Iranian Journal of Diabetes and Obesity
Volume:3 Issue: 1, Spring 2011

Obesity is a worldwide health problem, with increasing prevalence associated with an increased risk of chronic diseases. Decrease in energy intake has been shown to lower the risk of coronary artery disease (CAD) in obese. The common form of dietary restriction is daily calorie restriction (CR). Another form is alternate-day fasting (ADF). The ability of modified ADF to facilitate weight loss and lower cardiovascular risk factors has not been tested. This study examined the effects of combination CR and ADF in obese adults. 26 female obese inpatients completed a 4 week trial of controlled food intake during modified ADF period. All subjects consumed very low calorie diet on the fast day and then consumed diet including 1600 - 1700 Kcal in every other day. Body weight (BW) and blood pressure (BP) were measured daily. Fasting blood samples were collected at the first and 29th day of trial for biochemical analysis. During the course of the trial (4 wk), BW of the subjects decreased (P < 0.0001) from 96.87 ± 21.34 kg to 92.16 ± 19.85 kg. Mean BMI of the subjects at baseline was 37.38 ± 7.35 kg/m2, at the end of course decreased (P < 0.0001) to 35.56 ± 6.78 kg/m2. Systolic BP decreased (P < 0.0001) from 142 ± 13 to 122 ± 12mm Hg. Total cholesterol decreased (P < 0.0001) from 6.12 ± 1.1 to 5.42 ± 1 mmol/L, LDL (P <0.0001) from 3.99 ± 0.96 to 3.34 ± 0.87 mmol/L, fasting blood sugar (P < 0.0001) from 5.87 ± 1 to 5.23 ± 0.9 mmol/L, whereas change in triacylglycerol concentrations was not significant, HDL decreased (P < 0.005) from 1.43 ± 0.38 to 1.3 ± 0.31 mmol/L. These findings suggest that short time CR plus ADF is a viable dietary option to help obese individuals lose weight and decrease systemic blood pressure and some CAD risk factors. More and longer-term studies in human subjects are needed to support this important result.

This research was conducted to evaluate the prevalence of diabetic retinopathy (DR) in patients who were unaware of their eye condition. A descriptive cross-sectional study was performed in a 12-month period on patients who were referred to Meybod Imam Sadegh Diabetes Center. 152 patients who had no eye complaint were selected. Pupil dilation was created by Cyclopentolate and fondus examination was performed by indirect ophthalmoscope. In some cases for maculae examination, if needed, trimirror lens was used. Examination results and risk factors were recorded and statistically analyzed by SPSS. Of the 152 visited patients, 38 were male and the rest were female. Mean age was 53.2 years and mean diabetic period was 6.2 years. Without gender consideration 11% suffered from one type of DR. The results of this study showed that age, duration of disease, hypertension, blood sugar level and hyper lipidemia were effective risk factors for DR, but sex was not significantly related to DR. Diabetic retinopathy is a well-recognized complication of diabetes mellitus. Screening programs for detecting diabetic retinopathy and early identification of disease could significantly decrease the complications of DR. By a good planning, such as periodic eye examinations and adequate treatment, blindness due to diabetic retinopathy can be reduced.

The aim of this study was to evaluate the effect of good glycemic control on serum lipids levels and lipid peroxidation, and to find out the relationship between the level of malondialdehyde and HbA1c in type 2 diabetes. Fifty type 2 diabetic patients aged 40-60 years with the history of diabetes for more than 10 years were studied. Glycemic control was stable for six months which included: having a healthy diet, doing adequate levels of daily exercise, using medicine for diabetes control, control and measuring blood glucose more often. HbA1c, fasting blood glucose, serum levels of lipids, lipoproteins and oxidation parameter (malondialdehyde level) are measured at the base line and after 6 months good glycemic control. Good glycemic control decreased fasting blood sugar (FBS), HbA1c, total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C) and malondialdehyde. However, the level of high density lipoprotein cholesterol (HDL-C) increased. There was no significant relationship between malondialdehyde and HbA1cin type 2 diabetes. These results demonstrated that glycemic control in type 2 diabetic patients, in addition to beneficial effects on lipid profiles, may contribute in lowering lipid peroxidation parameter (malondialdehyde).

Streptozotocin (STZ) destroys the beta cells of pancreas by generation of reactive oxygen species and vitamin C has documented antioxidant properties. This study was designed to evaluate the preventive effect of supplementation of diet by vitamin C on induction of STZ-diabetes and its effect on carbohydrate and lipid metabolism of diabetic rats. Fifty male Wistar rats were divided randomly into non-diabetic (ND), diabetic (D), C1, C2 and C3 groups. The diet of C1, C2 and C3 groups were supplemented with 2.5, 5 and 10 g/kg of vitamin C, respectively. Four days later all groups except ND, were made diabetic by IP injection of STZ and blood glucose was measured 72 h later to determine the severity of blood glucose elevation. Weight gain was measured weekly. 21 days after induction of diabetes Glycosylated hemoglobin (HbA1C), triglyceride (TG), total cholesterol (TC), HDL-c and LDL-c were measured or calculated in plasma of 6 diabetic rats in each groups that their glucose was more than 200 mg/dl after STZ injection. Vitamin C significantly prevented blood glucose elevation after STZ injection in group C2. Weight gain decreased in all diabetic groups. Increase of HbA1c could not be prevented by vitamin C in any groups. TC and LDL-c decreased and HDL% increased in group C3. We suggest that the amount of vitamin C consumption may have an important effect on STZ-diabetes induction and it may be in agreement with opposite effects of free radicals on insulin receptor signaling. Furthermore, vitamin C may have some beneficial effects on lipid metabolism disorders of diabetes.

