مجله دیابت و متابولیسم ایران
سال نوزدهم شماره 3 (پیاپی 91، بهمن و اسفند 1398)

Type 2 diabetes mellitus (T2DM) is the most common type of diabetes that was classically characterized by pancreatic β-cell dysfunction. Changes in circadian patterns is one of the reasons which can increase the occurrence of diabetes. Melatonin is one of the biological molecules which plays an important role in regulating the circadian clock and also an inhibitory effect on insulin secretion in β-cells. The aim of this study was to examine the association between MTNR1B (rs10830962) gene polymorphism and the risk of T2DM.

Genotyping was carried out in a total number of 208 subjects including 108 patients with T2DM and 100 normal controls using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) which is confirmed by Sanger sequencing method.

The frequencies of CC, GC and GG among cases were 54.63%, 1.85% and 43.52% and in control subjects were 81%, 0% and 19% respectively (P<0.001). Frequency of G allele among diabetic patients was significantly higher than non-diabetics (OR=3.34, CI=2.10-5.36, P<0.001).

Our study showed that rs10830962 polymorphism of the MTNR1B gene can be directly associated with T2DM risk.

Diabetic foot is one of the main complications of diabetes, which is caused by a significant proportion of patients with diabetes and which imposes costs on the family and the health system around the world. This review aims to summarize the latest findings in the field of diabetic foot based on clinical guidelines.

In this review study, in order to achieve the best clinical guide in the field of diabetic foot by determining the search strategy and inclusion criteria, all related clinical guides were searched in the databases and websites of clinical guidelines.  Clinical guidelines related to diabetic foot care were searched and retrieved from January 2000 to early 2019 and screened separately by two researchers to select the selected clinical guideline.

Based on the study criteria, the clinical guide of the International Diabetic Foot Working Group was selected as the most complete guide in the field of diabetic foot. This summary is based on the International Working Group on the Diabetic Foot (IWGDF) Guidance 2015, consist of five documents including prevention of foot ulcers in at‐risk patients, footwear and offloading principles, diagnosis, prognosis and management of peripheral artery disease, foot infections in patients with diabetes and enhance healing of chronic ulcers of the foot in diabetes.

This Summary Guidance for Daily Practice is intended to overview of the main aspects of the prevention and treatment of foot problems in patients with diabetes. This summary guidance is adviced at healthcare providers and specialists in foot care throughout the world.

The proinflammatory cytokines of tumor necrosis factor alpha TNF-α and anti-inflammatory interleukin-10 have important roles in inducing and preventing systemic inflammation, respectively. The purpose of this study was to the synergistic effect of High-Intensity Interval training and resveratrol consumption on IL-10 and TNF- α in diabetic rats.

In this experimental study, 32 diabetic rats 225± 10 g based on Cohenchr('39')s sample size estimation table diabetic with combination of high-fat diet and streptozotocin (STZ) injection, were randomly divided into four groups: control(C), supplement(M), training (T)and training + supplement(TM). The training groups were exposed to high-intensity interval training with an intensity of 90 to 100% VO2max for 8 weeks, 5 sessions per week, each session for 18 minutes. The supplement groups received 10 mg / kg of resveratrol daily for eight weeks, three times a week by gavage. Blood samples were taken 48 hours after the last training session. Data were analyzed using one-way analysis of variance and SPSS software version 24 (ANOVA).

Results showed that IL-10 increased in the experimental groups but was not significant (P=0.109). TNF-α levels decreased in the TM group, whereas it increased in the T and M groups, which was significant compared to the TM group (P=.000). Fasting glucose, insulin and insulin resistance index decreased significantly in experimental groups (P=.000).

Eight weeks of high-intensity interval training plus resveratrol can have a positive effect on inflammation and insulin resistance by increasing IL-10 and decreasing TNF-α.

