مجله غدد درون ریز و متابولیسم ایران
سال بیست و یکم شماره 6 (پیاپی 108، بهمن و اسفند 1398)

Diabetes is one of the common chronic diseases in modern societies and self-care behaviors consider as one of the most important factors in controlling this disease. Regarding the impact of psychological factors on adherence to self-care behaviors, the current study aimed to predict self-care behaviors, based on goal setting skill and perceived stress of patients with type 2 diabetes.

In this descriptive, cross-sectional study, a total of 190 type 2 diabetic patients, referred to Kashan Diabetes Center and private clinics, were selected, using convenience sampling. For data collection, the participants completed the purpose in life questionnaire, perceived stress questionnaire, and self-care behavior questionnaire. The collected data were then analyzed, using Pearson’s correlation coefficient test and stepwise multiple regression analysis.

According to the present results, goal setting and perceived stress could not independently predict self-care behaviors in diabetic patients. However, the interaction effect of these variables could successfully predict these behaviors (P<0.01).

Our findings suggest that, by improving goal setting skill and perceived stress of patients with diabetes, we can improve their self-care behaviors.

Glycemic index (GI), glycemic load (GL), and satiety index (SI) are important factors in metabolic diseases, particularly diabetes and obesity. This study aimed to investigate the effects of barley flour on the GI, GL, and SI of white bread.

To determine GI, ten healthy individuals were examined on four different days within one-week intervals. The blood sugar level was measured during fasting and 15, 30, 45, 60, 90, and 120 minutes after receiving the glucose solution, white bread, and bread containing 25% and 50% barley flour. Also, to determine SI, a total of 20 healthy individuals were examined on three different days within one-week intervals. SI was measured using the visual analog scale (VAS) during fasting and every 15 minutes for the next two hours.

The GI and GL of 25% barley bread were 81.79 and 13.80, respectively. On the other hand, the GI of 50% barley bread (59.16) was in the moderate range and significantly lower than that of white bread (91.98) (P=0.03). Based on the results, the SI of both 25% barley bread (425.82) (P=0.04) and 50% barley bread (968.26) (P=0.02) was significantly higher than that of white bread.

The addition of barley flour to bread not only reduced the GI and GL, but also substantially increased the SI of white bread.

Gestational diabetes is one of the most common complications of pregnancy, which increases the risk of complications, such as preterm birth and low glucose at birth. Several studies have reported that diet plays an important role in preventing and managing gestational diabetes. The present study aimed to investigate the relationship between pre-pregnancy vegetable consumption and gestational diabetes in women residing in Tehran, Iran.

This prospective study was performed on 1026 women. Glucose tolerance tests were performed at 24-28 weeks of gestation, and the diagnostic criteria by the American Diabetes Association were used to define gestational diabetes. The participants’ dietary intake was examined, using a reliable and valid food frequency questionnaire, and their consumption of vegetables (i.e., green leaves, allium vegetables, cabbage, stems, and roots) was determined. The association between vegetable consumption and gestational diabetes mellitus was examined by logistic regression analysis.

A total of 71 (6.9%) women were diagnosed with gestational diabetes. The mean pre-gestational age and body mass index of the participants were 26.7±4.3 years and 25.4±4.5 kg/m2, respectively. The mean vegetable consumption in pregnant women with and without gestational diabetes was 134.7±17.1 and 116.1±5.3 g/day, respectively. The intake of stem vegetables (P=0.05) and fruit vegetables (P=0.04) in women without gestational diabetes was significantly higher than that of women with gestational diabetes. Fruit vegetables reduced the risk of gestational diabetes. However, no significant association was found between the intake of other vegetables and the risk of gestational diabetes after adjusting for confounding variables.

Considering the low consumption of fruit vegetables in women with gestational diabetes and the direct association between their intake and the lower risk of gestational diabetes, it is recommended to increase the intake of these vegetables to prevent this disease.

Prevention of complications associated with diabetes, besides the reduction of mortality and economic costs, are the most important goals of diabetes management. To achieve these goals, glycemic control, which requires education, is essential. Patients adhere to recommendations and guidelines when they have a clear understanding and perception of their disease. The current study aimed to investigate the effect of education based on illness perception on glycemic control in patients with diabetes.

This randomized clinical trial was conducted on 78 diabetic patients, referred to Quchan Clinic, Quchan, Iran. The participants were randomly assigned to either the intervention (n=38) or control (n=40) group. For data collection, the revised version of the Illness Perception Questionnaire (IPQ-R) was used, and glycosylated hemoglobin (HbA1c) level was measured before and after the intervention. The intervention group participated in two educational sessions (education based on illness perception), each lasting about 45 minutes. The subjects were assessed three months after the intervention, and the results were analyzed using SPSS version 22.

Three months after the intervention, the mean HbA1c level (9.28±1.318 vs. 8.33±1.422) and illness perception (132.53±12.971 vs. 159.47±9.772) changed significantly in the intervention group, compared to the pre-intervention phase. According to the analysis of covariance (ANCOVA), the serum level of HbA1c significantly changed after the intervention, compared to the pre-intervention phase (P<0.001).

According to the present findings, the intervention could improve illness perception in diabetic patients, leading to higher glycemic control.

Obesity predisposes individuals to functional decline and low self-esteem. Therefore, perceived social support can be a key determinant of individuals' reactions to this phenomenon and their health-related quality of life (HRQoL). The present study aimed to compare the association between HRQoL and perceived social support in overweight/obese adults in Tehran, Iran.

A total of 1674 participants of Tehran Lipid and Glucose Study, aged ≥20 years, were enrolled in this study. To collect data, the perceived social support, HRQoL, and demographic information questionnaires were used. The participants were categorized into two groups of normal weight and overweight (73.6%), according to the body mass index (BMI).

The mean age of the participants was 47.96±15.25 years, and 57.8% (n=963) of them were female. In both groups of low and high social support, the physical functioning score of HRQoL was significantly higher in normal-weight individuals, compared to their overweight/obese counterparts (OR: 1.94, CI: 1.21-3.10).

After adjusting for demographic, behavioral, and clinical factors in the group with lower levels of perceived social support, it was found that the likelihood of poor physical functioning, as a component of HRQoL, in overweight/obese individuals was almost twice as high as those with a normal weight.

The incidence of obesity, as a major health problem, has increased significantly over the past decades. This condition is associated with an increased risk of cancers, type 2 diabetes, and cardiovascular diseases. The current study aimed to investigate the effects of inflammation and changes of adipose tissue-resident immune cells on increasing the risk of cancer in obese individuals. In obesity, an increase in white adipose tissue changes the phenotype of tissue-resident macrophages to M1, resulting in chronic inflammation. This, in turn, increases the number of immune suppressor cells (e.g., regulatory T cells and myeloid-derived suppressor cells in white adipose tissue), but inhibits the anti-tumor activity of natural killer cells. Besides, hormonal and metabolic changes caused by obesity increase the risk of cancer. The elevated levels of hormones, such as insulin and leptin, activate the mitogenic Ras/MAPK pathway, and transduce inhibitory signals of apoptotic death in cancer cells. Also, the white adipose tissue acts as an energy source for cancer cells and promotes tumor growth and metastasis by producing pro-inflammatory cytokines, adipokines, and proangiogenic factors. Overall, obesity, by increasing the white fat mass, prepares a suitable microenvironment for triggering tumor formation and inhibiting anti-tumor pathways, which increase the risk of cancers.