مجله دیابت و متابولیسم ایران
سال بیست و دوم شماره 5 (پیاپی 108، آذر و دی 1401)

This review study aims to shade light on the effects of carrying out interventions and policies in order to reduce the incidence and prevalence of non-communicable diseases (NCDs) and their behavioral risk factors (i.e., unhealthy diet, insufficient physical activity and smoking) and strategies and approaches to reduce their attributed burden.

In this research, the documents and reports available in the Ministry of Health, developed action plans, recommendations of national and international organizations, evidence gathered from monitoring and evaluations and the "National Action Plan and Control of Non-Communicable Diseases and Related Risk Factors in the Islamic Republic of Iran, 2015-2025" were investigated with respect to  each of the three main risk factors of NCDs, including unhealthy diet, insufficient physical activity, and smoking (harmful consumption of alcohol has been reviewed in another article). Each risk factor has been discussed separately in the sections describing the current situation, policies and implemented interventions, findings, and future plans.

The implemented interventions and policies to achieve the goals stated in the "National Action Plan and Control of Non-Communicable Diseases and Related Risk Factors in the Islamic Republic of Iran, 2015-2025" in the field of unhealthy nutrition, resulted in revising the food standards. Interventions in the field of physical activity have caused a 1.5% reduction in the relative prevalence of sedentary behavior in the society. Our research also revealed that interventions in the field of tobacco consumption have led a total decrease of 7.44% among Iranian people over 18 years of age, but a decrease in the use of hookah is not recorded, and its consumption has increased by 28% in 2021 compared to 2011.

According to the findings, the goals stated in the aforementioned document have not been fully achieved, so new interventions and policies should be used by those involved.

Inflammation plays a critical role in the promotion of hepatocyte damage and liver fibrosis. In recent years the protective role of exercise and royal jelly (RJ), has been suggested for metabolic and inflammatory disorders. In this study, we aimed to evaluate the effects of aerobic training (AT) and RJ on pro-inflammatory markers in a rat's model of a high-fat diet (HFD).

In this experimental study, 45 male rats were randomly divided into five groups (Each group: n=9): Normal Diet (ND), High-Fat Diet (HFD), High-Fat Diet +Training (HFDT), High-Fat Diet + Royal Jelly (HFDRJ), and High-Fat Diet +Training + Royal Jelly (HFDTRJ). The supplement groups received 100 mg of royal jelly (kg/body weight) diluted in distilled water orally during the intervention period. The aerobic exercise program included treadmill running with an intensity of 50-60% oxygen consumption (VO2max), 5 days/week for 8 weeks.

HFD increased hepatic NF-κB (p=0.006), TNF-α (p=0.0001) and IL-1β (p=0.0001). AT, RJ as well as the combination of AT with RJ decreased NF-κB, TNF-α and IL-1β (p≤0.05). Decrease in NF-κB, TNF-α and IL-1β were significant in HFDTRJ group compared to HFDT and HFDRJ groups (p≤0.05).

The combination of AT and RJ may decrease inflammatory markers and improve HFD-induced hepatic steatosis by reducing the expression of NF-κB, TNF-α, and IL-1β.

The present study was conducted with the aim of comparing lifestyle education based on the Bezenf model and the World Health Organization model on FBS, 2HPPBS, HbA1c in patients with type II diabetes.

The research method was a semi-experimental and multi-group expanded type with pre-test-post-test designs and a control group with a follow-up period. The statistical population of this research included all patients with type II diabetes referred to the endocrinology department of Imam-Khomeini Hospital in 1400. In this research, from a list of 100 people with diabetes, 60 diabetic patients who met the entry criteria were identified. Then 45 people were randomly selected and replaced by random replacement in two experimental groups and one control group. Each experimental group received group psychological interventions separately, and at the end, both groups were subjected to a post-test. The obtained data were analyzed using mixed analysis with repeated measurements.

The results indicate the effect of lifestyle education based on the Bezenf model and the World Health Organization model on FBS (P=0/001), 2HPPBS (P=0/001) and HbA1c (P=0/006) and the stability of this effect was in the follow-up phase. Also, compared to lifestyle education based on the World Health Organization model, lifestyle education based on the Bezenf model was a more effective method to reduce HbA1c in type 2 diabetes patients but the difference in the effect of the two groups on FBS and 2HPPBS was not significant.

The results indicated the effectiveness of both educational models and the superiority of the BAZENF educational model. Therefore, Lifestyle education based on the Bezenf model and the World Health Organization model can be used by therapists as adjunctive treatments in interventions for people with type 2 diabetes.

