Iranian Journal of Diabetes and Obesity
Volume:3 Issue: 2, Summer 2011

Some data are available on the association between components of the insulin resistance syndrome and serum ferritin. Insulin resistance is observed in patients with polycystic ovary syndrome (PCOS); We hypothesize that body iron stores might be increased in these women. Two hundred and six people (103 PCOS patients and 103 healthy women who were matched for age) entered the study. Body mass index (BMI), waist circumference and blood pressure of the participants were measured and serum androgens, gonadotropins, insulin, glucose, cholesterol, triglyceride, CRP and ferritin were evaluated. Women with PCOS had a higher concentration of serum ferritin (146.5±14.6 pmol/l in PCOS vs. 129.6±21.3 pmol/l in controls, P= 0.03) and insulin as well (80.5± 62.5 Pmol/l in PCOS vs. 53.5± 29.8 Pmol/l in controls, p=0.017). No correlation was found between serum ferritin and BMI, blood pressure, waist circumference, fasting plasma glucose (FPG) and CRP. Multiple regression analysis, only showed an association between serum ferritin and severity of oligomenorrhea (r: 0.23, p=0.03). Serum ferritin levels are increased in women with PCOS irrespective of their BMI, CRP and insulin resistance. This might be due to oligomenorrhea and less blood loss in this population.

Low-grade systemic inflammation is associated with an increased risk of type 2 diabetes. C-Reactive Protein (CRP), an acute phase protein produced by hepatocytes, may be associated with diabetes. This study aimed to compare serum levels of CRP in women with gestational diabetes mellitus (GDM), impaired glucose tolerance test and control subjects. In this case control study, 30 women with GDM and 28 women with impaired glucose tolerance, (according to Carpenter and Coustan criteria) were compared with 31 normal pregnant women as control group. Groups were matched for gestational age, age and BMI before pregnancy. At 24-28 weeks of gestation, CRP levels were measured in three groups and compared with each other. Our study showed serum CRP level was not significantly different among three groups. The median of serum CRP level in women with GDM, abnormal glucose tolerance test, and normal women was 8.8(7.5), 6.9(8.25) and 11.40(5.8) mg/dL respectively. In GDM patients, there was a significant correlation between CRP and BMI before pregnancy (r=0.467, p=0.033). We didnt find a significant correlation between maternal serum CRP level and gestational diabetes but our study showed a significant correlation between pre-pregnancy BMI and CRP in gestational diabetic women.

Diabetes mellitus is one of the most common endocrine diseases with micro-vascular complications and is a common cause of polyneuropathy. We studied the effect of enalapril on electrophysiologic criteria and clinical symptoms of patients with type II diabetes and sensory neuropathy. A double blind study was conducted on 45 Patients with type II diabetes and neuropathy. They were normotensive and randomly divided into case and control groups. The case group received oral enalapril 2.5 mg twice a day for 3 months. The control group received placebo. We evaluated the changes in symptoms and electrophysiologic findings. In case group distal latency of peroneal (p=0.01), tibial (p=0.2), ulnar motor (p<0.001), ulnar sensory (p<0.001), median sensory (p<0.001), and median motor nerves (p=0.004) decreased.Amplitude of peroneal (p=0.01), tibial (p=0.01), ulnar motor (p<0.001), ulnar sensory (p<0.001), median sensory (p<0.001) and median motor nerves (p<0.001) increased. Electrophysioloic test of peroneal n. (p=0.01), tibial n. (p=0.01), ulnar motor n. (p<0.001), ulnar sensory n. (p<0.001), median sensory n. (p<0.001) and median motor n. (p<0.001) increased. We did not get any result about sural sensory potential at the beginning and the end of the study. Neuropathy symptom score was also decreased. (p=0.16) In case group electrophysiologic criteria of peroneal, tibial, median sensory and motor, and ulnar sensory and motor nerves showed significant improvement. But no significant changes were found in clinical symptoms.

Diabetes is a metabolic disorder which impairs carbohydrate and lipid metabolism. It is accompanied by cognition impairment in diabetic patients and animal models. Lipids play an important role in nerve membrane composition, structure and function. This study was designed to evaluate the effect of dietary butter and sesame oils on passive avoidance memory of streptozotocin (STZ) diabetic rats. Thirty six adult male Wistar rats were randomly allocated to four groups: normal control (NC) and diabetic control (DC) with free access to regular rat diet; and diabetic sesame oil (DS) and diabetic butter oil (DB) groups with diet supplemented by 10% butter oil and 10% sesame oil, respectively. Diabetes in DC, DS and DB rats was induced by IV injection of 50 mg/kg (body weight) STZ. Passive avoidance memory was tested six weeks after confirmation of diabetes, and cholesterol and phospholipids were measured in hippocampal tissue. Diabetes, especially in diabetic butter oil group decreased learning and memory. The levels of cholesterol and phospholipids in hippocampus were higher in diabetic control and diabetic butter oil (P<0.05) groups in comparison with normal control. Consumption of butter may worsen diabetic cognition impairment and the elevation of cholesterol may be a reason for diabetic cognition impairment.

