Iranian Journal of Diabetes and Obesity
Volume:11 Issue: 1, Spring 2019

The purpose of this study was to investigate the combined effect of aerobic activity and ginger supplementation on blood glucose and cardiovascular risk factors in overweight girls. In this semi-experimental study, 24 overweight female students were randomly divided into two groups; supplement group (n: 12, age: 25.88 (±0.46), Body Mass Index (BMI): 28.53 (±0.43)) and placebo group (n: 12, age: 26.23 (±0.77), BMI: 28.31 (±0.62)). The supplement group consumed 2 grams of ginger powder daily for two weeks before meals. Aerobic activity included two sessions of exhausting eccentric activity (negative slope on treadmill, one session before and one session after two weeks of supplementation). For data analysis, covariance analysis method with repeated measures and dependent T-test were used. The results showed that one session of aerobic activity induced the significant decrease of fasting blood glucose (FBS) in supplement group (P-value: 0.001), placebo (P-value: 0.001), and no significant changes of lipid profile, LDL (P-value: 0.45), HDL (P-value: 0.57), triglyceride (P-value: 0.42), total cholesterol (P-value≥ 0.61) in supplement group. Also, result of between-group comparison showed that compared to placebo group, using ginger supplementation for two weeks after aerobic activity caused the significant reduction in FBS (P-value: 0.001), triglyceride (P-value: 0.001) and total cholesterol (P-value: 0.01) levels in the supplement group. Regarding the effects of physical activity and ginger supplement on FBS and lipid profiles, it is recommended to use ginger supplement along with physical activity to control blood glucose and lipids levels.

There are changes in plasma glucose and HbA1c of type 2 diabetes mellitus (T2DM) patients in different seasons. HbA1c levels may increase during winter season in most T2DM patients without weight gain. In this study, we described the seasonal changes of HbA1c levels in T2DM patients. This analytical cross-sectional study conducted from 2013 to 2017 on 402 patients with T2DM, aged 20–80 years old who referred to Yazd diabetic research center. Body weight, height, waist circumferences (WC), blood pressure (BP), body mass index (BMI), fasting plasma glucose (FPG), 2 hours post-prandial (2hpp), and HbA1c measured and compared during four seasons. Four hundred and two T2DM patients invited and fulfilled this study. Most of them (56%) were women. The mean age of patients was 58.96 (± 11.10) years old. The mean HbA1c, 2hpp, systolic and diastolic blood pressure were significantly different in four seasons (P-value respectively: 0.022, 0.007, 0.001 and 0.005). The mean difference of HbA1c was significant in the warm and cold seasons (P-value: 0.047). The percentage of people who were below 7% had a significant difference between the warm and cold seasons (P-value: 0.015). The results of this study showed that, in Yazd with desert climate, postprandial hyperglycemia is more prominent in summer. The seasonal changes of glycemic status are an important factor in management of T2DM patients.

There are changes in plasma glucose and HbA1c of type 2 diabetes mellitus (T2DM) patients in different seasons. HbA1c levels may increase during winter season in most T2DM patients without weight gain. In this study, we described the seasonal changes of HbA1c levels in T2DM patients. This analytical cross-sectional study conducted from 2013 to 2017 on 402 patients with T2DM, aged 20–80 years old who referred to Yazd diabetic research center. Body weight, height, waist circumferences (WC), blood pressure (BP), body mass index (BMI), fasting plasma glucose (FPG), 2 hours post-prandial (2hpp), and HbA1c measured and compared during four seasons. Four hundred and two T2DM patients invited and fulfilled this study. Most of them (56%) were women. The mean age of patients was 58.96 (± 11.10) years old. The mean HbA1c, 2hpp, systolic and diastolic blood pressure were significantly different in four seasons (P-value respectively: 0.022, 0.007, 0.001 and 0.005). The mean difference of HbA1c was significant in the warm and cold seasons (P-value: 0.047). The percentage of people who were below 7% had a significant difference between the warm and cold seasons (P-value: 0.015). The results of this study showed that, in Yazd with desert climate, postprandial hyperglycemia is more prominent in summer. The seasonal changes of glycemic status are an important factor in management of T2DM patients.

