مجله غدد درون ریز و متابولیسم ایران
سال بیست و پنجم شماره 4 (پیاپی 130، مهر و آبان 1402)

Nowadays, diabetes mellitus is considered one of the most common diseases affecting the quality of life in the elderly. Therefore, this study was conducted to investigate the effect of self-care training program on health-related quality of life among elderly women with type 2 diabetes mellitus (T2DM).

In this clinical trial, 99 elderly women with T2DM were selected using random cluster sampling and randomly divided into test and control groups in Tehran from 2022 to 2023. The test group received seven sessions of 30-60 minutes of self-care training specific for patients suffering from T2DM, while the control group received the same training in four intensive sessions after the post-test. Data collection tools included a two-part questionnaire on demographic information and quality of life (LEIPAD). Data analysis was performed using SPSS software version 26 software and descriptive and analytical statistical tests.

In this study, 69.7% (69) of the participants were in the age group of 60-69 years. After the intervention, a significant difference was observed in the quality of life scores between the two groups (p<0.001). Within-group analysis also showed a significant difference in the quality of life scores before and after the intervention, with a positive change in the test group and a negative change in the control group (p=0.001).

Self-care education can improve the quality of life of elderly women with T2DM. Therefore, implementing such educational interventions is a suitable option for enhancing the quality of life of elderly women with T2DM.

Marital adjustment has a favorable effect on the physical and mental health of couples suffering from type 2 diabetes mellitus (T2DM). It is necessary to use interventions and training based on psychological approaches to influence the level of psychosocial adjustment of couples. Therefore, the present study was conducted to determine the effect of cognitive behavioral training on the psychosocial adjustment of couples with T2DM.

The current research is a semi-experimental study conducted on 40 patients and spouses of patients with T2DM. The samples were selected as available and the participants were evaluated with the scale of psychosocial adjustment before and after the intervention. The data were analyzed using the analysis of variance test with repeated measurements and with the help of SPSS software version 22.

The average age of the participants in the study was 54 years, and they had been married for 25 years on average, and they had at least ten years of T2DM. The psychosocial adjustment scores of the participants of the experimental and control groups were 73.60±8.31 and 45.33±2.35 before the intervention and 101.70±5.99 and 47.83±7.74 after the intervention, respectively. The analysis of variance test with repeated measurement showed that these differences are statistically significant (P≤0.05) and the cognitive-behavioral intervention improved the psychosocial adjustment of couples with T2DM.

According to the results indicating the effectiveness and efficiency of the treatment based on the cognitive-behavioral method, it is suggested that counselors and therapists use this method to improve the psychosocial adjustment of couples with T2DM.

Diabetes mellitus is a spreading disease in the world. Despite the effective role of supportive resources in diabetes management, there is currently no documented plan for the use of these resources in diabetic patients. So the research team, while designing a support resource-based care program based on qualitative study and systematic review, conducted the present study with the aim of validating the program in people with type 2 diabetes mellitus using the Delphi method.

This is a methodological study conducted to validate the Delphi care program. Panel members included 15 experts in the field of diabetes, who were selected by the snowball method. The data collection tool was a structured questionnaire with 38 questions that were designed based on different parts of the care plan. The data was analyzed using SPSS software (version 18), and the percentage of agreement with the questionnaire dialects continued until a consensus was reached.

In the first round of Delphi, the preliminary draft of the care plan was drafted and amended based on the suggestions and corrective opinions of the participants. Then the contents of the questionnaire questions were prepared. In the second round of Delphi and the consensus on the dialects of the questionnaire, the percentage of agreement of the members of the expert panel based on the questionnaire questions was obtained at 93.5.

Given that the scientific and practical acceptability of the care program based on support resources, based on the questions raised in the present study, was "very high" and "high", it is recommended that this program be used to design and complete related programs at the national level.

