Journal of Diabetes and Metabolic Disorders
Volume:6 Issue: 2, 2006

Medical ethics has a long history worldwide, and the move towards a trans-cultural ethics must be based on an appreciation of the civilization's history. It is often thought that medical ethics history has begun by Hippocrates, however it is much older. It is clear that various cultures such as Babylonia, ancient Egypt, Greece, and the Persians have attempted to regulate medicine and to protect patient's rights in the known ancient world. One of the earliest written provisions in this field, which comes back to about 1750 BC, is the code of Hammurabi written by Babylonian.
In this paper we aimed to explore the roots of medical ethics in Persian history, particularly, after adherence of Iranians to Islam. In this article, we used related books of great Iranian and non-Iranian historians, and examined some authentic articles collected through searches of databases such as Medline and Ovid and search engines such as Google Scholar.
History of medicine in Iran has begun about fourth century BCE. Great Iranian physicians had paid special attention to ethics in their practices, teachings and manuscripts. There was a gap between the ancient civilizations and the Renaissance era in Europe, commonly called the dark ages (Medieval). The immense strides have been made by the Persians in that long interval which is briefly reviewed.

Pancreatic islet transplantation has been reported as an appropriate method for treatment of type I diabetes patients, however there are strong indications that cytokine and chemokines secreted from transplanted islets play an important role in islet graft rejection in different stage post-transplantation. The NF-kB signaling pathway is activated in response to the stress resulted from isolation and purification process of pancreatic islets. Secretion and release of inflammatory mediators, including MCP-1, result from activation of this pathway which plays important part in activation of inflammatory processes accelerating graft rejection.
This study was performed to examine the effect of curcumin on secretion of inflammatory mediators and function of pancreatic islets.
We observed that curcumin significantly decreased MCP-1 release from mouse islets compared to the control group and had no effect on function of pancreatic islets.
Investigating the stimulatory signals leading to production and secretion of inflammatory mediators from pancreatic islets and discovering their underlying mechanisms will be useful in finding new therapeutic interventions for blocking inflammatory pathways and improvement in outcome of islet cell transplantation.

Metformin is used in treatment of non-insulin-dependent diabetes mellitus (NIDDM). The present study was aimed to study the pharmacokinetic and pharmaco-dynamic of metformin 500 mg tablet in healthy volunteers.
The test and reference metformin hydrochloride 500 mg tablets were administered to 12 healthy volunteers in a cross-over study. Metformin serum concentration and decrease in blood sugar levels (dBSL) were used for study of pharmacokinetic and pharmacodynamic.
There was no correlation between phramacodynamic and pharmacokinetic para-meters. Also there was no increase in dBSL-(AUC0-12) with increase metformin serum concentration-time. The results of our study show that both products could be bioequivalent according to serum concentration and not blood sugar data.
There was no concentration - effect (dBSL) correlation for both products. Metformin didnt decrease the blood glucose in healthy volunteers. In some volunteers there was no increase in blood sugar after meal and dextrose 20% oral solution administration which could be related to decreased absorption of glucose from gastrointestinal tract caused by metformin.

Aloe vera is a herbal plant being used as an anti-inflammatory agent, burning recovery as well as immune system boosting agent. The aim of this study was to evaluate the effects of Aloe vera on blood glucose , lipids and lipoproteins in streptozotocin-induced diabetic male rats.
This study was carried out on 56 male rats, weighing 150-200 gr. Animals are divided into 7 groups (one control and six test groups). Diabetes were induced in test groups via streptozocin (65mg/ kg-IP). After a week, blood samples analyses for FBS. All diabetic groups, except the control one, were taken 100,200,300,400 mg/kg Aloe vera extract and 5mg/kg glibenclamid by gavages for a period of 4 weeks, respectively. After this period fasting blood samples were collected from all groups.
The results showed that the FBS decreased in groups that received 400mg/kg and glibenclamid (respectively,162/62±23.12and193.37±26.51). In addition, 3-6 groups showed decrease TG and Cholesterol level in comparison with those of control groups. In all groups which received Aloe vera and glibenclamid, LDL level were significantly decreased in comparison with control groups but HDL level had no change.
The results of this research indicate that Aloe vera aqueous extract lead to decreased Blood glucose, Cholesterol, LDL and TG levels. Further studies is suggested for exact mechanism of Aloe vera in diabetic rats.

Fetal hyperinsulinemia correlated with large birth weight and impaired glucose tolerance test and obesity in second decades of life. In this study we compared the correlation between fetal insulin production (as estimated by amniotic fluid (AF) C-peptide concentration) and AF insulin with macrosomia (as estimated by neonatal birth weight >4000 gr).
Thirty eight neonates were studied. Ten infants were macrosom and 28 were normal (birth weight There was a significant correlation between infant serum C-peptide level and macrosomia. Amniotic fluid insulin level was higher in the macrosom infants but this correlation was not significant. AF C-peptide was higher in the macrosom group. Also there was a significant correlation between maternal serum C-peptide and macrosomia. Infant and mother serum insulin was higher in the macrosom group.
Our results suggest that fetal insulin (as estimated by AF C- peptide) and mother insulin and C- peptide production, can influence fetal weight and induce fetal macrosomia.

