelin, leptin and insulin concentrations. Results showed that moderate intensity, individuals can exercise longer with there by increase the energy expenditure and controlling their appetite, fundings which can be used to design exercise programs for the prevention and treatment of obesity.

About 20-40% of people with diabetes experience varying levels of distress and general symptoms of anxiety and depression. This study aimed to evaluate the effects of mindfulness-based stress reduction group training on depression, anxiety, stress, self-confidence and hemoglobin A1c in young women with type 2 diabetes. In this pretest-posttest-control group design study, we used instruments such as demographic data and depression, anxiety and stress (DASS-21) and the Rosenberg self-confidence questionnaires. The study population included 60 patients with diabetes randomly divided into 2, the experimental and control groups. The experimental group received the mindfulness intervention with 8 sessions each 2.5 hours while the control group received no intervention. Following this, during the ninth, session both groups again completed the questionnaires. Patients in experimental group reported lower levels intensity of anxiety, stress and HbA1C, but higher self-confidence in comparison to the controls after intervention (P<0.05), although differences in levels of the depression variable between two groups was not significant. In addition, between HbA1c and all variables, (depression, stress, self-confidence) significant correlations were observed. Results suggest that depression, anxiety, stress and self- confidence are associated with HbA1C level and a mindfulness-based stress reduction program can be effective in reducing the psychological symptoms in these patients, leading to increased confidence and improved glycemic control in women with type 2 diabetes.

Binge eating disorder (BED) is one of the most common mental disorders in overweight and obese individuals. However, it seems that there are psychological differences between people with and without this disorder. The aim of the present research was to compare impulsivity and difficulties in emotion regulation in overweight women with and without BED. For the research a descriptive, causal comparative method was used. Participants were selected voluntarily from among overweight and obese women attending health houses, gyms and weight loss clinics of Tehran. Fifty-two women with BED were identified based on criteria of diagnostic and statistical manual of mental disorders (DSM) for BED and were matched with 52 women without BED in terms of BMI and age. The research instruments were the Eating Disorders Diagnostic Scale (EDDS), the Barratt Impulsivity Scale (BIS-11) and the Difficulties in Emotion Regulation Scale (DERS). Data was analyzed using Multivariate Analysis of Variance (MANOVA). Findings showed that, compared with non-binge eating women, binge eating women had more impulsivity (P<0.05) and difficulties in emotion regulation (P<0.01). In particular, binge eating women had higher scores than non-binge eating women with regard to attentional impulsivity (P<0.01) and motor impulsivity (P<0.05). However, In terms of difficulties in emotion regulation, binge compared to non-binge eating women, binge-eating women had higher scores with regard to non-acceptance of negative emotions (P<0.01), difficulties engaging in Goal-Directed Behavior (P<0.01), Impulse Control Difficulties (P<0.01), and limited access to effective Emotion Regulation Strategies (P<0.01). These findings emphasize that impulsivity and difficulties in emotion regulation play an important role in individuals with BED and focusing on these factors would enhance treatment and management of BED patients.

Adipose tissue secretes many adipokines, including chemerin, visfatin, and apelin. The aim of the present study was to investigate the effect of 12 weeks of aerobic exercise on plasma levels of apelin and blood pressure in hypertensive middle-aged women. In this study, 30 elderly hypertensive women were selected and randomly divided into two groups, the control and experimental. The training program included aerobic exercises conducted, 3 times a week, for 12 weeks. Blood samples and blood pressure measurements of participants were obtained both before starting the exercise training and again 24 hours after the last training session. Data was evaluated by using the dependent and independent t-test for comparisons within groups and between groups, with significance level set at p≤0.05. After 12 weeks of aerobic exercise, decline in serum levels of Apelin (p=0.03), and systolic blood pressure (p=0.001) were observed in the experimental group, whereas no significant difference in diastolic blood pressure (p=0.12) was seen. In the control group however no significant changes in serum levels of apelin (p=0.50), systolic blood pressure (p=0.20) and diastolic blood pressure (p=0.40) occurred. The results showed that 12 weeks of aerobic exercise, caused a decreasing trend in levels of plasma apelin and systolic blood pressure, thereby lowering blood pressure of patients hypertensive.

Sickle Cell Disease, Hemoglobinopathy which often requires frequent blood transfusions, is an excessive deposition of iron in the tissues, often resulting in endocrine disorders. This study aimed to determine the prevalence of endocrinopathies and metabolic disorders in patients suffering from sickle cell anemia in Kerman. This cross-sectional study was conducted on 66 patients, suffering from sickle cell anemia. An information form was completed for all patients and blood samples were obtained for laboratory tests such as fasting blood sugar, serum TSH level, free T4 level, serum LH and FSH levels, serum PTH, total Ca, P and serum prolactin levels. Serum testosterone- and serum estradiol levels were checked separately, based on gender. Results were compared with normal laboratory tests, and statistically analyzed. In this study, sickle cell anemia patients, aged 14–59 were evaluated. None of the patients had diabetes mellitus. Hypothyroidism was observed in 24.2% of patients, hypoparathyroidism in 12.5%, hypogonadism in 21.2% and hyperprolactinemia in 53%. Overall, 65.1% were found to be suffering from endocrine disorders. Statistically significant differences were seen between endocrinopathies and age. Results showed age to be the important factor in endocrine disorders. Timely and appropriate treatments (including blood transfusion and receiving iron chelators) can evidently reduce iron overload in these patients and prevent its endocrine complications.