مجله غدد درون ریز و متابولیسم ایران
سال بیست و چهارم شماره 2 (پیاپی 122، خرداد و تیر 1401)

Diabetes is one of the most common metabolic diseases, which complicates many pregnancies. The present study investigated the prevalence of gestational diabetes and its related risk factors.

In this cross-sectional study conducted from April 2021 to March 2022, all pregnant women referred to the health centers of Ilam city, who had performed the OGTT test during the 24th-28th weeks of pregnancy, were included in the study. Data were collected using a researcher-made questionnaire addressing demographic characteristics, medical records, and pregnancy and childbirth records. Data were analyzed with SPSS software version 19 using frequency, mean, T-test, chi-square tests, Fisher's exact, and logistic regression. In this study, the significance level was set as p<0.05.

Of 638 pregnant women, 589 (90.4%) had no diabetes, and 60 (9.6%) had gestational diabetes with a prevalence of 9.6%. Gestational diabetes was more common in multiparous women aged above 30 years and overweight in early pregnancy (p=0.001). Age, level of education, body mass index, and economic status had a statistically significant relationship with gestational diabetes (p=0.001). History of stillbirth, history of abortion, macrosomia, history of diabetes in family, prediabetes status and previous gestational diabetes, and hypothyroidism were the possible risk factors for gestational diabetes (p=0.001). Urinary tract infections and blood pressure disorders were more common in those with diabetes (p=0.001).

Because gestational diabetes was more common in multiparous women aged above 30 years and overweight in early pregnancy, timely counseling and education for this pregnant group can effectively reduce the risk of developing gestational diabetes.

This research aimed to determine the effect of problem-oriented coping style training on treatment adherence and glycemic control in type 2 diabetic patients referring to the Diabetes Clinic of the Imam Khomeini Medical Training Center (RA) in Khomein, Markazi province, Iran.

In this clinical trial study, 78 diabetic patients were selected using the convenience sampling method and then randomly assigned into experimental and control groups. The experimental group received problem-oriented coping style training, and the control group was given the usual training. The patients' blood glucose control indices were measured before and after the intervention. The Diabetes Activities Questionnaire and the Lazarus and Folkman Coping Strategies Questionnaire were used to determine adherence to treatment and problem-oriented coping style training. Data were analyzed using SPSS software version 25.

The mean score of adherence to treatment increased significantly in the experimental group and decreased significantly in the control group following the intervention (p=0.003). There was no significant difference in the mean treatment compliance score between the control and experimental groups in the pre-test phase (p=0.0325); however, in the post-test phase, the difference was significant (p<0.0001). The average glycosylated hemoglobin showed a significant decrease in the experimental group in the post-intervention phase (p<0.001), This is while it increased significantly in the post-test phase in the control group (p<0.0001).

Problem-oriented coping style training has an effect on adherence to treatment and the improvement of blood sugar control indices in type 2 diabetes patients; hence, this method can be recommended for training patients.

The utilization of health services is an opportunity for using health services by the needy. Since COVID-19 can have significant effects on all life dimensions, including the utilization patterns, especially in patients with non-communicable diseases (NCDs), this study aimed to determine and compare the extent of utilizing health services by individuals with and without NCDs in the Shahrekord cohort study before and during the COVID-19 pandemic.

The present cross-sectional study was conducted on 760 patients of the age group of 35-70 years in the Shahrekord cohort study, which addressed the urban areas of Shahrekord and the rural regions of Ardel city during two separate periods. For all patients, the questionnaire on benefiting from health services was completed. The data was collected using the telephone interview method and then analyzed using SPSS software.

The mean and standard deviation of the age was 44.95±8.65 years in the patients without NCDs  and 53.38±8.60 years in those with NCDs(p<0.001). The rates of medical service reception in those without common NCDs before and during the corona epidemic were 3.2% and 15.3%, respectively. In those with common NCDs, the rates were 7.1% and 27.1%, respectively (p<0.001). During the coronavirus epidemic, the average duration of receiving service, duration of service, paid fee, and the frequency of receiving service were longer in the participants with chronic NCDs (P<0.001).