During recent years, opium consumption has increased among Iranian diabetic men. The belief that opium consumption can control or even eradicate DM is increasing. This study was conducted to compare the blood sugar, HbA1c, lipid profile and the frequency of diabetes complications in male type II diabetic patient with and without opium consumption. Two hundred thirty two type 2 diabetic men were included in a case- control study between September 2009 and June 2010. They were divided into two groups: with (n= 88), and without (n=144) current opium consumption. Serum glucose was measured by two hexokinase (automized and manual) and orthotolidine method, and Hb A1C was measured by chromatographic ion exchange. The opium consumption was evaluated by thin-layer chromatography (TLC) of urine. Analyses were performed using SPSS and P≤0.05 was considered significant. There was not a significant age difference between two groups. The mean duration of opium use was 36±6 months. The difference between mean serum fasting glucose levels in different methods of measurement was not significant between case and control groups. The results of this study showed a significant lower level of serum HbA1C (p=0.006) and triglyceride (p=0.005) in diabetic patients with opium abuse, but the frequency of peripheral neuropathy and ophthalmic photocoagulation was not different between two groups. Although the HbA1c was lower in males with opium consumption, the frequency of chronic complications of diabetes was not significantly different between two groups. We didnt evaluate other complications of opium consumption, especially mental and physical dependence. In summary, despite observed effects on some of glucose indices, opium is not a harmless treatment for diabetes.

We determine the prevalence of the metabolic syndrome in an urban population of Jahrom, a city located in the south of Iran. Randomly selected subjects ≥30 years-old were studied using stratified sampling. Target study sample was 892 (405 men and 487 women). Metabolic syndrome was diagnosed using modified Adult Treatment Panel guidelines when any three of the following were present: central obesity, raised triglyceride ≥150 mg/dl, low high-density lipoprotein (HDL) cholesterol (<40mg/dl in men and <50mg/dl in women), blood pressure ≥ 130/85mm Hg, and diabetes or fasting plasma glucose (FPG) ≥ 100 mg/dl. We used body mass index instead of central obesity. Metabolic syndrome was present in 257 (28.8%; CI 95%: %) subjects, 24.7% in men and 32.2% in women (P= 0.013). This prevalence increased with age in both men and women (p<0.05). The most common component of metabolic syndrome was high blood pressure (51.2%) and low HDL cholesterol (51.3%) in men and women, respectively. There is a high prevalence of metabolic syndrome in this urban population. Method of cardiovascular prevention should be focused on this issue.

To determine the prevalence of non-alcoholic fatty liver disease (NAFLD) in type 2 diabetic patients and to assess its possible risk factors. Two hundred and seventy two (186 females and 86 males) diabetic patients were studied. Liver ultrasound was performed along with the measurement of such labratoary tests as alanine transaminase, aspartate transaminase, alkaline phospahatase, fasting blood sugar, glycosilated hemoglobin, triglyceride, total cholesterol, low density lipoprotein, high density lipoprotein, thyroid stimulating hormone, thyroxine, blood urea nitrogen and creatinine. Patients with other causes of fatty liver disease such as autoimmune hepatitis or Wilson’s disease were excluded. The mean age of the subjects was 51±10 years. One hundred and eighty nine of them (70%) had fatty liver, of whom 60 (32%) and 129 (68%) subjects were males and females, respectively. One hundred and fifteen (61%) out of 189 patients were in grade 1, 66 (35%) were in grade 2, and the rest, 8 (4%), were in grade 3 of fatty change in liver. In logistic regression analysis, the variables with significant changes were Body Mass Index (BMI) with OR = 1.26 (95% CI = 1.16-1.37) and triglyceride (TG) with OR = 1.46 (95% CI = 1.01-2.11). The prevalence of fatty liver disease was high in the studied patients (70%). In diabetic patients, Body Mass Index (BMI) and triglyceride (TG) had significant relationship with the presence of fatty liver.

The use of herbal medicines in diabetes is promising but still far from proven. The purpose of this article is to examine the effect of herbal medicines in the treatment of diabetes, focusing on potential benefits and risks.Medline, expert interviews, books, articles and internet searches were used to identify herbal medicines with anti-diabetic properties and their diabetes-related health effects, proposed anti- diabetic effect, adverse effects, contraindications and drug interactions. Forty five herbs with known effect in the treatment of diabetes were selected for review, including: Trigonella foenum graecum L, Allium cepa L. & Allim sativum L., Silybum marianum, Mamordica charantia L., Camellia sinensis L. Morus nigra L., Gymnema sylvestre L., Ginkgo biloba L., ….Anti-diabetic health effects included increasing serum insulin, decreasing blood glucose, increasing glucose metabolism, and/or stimulating pancreatic function. Side effects were few or not reported. Many herbal medicines can be used for treatment, prevention and control of diabetes and as a component of diabetic patients’ diet. Of course some of these plants have adverse effects, contraindications, and drug interactions and also interactions between herbal medicines and synthetic drugs exist and may cause serious clinical consequences however at these researches side effects were few or not reported, but patients should inform their physician of the use of herbal products and consider the possibility of herb-drug interactions.