The relative stroke risk is increased in patients with diabetes. Awareness and knowledge of the risk factors and symptoms of stroke are essential for prevention and immediate effective treatment of stroke. The aim of the study was to determine baseline knowledge about the warning symptoms and risk factors of stroke in patients with type 2 diabetes (T2DM). This analytical cross-sectional study was conducted in Yazd-Iran 2015-2016. The pilot section included 10 T2DM patients. The main data was collected from 281 patients. The self-conducted checklist about knowledge of stroke risk factors, warning signs as defined by national institute of neurological disorder and stroke was prepared in three following parts. 1) Socio-demographic information. 2) Open-ended question about stroke risk factors, warning sign & symptoms and first action information. 3) Multiple choice questions related to the stroke risk factors, warning sign & symptoms and first action information. 408 T2DM patients were invited and 281 patients fulfilled in study. Most of them (70.4%) were women. The mean age of patients was 54.09±12.54 years. The most common general risk factors of stroke listed were “high blood pressure (92.9%), unhealthy diet” (86.8%), and “stress” (82.2%).The most common sources of stroke information were friends and family members (73.7%). Education program to increase T2DM knowledge of stroke may contribute to reducing the risk of stroke and increasing the speed of hospital presentation after the onset of stroke.

It is well documented that exercise training (ET) imposes beneficial effects on diabetes mellitus and its complication such as diabetic peripheral neuropathy (DPN). Regarding the importance of tropomodulin-2 (TMOD2) in nervous system plasticity, this protein may be recognized as a candidate mechanism for ET-induced neuroplasticity. The aim of this study was to investigate the effects of ET on cerebellar gene expression of TMOD2 in rats with DPN. Animals were randomly divided into three groups: healthy control (C), diabetic control (DC) and diabetic trained (DT). Diabetes was induced by a single intraperitoneal injection of streptozotocin. Behavioral nociception assessment was carried out by Von Frey Filaments and tail-flick tests. TMOD2 gene expression was assessed by real time-PCR. The mRNA levels of TMOD2 increased to 0.50-fold (P-value: 0.005) in comparison of the sedentary controls after 6 weeks of DPN. Also, TMOD2 gene expression in DT group was decreased to -0.68-fold changes in comparison of the C group (P-value: 0.001). In addition, the TMOD2 gene expression in DT group was lower than the DC group (P-value: 0.0001). The TMOD2 mRNA level in rat’s cerebellum was affected by ET and DPN, but its exact physiological roles were not clarified. Hence, identifying the importance of TMOD2 in DPN needs further research.

Many diabetic patients are susceptible to cardiovascular diseases which are known as one of the most important causes of mortality among diabetic patients. The aim of this study was to investigate the effects of eight weeks of resistance training on VCAM-1, ICAM-1 and CRP in diabetic rats. In this experimental study, 24 male Sprague- Dawley diabetic rats were selected and divided into three groups; (1) diabetes victim first week, (2) diabetes victim last week, and (3) resistance training. In order to investigate the effects of induction of diabetes, 16 healthy male rats were divided into two groups of healthy victim first week and healthy victim last week. The resistance training group had progressively participated in eight weeks (3 weekly sessions) resistance training, which has included climbing up in a specified ladder for rats, based on the average weekly weight from 30% of body weight for the first week to 100% of the body weight for the last one. Kolmogorov-Smirnov test, one-way ANOVA and Tukey's post hoc test (P-value≤ 0.05) were used to analyze the results. The results showed that induction of diabetes significantly increases of VCAM-1 (P-value: 0.004), ICAM-1 (P-value: 0.001) and CRP (P-value: 0.02) in rats. The eight weeks of resistance training significantly decreases the serum levels of ICAM-1 (P-value: 0.005) and CRP (P-value: 0.001). However, the eight weeks of resistance training did not significantly reduce serum level of VCAM-1 (P-value: 0.51) in diabetic rats. Resistance training has beneficial effects on the reduction of ICAM-1 and CRP levels, though an insignificant decrease in the levels of VCAM-1.

