Iranian Journal of Diabetes and Obesity
Volume:4 Issue: 2, Summer 2012

Limited joint mobility (LJM) has been described as the earliest clinical complication of diabetes mellitus.This study was performed to determine the frequency of limited joint mobility and to evaluate the association between LMJ and some chronic diabetic complications. A total of 125 patients with type 1 diabetes mellitus aged 11.89 ±3.75 years, with 4.2±2 years mean duration of disease were studied. Diabetic patients were compared with 125 healthy young controls that were group-matched for age and sex. Variables such as age, sex, duration of disease and mean HbA1c level were obtained from the patients′ medical records. LJM was assessed by observing the small joints of the hands in the prayer position. Student t-test and chi-square (X2) were used for comparisons between groups. The frequency of LJM was significantly higher in diabetic patients compared to healthy controls (19.2% vs. 4%, p=0.001). Diabetic patients with LJM had not longer duration of diabetes than those without LJM (4.33 years compared to 4.08 years, p=0.55). Its presence was significantly related to microalbuminuria (p=0.017) and higher systolic blood pressure (p=0.001). Diabetic patients showed a significantly higher frequency of LJM than non-diabetic patients. LJM in the hands of patients with type 1 DM was associated with microalbuminuria but it was not related to retinopathy.

Adiponectin (an insulin sensitizing protein) and zinc have insulin like effect. This study was conducted to assess the effect of zinc supplementation on serum adiponectin and insulin resistance in first degree relatives of diabetic patients. This study was a randomized clinical trial performed on 58 first degree relatives of diabetic patients with normal glucose tolerance test and body mass index (BMI) more than 25Kg/m2. The subjects were divided into two groups: a case group which consumed 50mg zinc orally per day for twelve weeks and another group that was not given zinc but regular exercise and weight control were recommended. Adiponectin, fasting blood glucose, insulin and insulin resistance were calculated by the homeostasis model assessment (HOMA) and lipid profile was measured in both groups before and after treatment. The mean age and BMI of participants were 37.6±7.4 years and 28.8±3.5 Kg/m2 respectively. The level of adiponectin increased significantly from 1.67 ±1.29 to 3.67± 3.08 mIU/ml in subjects who received 50 mg zinc compared to the control group (p=0.001). HOMA decreased from 1.89±1.07 to 1.54±1.34 in subjects who consumed zinc, but this reduction was not significant (p=0.13). Zinc significantly increases the level of adiponectin in first degree relatives of diabetic patients. The level of insulin and HOMA index after zinc supplementation decreased but this reduction was not significant.

Diabetes is the most common metabolic disease. One of the most common problems in diabetic patients is atherosclerotic cardiovascular disease which induced by hyperlipidemia. Also there has been currently great interest in the potential contribution of oxidative stress in development of diabetes complications. The present study was performed to associate between lipid oxidizability and serum lipid levels in diabetic patients. In this study, 55 diabetic patients in Yazd Diabetes Research Center were chosen. Lipid oxidizability, HbA1c and serum lipid levels were analyzed in patients. Lipids were measured by enzymatic method. HbA1c was estimated by the ion exchange chromatography. The lipid oxidation procedure was performed by addition of CuCl2. The kinetics of conjugated dienes formation was monitored by spectrophotometer and parameters such as ODmax, Lag Time, Vmax and Tmax were analyzed. In present study, there was no association between lipid oxidizability and serum lipids levels. Also there was no association between lipid oxidizability parameters and HbA1c. This study showed that high levels of blood lipids such as cholesterol and triglyceride do not have any effect on maximal amount of lipids peroxide products accumulation and maximal rate of oxidation during the lipid oxidation course.

Correlation of osteoporosis (OP) with type 2diabetes mellitus (DM) is not as clear as type 1 DM. The purpose of this study was to compare the frequency of OP and osteoporotic fractures in post- menopausal women with and without type 2 DM in Sari, Iran. Eighty post-menopausal women with type 2 DM and 80 non-diabetic controls enrolled in this study. Bone mineral density was determined with dual energy X-ray absoptiometry of L2-L4 in spine and femoral neck. Vertebral fracture was reported by a radiologist on thoraco-lumbar x ray. Hip and wrist fractures were determined by patients self-report and ascertained by radiographs. T test, X2 and Fisher's exact tests were used for data analysis. The mean age of diabetic women with and without osteoporosis was 69±2.7 and 69.3±5 years, respectively (p=0.01). Diabetes duration, HbA1C and BMI were not statistically different between two groups. Diabetic complications and anti-diabetic agents, or age and duration of diabetes were not different in diabetic patients with OP or osteoporotic fracture.The mean of T-score in lumbar spine was -1.65±1.3 in diabetics and -2.11±1.3 in controls (p=0.03). T-score in femoral neck was not significantly different. In diabetic patients, the prevalence of osteoporosis was 27.5% at lumbar spine and 17.5% at femoral neck and in controls were 46.3% and 27.5%, respectively (p=0.04 and 0.1). Fractures were less common in diabetics (18.8% vs. 32.5%, p=0.04). This study showed that osteoporosis and osteoporotic fractures is less common in post-menopausal diabetic women compared to non-diabetic subjects.