The prevalence of type 2 diabetes is increasing due to lifestyle changes, increasing prevalence of obesity and inactive physical activity, and glucose modulation is of great importance in these individuals. Thyme was studied on type 2 diabetic rats by streptozotocin and high fat diet.

Male Wistar rats weighing 110±10 g were used in this study. The rats were randomly divided into four groups of Thymus + Exercise, Thymus, Exercise and Control groups. The extract was taken 200 g daily through a gavage syringe. Exercise included: Running on a treadmill at a speed of at least 20 m / min and a maximum of 38 m / min for 60 minutes daily, 5 days a week, for 8 weeks. Serum malondialdehyde (MDA), glutathione peroxidase (GTX), superoxide dismutase (SOD), catalase (CAT) were measured by ELISA method.

Serum MDA and CAT levels were significantly higher in the control group (p = 0.002). The results also showed that there was no significant difference between SOD and GPX levels in different research groups (p = 0.790).

Intermittent exercise (HIIT) and thyme extract can improve oxidative and antioxidant balance in diabetic rats.

The aim of this study was to estimate the prevalence of clinical hyperthyroidism at the national and sub-national levels using the claims data.

National anti-thyroid medications (methimazole and propylthiouracil) sales data in 2014 were extracted from pharmaceutical sales data that were reported by Iranchr('39')s Food and Drug Administration (FDA). By using prescriptions data of Social Security Insurance Organization (SSIO) and Medical Services Insurance Organization (MSIO) in 2014, age-sex-province proportions of drug consumptions and Defined Daily Dose (DDD) of anti-thyroid medications were calculated. Moreover, by systematic review and meta-analysis of published literatures in hyperthyroidism in Iran, the prescription rate of anti-thyroid medications was calculated. Finally by using the whole data, the prevalence of clinical hyperthyroidism was estimated in each age and sex groups in national and provincial levels.

The prevalence (95% confidence interval) of clinical hyperthyroidism in Iran in 2014 is 0.32% (0.21-0.51%); 0.44% (0.29-0.68%) in females and 0.2% (0.12-0.33%) in males. Among provinces the least prevalence rate of clinical hyperthyroidism is 0.24% (0.16-0.38%) which belongs to Sistan and Baluchistan, and the highest prevalence rate is 0.38% (0.24-0.6%) which belongs to Gilan.

The prevalence rate that reported by this study is compatible with other surveys which performed in the world and Iran. As a result using claims data is a good source to predict prevalence of chronic diseases that have specific drugs.

The purpose of this study was to investigate the effect of concurrent training on pre-inflammatory (IL-1β, TNF-α) and anti-inflammatory (IL-10) cytokines gene expression in women with type2 diabetes.

18-patients (age30-38, >130 glycemic index) were selected, randomly, and divided into control (n=6) the concurrent training(diabetes, n=6) and the concurrent training (healthy, n=6)  groups. The concurrent training protocol consisted of 3 sessions resistance training per week, 8sets with 80% one maximum repetition( and the endurance training preformed with 30- minutes running (3sets×10 minutes) on a treadmill with 70-80 maximum heart rate(70-80 MHR), immediately. The leukocyte’s IL-1β, TNF-α and IL-10 genes expression determined by the Real time-PCR technique. The quantitative expression of the cytokines gene was calculated using the 2-ΔΔ CT method. The between- groups differences in variables were determined by independent t-test (permutation test) through REST software and independent one-way ANOVA.

The results showed that IL-1β, TNF-α mRNA genes expression reduced significantly after the concurrent training in both the training groups in comparison to the control group (P<0.05). In addition, the results also showed that IL-10 mRNA gene expression was not expressed in leukocytes after the concurrent training in both training groups in comparison to the control group (P>0.05).

In conclusion, the results suggest that the concurrent training modulate IL-1β and TNF-α mRNA genes expression significantly in diabetic women but could not change IL-10 genes expression. This type of exercise training seems to be more effective in reducing the expression of pro-inflammatory cytokines than in enhancing anti-inflammatory cytokines.