The purpose of this study was to investigate the effect of moderate and high intensity endurance trainings with genistein consumption on tumor necrosis factor alpha (TNF- α) and interferon gamma (INF- γ) in streptozotocin induced diabetic rats. In this experimental study, 64 male diabetic rats were randomly assigned into 8 groups of 8 (1) first week control (2) last week control (3) moderate intensity endurance training (4) high intensity endurance training (5) genistein consumption, (6) moderate intensity endurance training and genistein consumption (7) high intensity endurance training and genistein consumption, and (8) sham (dimethylsulfoxide). Moderate and high intensity endurance trainings were performed on a treadmill at speeds of 10- 17 and 18- 22 m/ min for 8 weeks, 3 sessions per week, and 60 minutes per session. Genistein groups received 30 mg / kg of genistein per day peritoneally. Independent sample t-test, two-way analysis of variance and Bonferroni's post hoc test were used to analyze the findings (P-value≤ 0.05). Endurance training and genistein consumption had a significant effect on TNF-α reduction in streptozotocin-induced diabetic rats (P-value≤ 0.05); however, the effect of endurance training and genistein consumption on IFN-γ reduction was not significant (P-value≥ 0.05); also the interaction of training and genistein consumption in reducing TNF-α and IFN-γ was significant (P-value≤ 0.05). It seems that endurance training and genistein consumption have interactive effects on decreasing the inflammatory factors in streptozotocin-induced diabetic rats.

The aim of this study was to investigate the effect of Resistance Training (RT) with Genistein on Interleukin-6 (IL-6) and C-reactive protein (CRP) in diabetic rats. 64 induced diabetic rats into 8 groups were investigated with experimental study: first week control, last week control, RT, 15 mg/kg Genistein consumption, resistance exercise with 15 mg/kg Genistein consumption, 30 mg/kg Genistein consumption, resistance exercise with 30 mg/kg Genistein consumption and placebo (dimethyl sulfoxide). Rats in groups 3, 5 and 7 performed 8 weeks of RT with 30 to 100% of body weight in 3 weekly sessions, and groups 4, 5, 6, and 7 received Genistein peritoneally with the mentioned doses. Also, to investigate the effects of diabetes induction on the study variables, 16 healthy rats were selected and divided into two groups: healthy first week control and healthy last week control. The data were analyzed using independent sample T-tests, two-way and one-way ANOVA with Bonferroni’s post-hoc test in SPSS software (P-value≤ 0.05). RT had a significant effect on CRP reduction in induced diabetic rats (P-value≤ 0.05). Genistein consumption decreased IL- 6 and CRP in diabetic rats (P-value≤ 0.05). Moreover, the interaction between RT and Genistein consumption had statistically significant effects on the reduction of IL-6 and CRP in diabetic rats (P-value≤ 0.05); 15 mg/kg Genistein consumption had a greater effect on the reduction of CRP than 30 mg/kg Genistein consumption in induced diabetic rats (P-value≤ 0.05). RT alone could not significantly reduce the levels of IL-6 in induced diabetic rats; however, it seems that Genistein consumption with RT have interactive effects on reducing inflammatory factors in induced diabetic rats.

RIP140 is one of the proteins that play a role in regulating and metabolizing lipid droplets. The aim of this study was to compare the three endurance training intensities (low, moderate and high) on the expression of RIP140 protein in visceral adipose tissue and insulin resistance in male diabetic wistar rats. Forty male wistar rats were assigned to five groups (n= 8) including diabetic group with low intensity endurance training (DLE), moderate intensity endurance training (DME), high intensity endurance training (DHE), diabetic control (DC) and healthy nondiabetic sedentary (NS) groups. After induction of diabetic rats by injection of streptozotocin, endurance training was performed with different intensities for eight weeks, three sessions per week. The relative expression of RIP140 protein was measured by western blot technique. To compare groups, dependent variables were analyzed by One Way ANOVA، Kruskal–Wallis and the post hoc Mann-Whitney U Test. Results showed significant effect of exercise on insulin resistance values (P-value: 0.001). Comparison of expression of RIP140 protein in diabetic and high intensity endurance training group, diabetic and moderate intensity endurance training group and diabetic, and low intensity endurance training group, diabetic control and healthy control by using Kruskal-Wallis test indicated a significant difference between these groups (P-value:0.006). Moderate and high intensity endurance training can significantly reduce the expression of RIP140 protein, and subsequently increase glucose uptake and ultimately reduce insulin resistance in diabetic rats

The case-report is about a 47 year old woman with adrenocorticotropin-independent macronudular adrenal hyperplasia (AIMAH), with is a rare cause of endogenous Cushing’s syndrome.
Urin free cortisol (UFC) and cortisol of 8AM were elevated along with the suppressed level of ACTH. Abdominal CT scan showed macronodules in both adrenals .The patient underwent left adrenalectomy and pathological data confirmed the diagnosis. The patient has been inhormon replacement therapy after surgery.