Iranian Journal of Diabetes and Obesity
Volume:7 Issue: 3, Autumn 2015

Social determinant of health (SDH) are different from medical care and services. These factors themselves are affected by social policies, and they influence health more than medical care and services do. Due to the importance of chronic non-communicable diseases especially diabetes in Yazd, and assuming the effect of SDH, the present study was conducted in order to examine the relationship between diabetes control and SDH.
This was a cross-sectional study. The statistical population were diabetic patients who has referred to diabetes center of Yazd. Sampling method was systematic random selection. The study inclusion criteria was type II diabetes, and exclusion criteria were gestational diabetes, type I diabetes, lack of inclination to participate in the study, lack of access to the patient, death, and immigration from Yazd. In order to examine the SDH more precisely, a combined variable labeled “socioeconomic position (SEP)” including the patient’s place of residence and job was created.
Totally 511 type II diabetes patients were studied; 288 women (56.4%) and 223 men (43.6%). The mean age of participants was 56.68 years with a standard deviation (SD) of 10.566. Among patients 119 patients (23.3%) reported tobacco consumption. (Table 1) Out of the sample, 223 men whose mean (±SD) HbA1c was 8.6284±1.87 and 288 women whose mean (±SD) HbA1c was 8.6269±1.69 were reported to have no significant difference in terms of their gender and hemoglobin number (P-value=0.922). There were significant difference in HbA1c mean between different groups and SEP.
It can be concluded that the role of social factors and also psychological and mental criteria in understanding the risk of chronic disease and health is due to the negative effects of economic and collective factors, and that the highest level of physical and mental risks is among patients who have experienced hard conditions over time.

Lumbar spinal canal stenosis (LSCS) has prominent position in spinal disorders of the elderly. Ligamentum flavum hypertrophy plays a dominant role in narrowing of the LSCS. There are some clues that Ligamentum flavum hypertrophy is associated with diabetes mellitus. Our objective was comparison of histological properties of ligamentum flavum in Lumbar spinal canal stenosis patients with and without diabetes mellitus.
In this case control study, during 9 months, twenty-nine patients, who were candidate for decompressive laminectomy because of ligamentum flavum hypertrophy, were studied. They were labeled as diabetic if had history of diabetes mellitus or fasting blood sugar ≥126mg/dl for two times or blood sugar >200mg/dl anytime with symptom of hyperglycemia. Ligamentum flavum was removed through surgery. Samples were evaluated by pathologist using Hematoxylin &Eosin, Masson’s trichrome and Verhoeff van Gieson staining. Evaluation includes grading of fibrosis, loss of elastin fibers, calcification and number of cellularity of samples. Data analyzed with Fisher’s test and Mann-Whitney test.
In this study 41% of patients (12 persons) were suffering from diabetes mellitus. There was no significant difference between diabetic and nondiabetic patients in histological properties. (P>0.05); but the weight of diabetic patients was higher than nondiabetics (P-value =0.038)
These results show that diabetes mellitus has no effect on histological change in ligamentum flavum of spinal canal stenosis and mechanical stress (due to overweight) has a more important role in pathogenesis of spinal canal stenosis.

The aim of this study was to evaluate the effect of zinc and magnesium supplementation on glycemic control and serum insulin in type 2 diabetic patients.
In this randomized clinical trial 70 diabetic patients who referred to Yazd Diabetes Center were selected. Subjects received 500 mg/day magnesium oxide or 100 mg/day zinc sulfate randomly for 8 weeks. At the start and end of treatment period fasting blood sugar (FBS), 2 hour postprandial glucose (2-hpp), glycated hemoglobin (HbA1C) and fasting insulin level were measured.
Magnesium and Zinc supplementation for 8 weeks cause significantly decrease in HbA1c (P=0.005, P=0.001).No significantly difference was observed after trial between magnesium and zinc groups in FBS (42.08 ±7.43 vs. 35.15 ± 6.52) (P=0.97), HbA1C (1.22±0.21 vs. 1.77±0.32) (P=0.07) and fasting serum insulin (39.81 ±7.03 vs.36.68±6.81) (P=0.83) respectively.
Results of this study showed that 500 mg/day magnesium oxide or 100 mg/day zinc sulfate administration for 8 weeks could improve HbA1C in type 2 diabetic patients and this effect is same in two groups. But more studies for evaluating effect of magnesium and zinc supplementation on type 2 diabetic patients were suggested.

