مجله دیابت و متابولیسم ایران
سال شانزدهم شماره 3 (پیاپی 73، بهمن و دی 1395)

Research, as systematic way to discover, interpret, explain, predict, modify, and control events, entails the knowledge-based performance of individuals, organizations and systems. Today, knowledge is a tool for development, entrepreneurship, and improving economic value added rather than be a product of development. Also, Health systems, with their increasing complexity and scope, are causes and especially effects of an increasing rate of production, translation and implementation of health-related knowledge. This knowledge, with complexity, vast range, and variety, is produced by variety of research projects which mainly resulted from different problems addressed and presumed epistemic positions by them.
Authors believe that a comprehensive outlook on the variety of research projects in the health system could help to change the stereotypical view on research in the health system. To the best of our knowledge, this paper is a novel, narrative review gathering and presenting various existing classifications of research projects in the light of an inductive distinction. It aims to help specialists in the different levels of health system to profoundly understand and meticulously apply research results and to help researchers and research bodies to more accurately define, manage, prioritize, and allocate resources for future research projects to solve upcoming problems.
Different aspects used in this paper to classify health research projects are the followings: The purpose of research, the research paradigms, tacit or explicit knowledge, primary or secondary knowledge, relation with known disciplines, functions of the health system, the partnerships of non-academic persons, decision-making level, taxonomy of questions, and levels of evidence.

The higher dietary acid load may affect blood pressure, blood sugar levels, and insulin levels. The purpose of this systematic review study is to examine the relation of dietary acid load with blood pressure and blood glucose.
We searched in PubMed, Google Scholar, Scopus and Medline up to July 2016, using the keywords "dietary acid load", "serum glucose", "insulin resistance" and "hypertension ". 12 studies (6 cross-sections, 5 cohorts and 1 intervention) were included in this systematic review.
Out of eleven articles related to blood pressure, three studies showed a significant relationship between dietary acid load scale and hypertension. Three studies found only a significant association between dietary acid load and systolic blood pressure, while other studies did not show any significant correlation between dietary acid load and systolic or diastolic blood pressure. Moreover, in relation to blood glucose control, among eight studies, one study demonstrated a significant relationship between increasing dietary acid load and the incidence of diabetes. One study reported a significant relation of dietary acid load with fasting blood glucose and glycosylated hemoglobin concentration. In addition, two studies indicated a significant correlation between increased dietary acid load and insulin resistance, but other studies not revealed a meaningful relationship.
Since most studies suggest a significant association between increased dietary acid load and higher blood pressure, therefore it seems which dietary acid load can effect on blood pressure. The results of the investigation of the relationship between dietary acid load with glucose, insulin levels or diabetes have many contradictions. According to limited studies in this field, there is a need to further trial or prospective studies regarding the dietary acid load and the incidence of diabetes, insulin levels, and other blood glucose markers.

Diabetic Nephropathy is one of the main microvascular complications of diabetic mellitus. Methylenetetrahydrofolate Reductase (MTHFR) is one of the candidate genes of diabetic nephropathy. MTHFR (C677T) polymorphism reduces catalytic activity of MTHFR and leads to increase level of plasma homocysteine. The aim of this study was to evaluate the association of C677T polymorphism with diabetic nephropathy.
In this case control study, 300 individuals, including type 2 diabetes mellitus with diabetic nephropathy (N=104), diabetes mellitus patients without diabetic nephropathy (N=100) and controls (N=96) participated. The MTHFR genotype was determined using PCR-RFLP technique and biochemical parameters were measured.
Genotype frequencies were significantly different between patients with diabetic nephropathy and diabetes mellitus without nephropathy (TT vs CC; P=0.02,OR:0.5,CI:0.3-0.9).The allele frequency was also significantly different between diabetic nephropathy and diabetics mellitus without nephropathy(P=0.013,OR:1.754,CI:1.123-2.740).
These findings suggest that there is an association between C677T polymorphism and nephropathy in patients with type 2 diabetes. Allele C increase the risk of nephropathy, and T allele has a protective role in susceptibility to disease.

Diabetes is the most common endocrine disorder that affects many people every year. Diabetic nephropathy is main complication of diabetes type 2. Renoprotective effects of vitamin “D” in chronic kidney disease have been reported that including diabetic nephropathy. The purpose of this study is to investigate the association between polymorphism (rs731236 (Taq1)) at gene receptor vitamin D (VDR), and the risk of diabetic nephropathy in patients with type 2 diabetes.
Methods In this case-control study, 104 patients with type 2 diabetes and nephropathy, 100 patients with type 2 diabetes and no nephropathy, and 98 people without diabetes and nephropathy who referred to the Diabetes Clinic of Tehran University of Medical Sciences were included . Clinical data were obtained and biochemical parameters were measured. The DNA samples were extracted from blood samples by phenol chloroform method. TheTaqI polymorphism (rs731236) was studied by TaqMan specific genotypes.
Urea, creatinine and urine albumin values were significantly higher and glomerular filtration rate was lower in nephropathy group. Although frequency of TT genotype and also T allele was higher in nephropathy group, the difference was not significant.
There was no association between Taq1 polymorphism and diabetic nephropathy in the studied population

Patient’s adherence to treatment regimen can predict treatment plan and decrease intensity and symptoms of sickness. This study aimed at determining the effect of educational intervention based on AIM (Ability, Information, Motivation) model on improving adherence of patients with type 2 diabetes.
This semi experimental interventional study was performed on 180 patients with type 2 diabetes as intervention and control groups. The patients selected using simple random sampling. Study instrument was a questionnaire including demographics (14 items) and AIM model questionnaire (10 items about information, 9items about motivation, 6 items for ability). After baseline, educational intervention was performed in intervention group and post test conducted after six months for both groups. Collected data was analyzed with SPSS software version 23using Mann–Whitney U, Wilcoxon and chi-squared tests. The significant level was considered less than 0.05.
There was no significant difference in demographics and AIM model constructs between two groups (p>0.05). After educational intervention, intervention group revealed a significant difference with control group in terms of information (P study results revealed AIM model based educational intervention has an important role on treatment adherence among type2 diabetic patients. With increasing patient information and belief regarding disease patient’s motivation will be improved.

In recent years, dietary supplements play an important role in maintaining a healthy diet in most chronic diseases such as diabetes. Spirulina platensis as a food supplement has been raised and regulator effects on cholesterol and antioxidant and immune regulating effects of this supplement are also considered. It contains vitamin B, beta-carotene, vitamin E, high value proteins, minerals, gamma linolenic acid and antioxidants.
In this study 50 patients with type II diabetes were randomly selected and after taking patient's history they were divided into two equal groups including control. 8 grams of spirulina that was prepared in tablet (each 1 gram) form was administered daily to patient group for three months. Fasting blood sugar levels monthly and hemoglobin A1C levels at the beginning and end of the projects were measured in both groups and their results were compared with each other.
Fasting plasma glucose in patient group after 3 months of treatment with spirulina powder gave a significant reduction from the 158.1± 44.2 mg/dl at the beginning of study to 127.8 ± 36.7 mg/dl but was not significant in the control group. Glycosylated hemoglobin in the both groups decreased but this decrease was not statistically significant.
Spirulina platensis as a supplement can be administered in type II diabetic patients that used oral anti-diabetic drugs. It is effective in reducing fasting blood glucose in the short term but its effect on hemoglobin A1C need to prescribe longer.