Diabetes is one of the most common metabolic diseases in the world. It affects 6.6% of world population and about 3 million individuals in Iran. Nowadays chemical and herbal medicines are widely prescribed to cure obesity. In Iran, cumin (Cuminum Cyminum L.) is a plant used in traditional medicine to cure obesity, and some of the new studies have suggested that cumin has a role in diabetes treatment and also in reducing the lipids level. In this study, we investigated the cumin oil and sibutramine effect on the prevention of weight gain and the level of serum leptin, glucose, and lipids in normal Wistar rats. We divided 36 male rats of Wistar race into 3 equal groups: the control group with normal regimen, the cumin oil group with normal regimen, the sibutramine group with normal regimen. The consumed dosages of cumin oil and sibutramine were 400 µg/kg and 3mg/kg respectively which was given to the rats by gavage (tube feeding). In this study, we took samples of the hungry rats during three various periods including the first day of the study, 20th day (the beginning of the medicine usage) and 55th day (the end of the medicine usage) in order to measure their glucose and serum lipids. The results of this study showed a significant decrease in glucose, cholesterol, triglyceride, LDL (P<0.001) and a significant increase in serum HDL (P=0.05). Both drugs prevented weight gain at the end of study (P=0.05). The findings indicate that cumin oil like sibutramine via consumption by gavage can affect the serum glucose and lipids in rats and also prevent weight gain.

Tea, camellia sinensis, which is used as a popular beverage in Iran, may reduce the risk of cardiovascular diseases suchas coronary heart disease (CHD). In this investigation, we studied the effect of Iranian black and green tea on serum and liver lipid profile which is closely associated with obesity and many cardiovascular diseases. 24 male adult Wistar rats were randomly divided in to 4 equal groups: Control (C), high-fat (HF), black tea (HF+BT), and green tea (HF+GT). Accordingly, serum total cholesterol (TC), triglyceride (TG), very low density lipoprotein cholesterol (VLDL-C), low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) were among the parameters determined in high fat diet rats. We also evaluated the TC, TG and total lipid (TL) content of liver. Results show that optional consumption of both of teas for 8 weeks significantly decreased serum TC by 40% and only black tea lowered serum TG and VLDL-C by 34.3%. Whereas the level of serum LDL-C decreased by 36.5% after using green tea. Consumption of green tea reduced TG and TC level at liver by 47.4% and 24.7%, respectively. Based on lowering effect of Iranian black and green tea on lipid profile of serum and liver, presentation of tea together with a high fat diet reduces some of hyperlipidemia indices by significant amounts and may, therefore, reduce the risk of obesity and cardiovascular diseases.

The purpose of this study was to investigate the effect of coriander seed powder (CSP) on the atherosclerotic and cardioprotective indices in type 2 diabetic patients. In this study, fifty type 2 diabetic patients consumed 2 capsules of the CSP /day for a period of 6weeks. Blood samples were collected from the patients before and after the course of CSP consumption after 12 h of fasting. The plasma glucose, total cholesterol, triglyceride, LDL-C, HDL-C, urea and creatinine were measured before and after the CSP consumption for 6 weeks. Atherosclerotic and cardioprotective indices were calculated. The CSP consumption for 6 weeks in type 2 diabetic patients significantly reduced plasma glucose, total cholesterol, triglyceride, and LDL-C (p< 0.001), but HDL-C was not significantly changed (p≥ 0.05).But there was no significant effect on urea and creatinine concentrations. Atherosclerotic index decreased while cardioprotective indices increased. Since the CSP consumption reduced several components of metabolic syndrome and decreased atherosclerotic and increased cardioprotective indices, the CSP may have cardiovascular protective effect in type 2 diabetic patients.

Skin disorders are common in diabetic patients and may also act as clues for diagnosis in undiagnosed cases. These manifestations may be summarized in five categories including non-infectious, infectious, treatment-related and miscellaneous manifestations as well as diabetic foot ulcer. The most common non-infectious disorder occurring in up to 70% of patients is diabetic dermopathy. Infections with staphylococcus aureus and streptococcus hemolytic group A, and dermatophytoses are seen frequently in diabetics. Moreover, severe and life-threatening infections such as necrotizing fasciitis, malignant external otitis and rhinocerebral mucormycosis may be seen especially in elderly diabetics. Diabetic foot ulcer is also a major problem in longstanding diabetes and needs particular attention. Complications due to treatment of diabetes are also found in some patients.In conclusion, skin manifestations must be considered as an important issue in any patient, especially in obese ones. Improved metabolic control as well as using newly introduced drugs may help reduce or even resolve these problems.