The reception of medical services and outpatient services in the two groups of patients with and without NCDs during the coronavirus pandemic increased compared to the pre-pandemic period. This point should be considered as a lesson learned from the epidemic by the health system policymakers and planners to lay the grounds for providing care services, especially for chronic patients during epidemics.

This study examined the effect of adding selenium to levothyroxine on controlling  primary overt hypothyroidism and reducing the serum level of thyroid peroxidase antibody.

This study was a double-blind, randomized clinical trial on individuals with primary autoimmune hypothyroidism. The patients were randomly divided into two intervention (I) and control (C) groups. Group I was treated with levothyroxine plus selenium, and Group C was treated with levothyroxine alone for three months. The anti-TPO antibody titer and serum levels of TSH, T3, and T4 were measured before and after treatment. Individuals were matched according to the season of visit and body mass index.

Fifty-three persons with a mean age of 33 years (10% male) participated in this study. Twenty-one individuals in Group I and twenty individuals in Group C completed the study. There was no significant difference between the two groups regarding age and gender. In none of the groups, anti-TPO antibody titer did not change significantly before and after the intervention. The serum level of the antibody did not differ significantly between the two groups before and after the study. Following the treatment, Group C was euthyroid; however, the intervention group, despite a decrease in TSH and an increase in T3 and T4, was not euthyroid. The participants reported no side effects.

In this study, adding selenium to levothyroxine sodium did not significantly change the serum level of anti-TPO, TSH, T3, and T4 in the patients with overt primary hypothyroidism.

Cinnamon is a plant containing anti-inflammatory, anti-apoptotic, and antioxidant substances. Previous studies have revealed the reducing effects of obesity and hyperlipidemia and, on the contrary, the reinforcing effects of cinnamon on fertility. Therefore in this study the effect of the hydroalcoholic extract of cinnamon on Body Mass Index (BMI) and gene expression of cation channel of sperm (CatSper) in male Wistar rats receiving high-fat diets was investigated.

Thirty-six male rats were divided into six groups. Control group received normal diet and no treatment. The five other groups received high-fat diet for eight weeks. The diet control group received only high-fat diet, the vehicle group received carboxymethyl cellulase 0.5% (5 mg/kg), the lovastatin group received 10 mg/kg lovastatin, and the cinnamon groups received 130 and 260 mg intra peritoneum for six weeks daily. BMI was measured at the end of the study. The expression levels of Catsper genes were also evaluated using Real-Time PCR. Data were analyzed with SAS software version 9.1 using one-way analysis of variance (ANOVA) and Duncan tests (p<0.05).

The hydroalcoholic extract of cinnamon significantly reduced BMI (p<0.05). The expression level of Catsper1-4 genes decreased in the model and vehicle groups compared to the control group (p<0.05); however, the expression level of Catsper1-4 genes increased in the cinnamon and lovastatin groups compared to the control group.

Cinnamon as a pretreatment has beneficial and reducing effects on BMI. Moreover, in pretreatment with cinnamon, the increased expression of Catsper1-4 genes is observed.

Fructose is a lipogenic monosaccharide affecting glucose homeostasis and other metabolic biomarkers; however, there is conflicting evidence in this regard. The current systematic review aimed to determine the effects of fructose on metabolic biomarkers in individuals with T2DM using randomized clinical trial studies.

In this systematic review study, after searching the PubMed, Science Direct, and Google Scholar databases using some keywords (namely fructose, type 2 diabetes, and metabolic biomarkers), 14 clinical trials related to the objectives of the present study, which were published from 1985 to 2020, were collected and reviewed.

Studies showed that fructose in patients with diabetes may reduce fasting and postprandial blood sugar, hemoglobin A1c, insulin resistance, and fructose amine. In interventions with fructose,  the concentrations of total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), lactate, pyruvate, and C-peptide remain unchanged. The findings of most of the reviewed articles indicated that the serum triglyceride concentration remained constant after fructose consumption. There is no clear evidence on the effects of fructose on blood pressure, plasma insulin concentrations and glucagon. Also, most of the findings showed no potential change in anthropometric variables.

The findings of some studies have indicated a slight decrease in fasting blood sugar following fructose consumption. However, since these studies had a small sample size and a short intervention period and also used small amounts of fructose for intervention, using fructose in the food industry and in the diet of diabetics is not recommended. Further studies are needed to include this nutrient in diets.