Despite the existence of very effective drugs in controlling blood sugar in diabetic patients, unfortunately, a small proportion of patients follow their medication. Several factors may affect in drug adherence. In this study, the effect of drug-related beliefs on medication adherence in diabetes was investigated.

In a cross-sectional study using available sampling method, 248 patients with type 2 diabetes referred to the specialized diabetes clinic in Hamedan in 1400 were selected. Medication compliance was checked with MMSQ-8 and medication belief was checked with BMQ questionnaire. Data were analyzed using chi-square, ANOVA, Kruskal-Wallis and Spearman's correlation at significance level of 0.05.

The mean age was (16.9) 52.6 years. 51.6% were women, 61.3% were men. poor, moderate, and good medication adherence rate were 53.2%, 25.8% and 21%, respectively. In patients with poor, moderate and good drug treatment, the mean (SD) of the belief score for the Specific Necessity were 17.9 (5.8), 17.2 (3.7) and 17.7 (1.2), respectively. Belief of Specific concern 16.6(0.6), 17.6 (2.3) and 1/17(1.8), belief of General overuse 13.2 (2.2), 12.6 (2.6) and 12.2 (2.3), belief in General harm were 10.6 (2.9), 10.2 (3.5) and 8.5 (0.3) and the total score of belief in drug treatment were 58.3 (1.8), 57.6 (6.8) and 55.5 (4.7) and which only the belief of General harm was statistically significant (P<0.05).

More than half of patients do not follow appropriate medication adherence. Belief about harmful side effects of diabetes drugs were significantly associated with a decrease in medication adherence.

mTOR and CREB proteins are two important factors in cellular pathways and regulating fat tissue metabolism. Therefore, the aim of this research is the effect of endurance training on the amount of mTOR and CREB proteins in the adipose tissue of type 2 diabetic rats.

In this experimental study, 18 rats 2-month-old male Sprague-Dawley rats with a mean weight of 270±20g were selected. 12 rats became type 2 diabetic by intraperitoneal injection of Streptozotocin solutions. These rats were randomly divided into 2 groups: diabetic training and diabetic control (6 heads per group); A healthy control group (6 heads) was also considered. The training group practiced endurance training 4 days a week for 6 weeks. Data were analyzed using SPSS software version 23 and one-way ANOVA and Tukey post hoc tests.

mTOR protein content showed a significant change after 6 weeks of endurance training (P=0.0001); Tukey's post hoc test showed that this change was significant between the pairs of diabetic training groups to healthy controls (P=0.004) and diabetic control groups to healthy controls (P=0.0001). CREB protein content showed a significant change (P=0.0001); this change was significant between the pairs of diabetic training to diabetic control groups (P=0.02), diabetic training to healthy control (P=0.0001), and diabetic control to healthy control groups (P=0.0001).

mTOR and CREB proteins decreased after Endurance Training, which can be effective in regulating adipose tissue metabolism; however, more training conditions should be considered.

Unc-51 Like Autophagy Activating Kinase-1 (ULK1) and FAK Family Kinase-Interacting Protein of 200 kDa (FIP200) play an essential role in controlling autophagy and muscle volume. The aim of this research is to investigate the effect of endurance training on the intracellular content of ULK1 and FIP200 proteins in the left ventricular of rats with type 1 diabetes.

In this experimental study, 18 rats 2-month-old male Sprague-Dawley rats with a mean weight of 300±20g were selected. 12 rats became diabetic by intraperitoneal injection of Streptozotocin solutions. These rats were randomly divided into 2 groups: diabetic training and diabetic control (6 heads per group); A healthy control group (6 heads)was also considered. The training group practiced endurance training 4 days a week for 6 weeks. Data were analyzed using SPSS software version 23 and one-way ANOVA and Tukey post hoc tests.

The content of ULK1 (increase) and FIP200 (decrease) after endurance training showed a significant change among the research groups in the left ventricular (P=0.0001). Tukey's post hoc test showed that this change is significant between the pair of diabetic training groups to diabetic control, diabetic training to healthy groups, and also diabetic control to healthy groups (P≤0.05).

Endurance training showed that it can have a dual nature to control autophagy in diabetic subjects by increasing ULK1 and decreasing FIP200. There is a need for more investigations in the field of exercise physiology on the proteins responsible for autophagy, especially in type 1 diabetes subjects.