To determine the level of Lipoprotein (a) in diabetic patients comparing to control group. This cross-sectional study was conducted on the patients referred to Endocrinology Clinic of Bu Ali-Sina Hospital in 2009. 180 subjects including 90 diabetic and 90 healthy subjects as control group enrolled in this study. All diabetic patients had glycemic control. We measured serum FBS, TG, cholesterol, LDL, HDL and serum Lp (a) in both groups. Data were analyzed by T-test and chi-square. BMI, sex and age were similar in two groups. Lp (a) level was significantly higher in diabetic ones compared with control group (35.27 ± 28.6 vs. 20.22 ± 10.3 mg/dl, P < 0.001). Serum TG, Cholesterol, LDL were also significantly higher in diabetics (P < 0.001) while HDL was lower. HDL-Cholesterol level was significantly higher in diabetic men than women [OR = 0.18 CI 95% (0.06- 0.56)], and there was positive correlation between FBS level and lipid profile. Lp (a) as an independent risk factor for atherosclerosis has elevated level in diabetic patients. So lowering its concentration would help prevention of CAD, a known cause of death in diabetic patients.

Diabetes mellitus is one of the most common medical problems worldwide. Approximately 18% of persons over 65 years old are diabetic. WHO estimates that the prevalence rate of diabetes (4% in 1995) will increase to 5.6% in 2025.Diabetic foot problems are potentially the most preventable long–term complication for diabetes.The purpose of this study was to test the utility of the Health Belief Model (HBM) in understanding and predicating the intention of diabetic patients in prevention of their foot lesions and amputations. This cross–sectional study was carried out on 100 diabetic patients in Yazd. The data were collected using a researcher-made questionnaire in four sections. All of data were collected by direct interview and in basis of constructs of Health Belief Model (HBM). The data were analyzed by SPSS. There was no significant difference between mean grade scores of HBM and period of disease (P > 0.05). There was significant difference between perceived severity, perceived benefits and barriers and level of education of patients (P < 0.000). There was no significant difference between the foot care and period of disease (P > 0.05). The mean grade scores of knowledge, constructs of HBM and practice of participants about foot care was as follows: Mean grade score of knowledge 4.87 out of 12, perceived susceptibility 12.33 out of 20, perceived severity 14.56 out of 20, perceived threat 26.88 out of 40, perceived benefits 13.33 out of 20, perceived barriers 12.08 out of 20 and mean grade score of practice in foot care was 3.81 out of 10. The findings of this study showed that higher mean grade scores of knowledge and constructs of HBM resulted in better foot care by the patients. So our results and results of many other studies carried out on HBM, revealed that HBM constructs may change and improve behavior in participants.

To evaluate the effect of two simultaneous protocols in reducing recovery time and assessment of adverse effects of different fluid replacement therapy in management of diabetic ketoacidosis. In this randomized clinical trial study, two standard protocols were chosen to evaluate recovery time and incidence of DKA complications. 18 subjects who had severe diabetic ketoacidosis were included in our analysis. In the course of treatment, hypokalemia happened in 5 cases in protocol 1 and 4 cases in protocol 2. Hypernatremia occurred in 2 cases of protocol 1 and 4 cases in protocol 2. Hyponatremia occured in 4 cases of protocol 1 and 2 cases in protocol 2. The mean recovery time of acidosis in protocol 1 was 21 ± 5.9 (mean ± SD) hours and 23 ± 10.9 hours in protocol 2. None of them had any signs and symptoms of cerebral edema or mental status deterioration in the course of treatment. According to our study, different volume deficit calculated as a base for dehydration which was replaced in different times and in a similar clinical setting, had not added any risk of complications during the treatment. Also no significant differences were found in recovery time related to the different fluid replacement protocols. We also found that complication of therapy increases with the severity of diabetic ketoacidosis.

Polycystic Ovary Syndrome (PCOS) is the most common endocrinopathy in women of reproductive age characterized by the presence of polycystic ovaries, menstrual dysfunction and biochemical or clinical hyperandrogenism. Lifestyle modification is important in treatment of obese and overweight women with PCOS. This study was performed to evaluate the benefit of aerobic exercise training on obesity and insulin resistance in young women with PCOS. Twenty obese PCOS patients aged 15-30 underwent a 12-week aerobic training program. Anthropometric parameters (weight, height, maximum oxygen consumption, waist circumference, waist to hip ratio and body fat percentage), metabolic and hormonal profiles (glucose and insulin) were assessed and compared at the baseline and after the 12-week training program. After a 12-week aerobic training program body weight decreased from 76.9 ± 11.69 to 74.01 ± 11.82 Kg, body fat percentage decreased from 37.01% ± 4.16 to 35.57% ± 4.13 and waist circumference decreased from 86.4 ± 8.75 to 82.29 ± 6.59 cm (P < 0.05). There was also a significant increase in V02max, from 34.77 ± 1.86 to 35.87 ± 1.94 (P = 0.006). Changes in fasting glucose, fasting insulin, and insulin resistance were not significant. Aerobic training program improves anthropometric parameters, and metabolic and hormonal profiles in young women with PCOS.