 To overcome the limitations of the definition of metabolic syndrome (MetS) in clinical use, a health index named quantitative Metabolic Syndrome Severity Score (cMetS-S), has been recently introduced and validated in the Tehran Lipid and Glucose Study. This study investigated the association between the severity of MetS based on age and gender (cMetS- score), and cardiovascular diseases (CVD) beyond the components of MetS.

 At the beginning of the study, participants aged 20-60 years were enrolled. Those with cardiovascular disease, cancer, use of corticosteroid, estimated glomerular filtration rate <30 ml/min/1.73m², or pregnancy were excluded. The association between cMetS-S and cardiovascular diseases was evaluated continuously for 18 years follow-up among 8,500 participants using Cox proportional hazards regression models and its performance in predicting cardiovascular disease events was compared with the MetS criteria.

 Participants with higher cMetS-S showed a significant increase in the risk of cardiovascular disease (CVD), coronary heart disease (CHD), and non-coronary heart disease (non-CHD). Independent of the confounding factors of metabolic syndrome components, each 1-SD unit increase in cMetS-S was associated with risk ratios of 1.67, 1.60 and 1.88 for cardiovascular diseases, coronary and non-coronary cardiac events, respectively. Model fit analysis showed better CVD prediction value for cMetS-S independent of (MetS) components, compared with metabolic syndrome (p<0.0001).

 The cMetS-S predicts cardiovascular diseases more accurately than the MetS and its components. The standardized cMetS-S, which considers the weighted contribution of MetS components and their variations by age and gender, may serve as a health metric for determining the severity of metabolic syndrome.

Leptin and adiponectin are two peptide hormones that regulate energy balance. Physical activity can improve plasma levels of leptin and adiponectin. This study aimed to evaluate the effect of aerobic training on plasma levels of leptin and adiponectin in overweight and obese children and adolescents. 

The search was conducted in PubMed, Web of Science, Scopus, SID, and Magiran databases until January 2024. The present meta-analysis was conducted to investigate the effect of aerobic training on plasma levels of leptin and adiponectin in overweight and obese children and adolescents. Mean difference and %95 confidence interval (CI) were calculated using random effect model. Heterogeneity was evaluated using the I2 test and publication bias was evaluated by visual analysis of the funnel plot and Egger's test. 

A total of 21 studies with (28 interventions) 816 overweight or obese children and adolescents were meta-analyzed. The results showed that aerobic exercise caused a significant decrease in serum leptin [P=0.001, (-0.57 to -0.19) SMD=-0.387] and a significant increase in serum adiponectin [P=0.001, (0.25 to 0.60) WMD=0.430] became overweight and obese compared to the control group. 

In general, the results of this meta-analysis demonstrate that aerobic exercise is an effective and beneficial exercise method for reducing leptin blood circulation and increasing adiponectin in overweight and obese children and adolescents. Therefore, it seems that types of aerobic exercise may be a non-pharmacological and practical intervention to regulate adipokines and reduce disorders related to overweight and obesity in children and adolescents.

Several studies have investigated the effect of creatine supplementation on indirect markers of muscular damage and sports performance of athletes. However, pooled data from several studies suggest that the benefits of creatine on recovery of athletes are limited. The aim of this study was to investigate the effect of creatine supplementation on post-exercise recovery and muscle injury factors in healthy subjects.

A systematic search of articles published in English and Persian databases until November 2023 was conducted to investigate the effect of creatine supplementation on muscle injury markers creatine kinase (CK) and lactate dehydrogenase (LDH) and muscle soreness in healthy subjects. Weighted mean difference (WMD) and standardized mean difference (SMD) and 95% confidence interval were calculated using random effect model.

A total of 20 studies including 458 subjects were included in the present meta-analysis. The results showed that creatine did not cause a significant change in muscle soreness in any of 24, 48, 72, and 96 hours after exercise compared to the control group. Also, creatine did not cause a significant change in CK in any time spectrum compared to the control group. In addition, creatine did not cause a significant change in LDH in different time ranges after exercise compared to the control group in athletes and non-athletes.

The results of the present study show that creatine supplementation is not effective in reducing muscle soreness and muscle injury factors after exercise.