مجله غدد درون ریز و متابولیسم ایران
سال هجدهم شماره 6 (پیاپی 90، بهمن و اسفند 1395)

Childhood obesity is an important risk factor for adult obesity and its consequences, its prevention and control are hence vital; considering the limited health resources, the most appropriate policies should be implemented.
After reviewing literature, taking into account national health policies and priorities, of other countries, international organization and guidelines of authorized officials, eight priority criteria and twenty policies for prevention of childhood obesity were extracted and submitted to selected stakeholders as questionnaires to determine policy priorities using the Delphi technique.
The three highest score priority criteria were efficacy, feasibility and inequality, Five high priority policies were: 1- Improving public health education in particular for healthy foods; 2- Adding obesity prevention and healthy diet disciplines/lessons to school teaching curriculum for mothers and kindergarten training courses; 3-Improving community and school physical activities and sports by revising management strategies; 4-Controling media regarding food and drink advertising and 5- Encouraging participation in physical activities by implementing revised policies for public transportation.
The prioritised policis in addition to other stakeholder opinions can be used for selecting most appropriate strategies and action plans to combat childhood obesity.

One of the important parameters in health-related planning for any community is to determine trends in disease incidence of that community. This study aims to use the joinpoint regression model to determine changes in mortality trends of diabetes in seven Asian countries.
Diabetes mortality data for six Asian countries and Iran were collected respectively from the World Health Organization and the Iranian Ministry of Health. The data were analyzed using the joinpoint regression model. To estimate regression parameters, least squares and permutation test were applied. Analyses were performed in Joinpoint3. 4 software.
Mortality rate from diabetes during the years under study increased on an annual basis in Armenia, Iran, Bahrain, Russia, South Korea and Kazakhstan as much as 7.5%, 4.5%, 2.7%, 1.2%, 5%, 3.1%, respectively. In Singapore, it had a 3.8% annual decline. The mortality rate of diabetes in the seven Asian countries increased at rate of 3.2% from 1985 to 2010.
Given the annual changes in the diabetes-associated mortality rate in Armenia, Iran and South Korea compased to the annual rate of the seven countries, it is suggested that these three countries develop programs for screening and controlling diabetes.

This study aimed to determine the effectiveness of educational intervention based on a self-efficacy model and its effect on two constructs of self-efficacy and outcome expectations in order to promote self-care and glycemic control in patients with type II diabetes.
This pretest-posttest with randomized control group study was conducted on 80 patients with type-2 diabetes. These patients were selected based on inclusion criteria and were randomly divided into the intervention and control groups (n=40 each). The intervention group attended six sessions of group and face-to-face consultation sessions focused on self-efficacy and outcome expectation strategies. Data were collected through laboratory tests and questionnaires before and three and six months after the intervention. Data were analyzed using SPSS software version 21and One-Way ANOVA and ANOVA for repeated measurestests.
Three months after the intervention a significant increase occurred in intervention groupsin self-efficacy, outcome expectations and self-care and these changes were statistically significant at 6 months after the intervention. Six months after the intervention a significant decrease in HbA1c was observed.After the intervention diet, physical activity and foot care improved significantly. No significant improvement occurred in self-monitoring of blood glucose and medication adherence.
The results of this study suggest that educational interventions based on the self-efficacy model in six months is beneficial for diabetic patients. It seems that implementing these educational strategies can be effective for patients with diabetes and are recommended to be used in their education for metabolic control.

The glucagon-like peptide-1 (GLP-1), is a neuropeptide and an incretin that helps regulate glucose and insulin concentrations. The effects of acute aerobic exercise however on the response of GLP-1 are unclear. The purpose of this study was to investigate the effect of acute aerobic exercise on glucagon -like peptide-1 (GLP-1) serum levels, glucose and insulin in women with type II diabetes mellitus.
In this study, 20 patients with type II diabetes were enrolled in two groups (experimental and control). The experimental group underwent aerobic training one times (running on treadmill) with moderate intensity 65-75% HR max to exhaustion. Blood samples before exercise, immediately after and 24 hours after exercise were collected for measuring GLP-1, glucose and Insulin.
Results showed that none of sampling time effects on GLP-1, glucose and insulin were significant (p>0.05). also, Pearson correlation showed that was significant relationship between GLP-1 changes levels and glucose (p Results indicate that in women with type II diabetes, acute aerobic exercise, with moderate intensity to exhaustion immediately and 24 hours after exercise has no effect on serum levels of GLP-1, glucose and insulin.

