مجله دیابت و متابولیسم ایران
سال شانزدهم شماره 6 (پیاپی 76، امرداد و شهریور 1396)

Diabetic nephropathy is a chronic kidney disease and of more common complications of type 2 diabetes mellitus. The current diagnostic markers of diabetic nephropathy, albumin and creatinine, are only able to catch the disease in the stage of renal damage. The aim of this study is evaluation of targeted metabolomics of serum amino acids to identify the association of the changes of serum amino acid profile with diabetes and diabetic nephropathy.
This cross-sectional study was conducted in 2015-2016 on thirty patients with type 2 diabetes subsequent diabetic nephropathy and thirty type 2 diabetic patients without nephropathy attending diabetes clinic of endocrinology and metabolism institute and thirty non diabetic persons. Blood hemoglobin, HbA1c and BUN and also, serum albumin, uric acid and the albumin/creatinine ratio from a random urine specimen were measured by standard methods and serum amino acids level were identified using high performance liquid chromatography (HPLC). Statistical analysis ANOVA, Kruskal-Wallis, and nominal regression were used for the comparison of the investigated groups.
significant differences were seen in serum levels of 8 essential, branched-chains, aromatic and 8 non-essential amino acids alanine, aspartic acid, serine, glutamine, arginine, glycine, tyrosine and ornithine between three groups. Serum levels of arginine and isoleucine were higher in the diabetic group than non-diabetics. However, Levels of amino acids serine, glutamine, glycine, threonine, tyrosine, tryptophan, methionine, valine, ornithine, and lysine in 2 groups of diabetic nephropathy and diabetes were higher than non-diabetic patients.
For every standard deviation decrease in serum levels of amino acids serine, alanine and isoleucine, in comparison to diabetic patients, the risk of diabetic nephropathy were increased 3.257 (95%CI: 0.10- 0.94, P=0.039), 2.207 (95%CI: 0.18- 0.81, P=0.039) and 2.652 (0.21- 0.96, P=0.012), respectively.
Since this study was conducted in patients in the early stages of the disease, reduced serum levels of the amino acids serine, leucine and alanine may be associated with development and progression of diabetic nephropathy. and in the future with more studies in this field can be used in metabolic control and improvement of the prognosis of patients with diabetic nephropathy.

diabetes causes psychological problems besides physiologic ones for the people. Therefore the purpose of the present study was to determine the effectiveness of acceptance and commitment therapy on mental health of the patients with type 2 diabetes in the city of Isfahan.
the research method was semi-experimental and its design was pretest, post-test with control group and follow-up stage. The statistical population of included diabetic patients in Isfahan charity diabetes center in 2015. In order to do the study, 30 patients with type 2 diabetes were selected through improbable available and purposeful sampling method and put into experimental and control groups (15 in the experimental and 15 in the control group). The applied instruments were General health questionnaire (GHQ) and demographic questionnaire. After administering pretest, the experimental group received acceptance and commitment therapy during eight ninety-minute sessions in eight weeks while the control group didn’t have such intervention. After finishing therapeutic session, the people in two groups had the post test. After two months the follow-up test was administered. After data collection, the data analysis was conducted via COVARISNCE statistical analysis method through SPSS21 software.
the results showed that there is a significant difference between experimental and control group between pretest and posttest scores (P considering the significant effect of acceptance and commitment therapy on the mental health of the patients with type 2 diabetes, it is suggested to use this method to increase mental health of these patients.