Studies reported conflicting results’ regarding the status of depression and glycemic control in patients with type II diabetes(T2DM), therefore, this study was performed to determine the relationship between depression and glycemic control in T2DM patients.
This cross-sectional study was performed on 150 T2DM patients referred to Yazd diabetes research center, 2014. Data were collected by using Beck Depression Inventory. Data collected were analyzed by SPSS-21 with using descriptive statistics and analytical testing at α=0.05.
Mean and standard deviation (SD) of age, disease duration and HbA1c levels respectively were; 58.18±9.63 years, 10.83±6.01 years and 8.52±1.59 mg/dl. About 97 patients (64.7%) were women, 88 (58.7%) had hypertension, 57 (38%) hyperlipidemia, 28 (18.7%) good glycemic control. There was no significant relationship between depression status and HbA1c control, hypertension, hyperlipidemia, insulin type and disease duration. Patients with moderate depression status and women had significant relationship with macrovascular complications.
Despite the lack of significant relationship between depression status and HbA1c control and given the significant relationship between moderate depression status and HbA1c control with macrovascular complications, it seems are needed more extensive studies.

In patients with diabetes mellitus, increased rate of lipoprotein oxidation and oxidative stress have important role in diabetic angiopathy, including nephropathy. We designed a study for comparing the level of Ox-LDL in diabetic patients with Macro-albuminuria, Micro-albuminuria, versus Normo-albuminuric.
One hundred and thirty five patients with type 2 diabetes mellitus who had been referred to the Yazd Diabetes Clinic, from 1391 through 1392, were enrolled to our study. The 24 hours urinary albumin excretion was measured and Macro-albuminuria defined as albumin excretion of greater than 300mg per day and below 30mg per day in normo-albuminuric group and between 30-300mg defined as Micro-albuminuria group. Plasma level of OX-LDL was measured.
The plasma OX-LDL level in patients with Macro-albuminuria was higher than those in Normo-albuminuric group, (16.1±3.6 U/ml versus 8.6±1.7 U/ml). There was a significant correlation between the OX-LDL and urine albumin in Macro-albuminuria and Micro-albuminuria groups. There was no significant correlation between the OX-LDL and HbA1C level and diabetes duration.
Significantly elevated plasma OX-LDL in patients with Macro-albuminuria suggests that OX-LDL may play an important role in the progression of diabetic nephropathy.

Diabetes is a chronic disease causing not only somatic complications like hyperglycemia, but also increased psychological consequences and impaired psychological well-being in diabetics. Various psychological treatments have been applied so far to reduce the mental symptoms and promote the mental well-being of these patients. This study aimed at determining the efficiency of dialectical behavioral therapy in psychological well-being of diabetic patients.
Using the purposive sampling method, 20 diabetic patients were selected and assigned randomly to two experimental and control groups. Ryff's Psychological Well-being Questionnaire was used to collect the required data.
Our findings indicated that the dialectical behavioral therapy was effective on psychological well-being of the diabetic patients. This method proved to be effective in our research hypotheses regarding different aspects of psychological well-being, i.e., self-acceptance, positive relations with others, self-autonomy, environment domination, purposeful life, and personal development.
Due to the effectiveness, it is advisable to use this therapeutic modality as a complementary method to other therapies.

The aim of this study was performed to determine the effectiveness of acceptance and commitment therapy on psychological flexibility in obese women in Isfahan, Iran.
This was a quasi-experimental pre-test, post-test trial with follow-up. The study population was all of the obese women in Isfahan in 2014 (BMI≥30).the sample of study was selected by convenience sampling method. They were randomly assigned to two experimental and control groups (15 per group). The Acceptance and Action Questionnaire for Weight-Related Difficulties (Lillis & Hayes, 2008) was the study instrument. The intervention was 8 sessions of 90 minutes. Acceptance and commitment therapy was provided only to the experimental group. Data was analyzed by SPSS.
Results of covariance analysis showed a significant increase in psychological flexibility at post-test and follow-up stage (P Our findings showed that acceptance and commitment therapy has been effective on psychological flexibilityof obese women.

Isolated visual hallucinations is considered as the Charles Bonnet syndrome. Ophtalmic or brain organic disease is a necessary or exclusionary criterion for diagnosis. In previous reports, it reported only solitary hallucination. In this report, we found multiple hallucinations.
In this article we report a 64 year-old blind man with renal failure under hemodialysis who suffered from the Charles bonnet syndrome. His left eye was blind about 6 months ago, He fell some flies attack him and lying on his face. He believed that insects crawling on his face (Tactile hallucination). It was ruled out delirium, psychotic and mood disorders.
Not only visual hallucination, but also the tactile and gustatory hallucination can find about Charles Bonnet syndrome.