Effects of whey protein on reduction of blood glucose and appetite have been reported. In the present study the effects of whey protein on glycemic index (GI) and satiety index (SI) of mashed potato were investigated.
To determine the GI, 10 healthy subjects (6 male, 4 female) were enrolled in the study on 4 separate days at 1 week intervals. On each day, they were given potato puree, potato.4 or 9 grams of whey protein or glucose solution in random order. Fasting blood samples were taken at fasting and at 15, 30, 45, 60, 90 and 120 minutes after food ingestion and the GI was calculated. To determine the SI, 20 healthy subjects (10 male, 10 female) were enrolled and on 4 separate days at one week intervals, daily they were given white bread, potato puree, potato.4 or 9 grams of whey protein in random order. The satiety was measured at fasting and every 15min over the next 2 hours after food ingestion; using a satiety questionnaire and the SI was calculated.
Adding whey protein to mashed potato reduced the area under the blood glucose curve, though it was not significant (p=0.155). No did the GI of potato change significantly (p=0.245). However, the area under the satiety curve of potato increased significantly by adding whey protein (p Although adding whey protein did not change the GI of potato, but it significantly increased its SI.

Considering the high prevalence of diabetes is world wides, self-care programs in diabetic patients are important. There are many studies about self-care programs and assess the outcome of these programs. But the quality of methodology and reporting of these investigations in Iran for use in evidence-based practice has not been extensively studied. This study aimed to determine the quality of the methodological reports of randomized controlled trials on self-care programs in diabetic patients, published in Iranian journals.
In this Secondary study randomized controlled trial articles in Persian and English-language related to diabetes and self-care education, published at local journals magazines in Magiran, SID, Iranmedex, Irandoc databases and Google Scholar and Scopus from 2010 up to June 2016 were searched and assessed using the Jadad scale.
Results showed 29 articles based on Jadad 5 and 13 points had average scores of 2±0.92 and 8.65±1.11 respectively. Randomized allocation in 89.65 % of the studies was noted. Only 3 cases (6.89 %) of the studies were blinded and 13 studies (44.82 %) were reported withdrawal and its causes.
Results of this study showed poor quality of methodological reporting, i.e. (average score below 9). Weaknesses observed in the reporting of trials, required more accurate guidelines and clinical trial assessment tools for authors and scientific journals reviewers.

The hypothalamic-pituitary-gonadal (HPG) axis controls reproductive function. The hypothalamus secretes GnRH that is transported to the anterior pituitary gland to stimulate the release of the gonadotrophic hormones. Which act on the gonads to stimulate sexual maturation, gametogenesis and steroidogenesis. Although GnRH neurons are a key component of the HPG axis, other neurotransmitters or neuropeptides in the hypothalamus, such as glutamate, GABA, galanin, dopamine and kisspeptin have been suggested to be involved in the regulation of GnRH secretion. In addition to GnRH neurons, pituitary and gonads, some of these neuronal populations such kisspeptin are extremely sensitive to changes in the levels of steroid hormones and endocrine disrupting compounds (EDCs). Several EDCs, such as pesticides, bisphenol A, phthalates, tamoxifen, phytoestrogens and mycoestrogens can interact with the female and male reproductive system function and lead to disruption of endocrine function. Reproductive system development and function may be susceptible to the effects of such EDCs. By far, the greatest concerns for the potential adverse effects of EDCs have focused on their deleterious impact on reproductive health. It has been demonstrated under laboratory conditions and epidemiological studies that EDCs can exert detrimental effects especially during hormonal critical periods such as fetal and neonatal periods on the reproductive system. This article reviews some evidence that EDCs can impair the HPG axis and reproductive function.