Diabetes is a common disease and one of the biggest health problems in the country. These patients, in addition to physical problems, also suffered from mental problems which the disorder of body image is one of the most prominent problems. This study compared mental image of patients with type 2 diabetes treated with oral medication and those with insulin.
This study was conducted in a descriptive-analytic way in 1394. The study population included patients with type II diabetes are treated in diabetes center of Aran and Bidgol in 1394. A sample of 168 people was randomly chosen. Needed data was collected by demographic and multi-dimensional questionnaire using a person's attitude about their body image (MBSRQ) Dry reliable 0.73 and were analyzed with SPSS 22 software by using independent t tests, chi-square and Mann-Whitney and Fisher
Base on the duration of disease, the most common was among patients with oral treatment (82.1 percent) and treated with insulin (58.3 per cent) of less than 10 years. Average rating of orientation to fit oral treatment was for patients with 41.79 and 40.15 for insulin therapy, in health assessment section for patients with 17.58 oral treatment and 16.71 for insulin. State of disease trends was in 63/1 percent of patients with moderate oral treatment and 46.4 percent with severe insulin treatment. Independent t test results showed a significant difference between the scores of two patients in the above sections (P Generally, average mental image in patients treated with oral medication was not more than patients treated with insulin. Because one of the negative effects of diabetes on patients is psychiatric disorder, therefore, to improve the mental state of these patients and improve health and to control disease in these patients, research findings is expected to be the use.

Considering the importance of chronic diabetes and significant impact on patient's quality of life, A study to evaluate health-related quality of life in type II diabetic patients referred to diabetes clinic in Sabzevar And factors associated with planning and designing health promotion interventions in the areas studied
This cross-sectional study in which 197 patients with type II diabetes referred to diabetes clinic participated. Of data through a two-part questionnaire that included demographic characteristics, social and Quality of Life Questionnaire, which has a five physical, psychological, social, economic and disease and treatment, collected and then using SPSS version 16 and using Chi-square tests, ANOVA, t-test and Spearman correlation coefficient were analyzed.
The findings of the study suggests that most participants in the study were in the age group aged 50 to 60, 77.2% female, 85.8% were married, 74.6 percent were housewives. Average quality of life in terms of physical functioning, role limitations due to emotional problems and emotional health and physical pain was good. There was a significant difference between the score of physical function, feeling well and pain according to education (P≤ 0/05).
The findings of this study have informed us about the impact of diabetes on the quality of life of patients with this disease, which can be used to plan the care of chronic patients and improve their quality of life.

Usually excess feeding in stored in the body as fat and leads to overweight. One of the causes of catching type 2 diabetes is obesity. Proinflammatory cytokines such as TNF- α and IFNγ can damage insulin signaling in insulin-sensitive tissues. In this study, the effect of garlic extract on the expression of TNF-α and IFNγ secreted by the mononuclear cells was measured.
After taking peripheral blood from patient with type 2 diabetes, mononuclear cells were extracted by Ficoll Method. Cells were a culture with two different concentration of garlic extract (10% and 30%) for 48 and 24 hours. Then for measuring TNF-α and IFNγ release level, ELISA method was used.
Garlic extract can reduce the amount of TNF-α secretion from cells mononuclear, although the timing and concentration of the extract had no effect on the results. Moreover, garlic extract had no effect on the secretion of IFNγ.
Using garlic extract can be adopted therapeutic strategies aimed at adipose tissue inflammation and insulin resistance that is useful for the prevention and treatment of type 2 diabetes.

The adipokines omentin-1, vaspin, and retinol binding protein-4 (RBP-4) are mediators of body composition and adipose tissue that contribute to metabolic changes caused by obesity. The aim of this study was to determine the association between serum levels of these adipokines with body composition indices and metabolic status in different phenotypes of body size.
In the present cross-sectional study, a total of 350 women, including 127 metabolically healthy (MH) subjects and 223 metabolically unhealthy (MUH) subjects participated. The subjects were considered as MH in the presence of at least 4 of the five following metabolic indices: TG ≤ 1.70 mmol/L, LDL-C≤ 2.60 mmol /L, TC≤ 5.20 mmol /L, HDL-C≥1.30, and HOMA-IR≤ 1.95; otherwise subjects were considered as MUH.
The results showed that serum levels of omentin-1 have a significant positive association with MHS (OR = 1.04, p Serum levels of adipokines may be an appropriate predictor for metabolically healthy status. Further studies in this field can reveal possible mechanisms.