Diabetes mellitus can have variable and sometimes profound effects upon the oral tissues. It has been shown that uncontrolled or poorly controlled diabetics have particularly a greater incidence of severe recurrent bacterial or fungal infections and periodontal diseases. The purpose of this study was to determine thee relationship between oral manifestations in diabetic patients and duration of disease, and glycemic control.
We studied 116 diabetic outpatients referred to Diabetes Clinic of Shahid Bahonar Hospital of Kerman Province. We evaluated the following parameters: dental caries, periodontal status, xerostomia, burning sensation and mucosal alterations. We also recorded information about history of diabetes and glycemic control. Data were subjected to SPSS and X, t- test.
The most frequent alterations in this study were gingivitis (96.3%), periodontitis (90.2%), and xerostomia (97.24%). Burning sensation and periodontal diseases were significantly correlated to duration of diabetes (P=0.002, P=0.012 respectively).The results of the present study showed that periodontal diseases occur more frequently in moderately and poorly controlled diabetic patients than in those with good glucose control, but this difference was not statistically significant.
In this study, dry mouth and periodontal diseases are common complaints among diabetic patients. Therefore management of oral diseases in diabetic patients should include a comprehensive evaluation of salivary function and periodontal status.

Diabetes is a chronic disease which requires patient participation in treatment process. The outcome of the treatment depends on the patient health belief and the cognition about illness. The aim of this study was to clarify the effect of educational intervention focusing on Health Belief Model in health beliefs and awareness of diabetic patients.
As a clinical trial 64 diabetic patients were selected from 4 hospitals in Tehran in 2006. Patients randomly assigned to two equal number groups, as case and control groups. After determine of education needs using the health belief model, education program were performed in intervention group. Data from each patient was collected by using questionnaire, at the initial visit and two month after education. Parametric and nonparametric tests were used for statistical analysis.
Independent t test didnt show a significant difference between two groups in the HBM's domains before the educational program (p>0.05). After education the same test indicated a significant difference between two groups (p0.05). In the intervention group awareness from 11 to 15(p Educational intervention focusing on changing health beliefs and increasing awareness may be effective in promoting self care behaviors in diabetic patients.

Adiponectin and leptin are hormones which are related to body fat tissues and body weight. In pregnant women, conflicting associations have been reported between the role of serum concentrations of adiponectin and leptin with infant birth weight. The aim of this study was to determine the association between maternal and cord blood adiponectin and leptin concentrations with birth weight.
As a cross-sectional study 86 pregnant women referred to university hospital clinics were recruited. Maternal and umbilical cord blood samples were obtained in delivery room just after birth. The maternal and umbilical cord serum samples were analyzed for adiponectin and leptin. Their birth weight and height were measured at labor.
The mean of maternal BMI, birth weight, and gestational age was 23.8±4.8 kg/m2, 3.13±0.14 kg, and 38.15±2.6 week, respectively. No correlation between adiponectin and birth weight were found. Birth weight positively correlates with leptin.
leptin concentrations in cord blood may be reflected the alternation of body fat tissue in infant and independently associated with infant birth weight.

Plasma concentration of adiponectin was found to play an important role in regulation of glucose metabolism, insulin resistance and conditions commonly associated with obesity. The aim of this study was to assess adiponectin level and its relation with percent of body fat mass and insulin sensitivity in over-weight men.
This study was conducted on two groups of type 2 diabetic (n=20) and non-diabetic (n=20) overweight adult men. Serum level of adiponectin (ELIZA), FBS (GOD-PAP), fasting insulin (immunoreactive assay) and body fat mass (Bio-electric impedance) were measured. Insulin sensitivity was calculated using QUICKI.
Diabetics had significantly higher mean of fat mass% than non-diabetics (26.55± 2.87% vs. 22.93±2.64; p Lower level of adiponcetin in diabetics than their non-diabetic counterparts. As well as the positive association of adiponectin with insulin sensitivity confirm the suggested role of decreased level of adiponectin in conditions such as insulin resistance and diabetes.

This study was conducted to determine the effectiveness of nutritional interventions on some non-communicable disease risk factors among Tehran's urban population.
In the TLGS, a sub-sample of 1474 subjects aged 3 years and over, was selected for dietary assessment; nutritional interventions were implemented for cases. After a 3.8 year follow up, data were collected for 578 subjects who participated in the second phase of the study. Subjects were divided into controls (356 subjects) with no intervention and cases (222 subjects) with interventions. Mean BMI, energy intake, macronutrients, fiber, micronutrients, serum lipids, FBS, systolic and diastolic blood pressure were measured and compared using paired t-test. ANCOVA used to compare these means after controlling for age, sex, and baseline variables.
Adjusted for age, sex and baseline variable, FBS ( 90±17 vs. 92±14 mg/dl, p The present study shows decreased FBS, total serum cholesterol, and daily cholesterol intake after nutritional interventions. Specific education and intervention measures with respect to cultural and socioeconomic factors may modify dietary patterns and are effective in primary prevention of non-communicable diseases.