Iranian Journal of Diabetes and Obesity
Volume:5 Issue: 1, Spring 2013

Abstract It has been reported that adenosine deaminase (ADA) is a good marker for insulin function but its clinical significance in type 2 diabetes mellitus (T2DM) is not yet characterized. This study aims to assess the association of ADA with glycated hemoglobin (HbA1c) and uric acid (UA) in T2DM patients. The study population consisted of 120 subjects divided into 3 groups: Group A: non diabetic controls (n=40), Group B: diabetic subjects with HbA1c<7% (n=40), and Group C: diabetic subjects with HbA1c>7% (n=40). This study was carried out in the Nepalgunj medical college and Hospital, Nepal, between April 2012 and April 2013. In our study, fasting plasma glucose (FPG), HbA1c and ADA levels were found to be increased in T2DM patients as compared to controls. ADA activity is found to be higher in Group s B and C as compared to group A. The correlation between ADA and HbA1C was positive in both Group B (r=0.03) and C (r=0.28). There was negative correlation between UA levels and HbA1c (r=-0.07). There was an increase in serum ADA levels with increase in HbA1c levels, which may play an important role in determining the glycemic status in diabetes. It was found that the UA levels increased with moderately increasing levels of HbA1c (<7%) and then decreased with further increasing levels of HbA1c (>7%). Serum ADA and UA levels reflect closely related components of T2DM.

Abstract Diabetic peripheral neuropathy (DPN) is one of the most common complications of diabetes. Beside the known factors such as hyperglycemia in the pathogenesis of this complication, other etiologies may play role in the pathogenesis of this complication. The aim of this study was the evaluation of the role of serum vitamin D and vitamin B12 levels in this process. We enrolled 76 diabetic patients (38 patients with DPN and 38 patients without DPN) who were matched in the terms of age, gender, BMI and duration of diabetes. Diagnosis of DPN was based on nerve conduction studies on sural, peroneal and tibial nerves. Serum vitamin D and vitamin B12 levels were measured in these two groups. Case and control groups had not significant differences in demographic characteristics. Serum vitamin D level was slightly lower in case group (24.1 ± 19.3 ng/ml vs. 24.9 ± 22.3 ng/ml), but the difference was not significant (P=0.857). Serum vitamin B12 level was higher in patients with DPN without significant difference in the two groups (444.2 ± 273.5 pg/ml vs. 390.4 ± 213.9 pg/ml) (P=0.343). The results of this study showed that serum vitamin D and vitamin B12 levels had not significant difference in patients with and without DPN. Further studies are required to better evaluate the role of these factors in development and progression of DPN.

Abstract Diabetes mellitus is the most common metabolic disease. One of the most common problems in diabetic patients is atherosclerotic cardiovascular disease which is induced by hyperlipidemia. Impaired lipid metabolism resulting from uncontrolled hyperglycemia has been implicated in cardiovascular complications in diabetic patients. Also, glycated hemoglobin (HbA1c) has been regarded as an independent risk factor for cardiovascular disease. The aim of this study was to examine the correlation between HbA1c, fasting blood sugar (FBS) and 2 hours postprandial glucose (2hpp) with serum lipid levels in type 2 diabetes. In this study, 100 diabetic patients in Yazd Diabetes Research Center were chosen. FBS, 2hpp, HbA1c and serum lipid levels were analyzed in patients. Serum Lipids and glucose were measured by enzymatic method. HbA1c was measured by DS5 analyzer and DS5 Pink Reagent kit. There was significant correlation between FBS and total cholesterol (TC) (r=0.25, P=0.039), 2hpp with TC (r=0.338, P=0.033) and 2hpp with LDL (r=0.39, P=0.01), but there were no correlations between HbA1c and TC (r=0.2, P=0.06), HbA1c and triglyceride (P=0.2, r=-0.14), HbA1c and HDL (P=0.25 r=-0.14) and HbA1c with LDL (P=0.08, r=0.2). The results of this study showed that the high levels of serum glucose are associated with high levels of cholesterol and LDL and can be a risk factor for cardiovascular diseases.

Abstract Gestational diabetes mellitus (GDM) is characterized by glucose intolerance during pregnancy. Incidence of gestational diabetes can increase by several factors such as obesity, aging, diet and genetic factors. This study aimed to assess the role of nutrition, biochemical and demographic factors in development of GDM in pregnant women. In this prospective study, pregnant women with and without gestational diabetes mellitus were divided into control and GDM women. At the onset of the study, all subjects were asked to complete a demographic questionnaire. Serum samples were obtained from each woman and the biochemical parameters were measured and then analyzed by GraphPad Prism version 5. Our results showed a significant relationship between age and BMI with GDM. The level of triglyceride (mg/dl), HOMA Index (mmol/L×µU/mL), FBS (mg/dl), and Insulin (µU/mL) were significantly higher in GDM women compared to the control group. Serum HDL concentration was significantly higher in normal pregnant women compared to patients with GDM. Education level was also higher significantly in control group. The amount of fruits and vegetables consumption was lower in GDM compared to control group significantly. Furthermore, the women who had consummated fruit and vegetables in their diet less likely developed GDM. This study suggests a strong association between GDM and the consumption of high-calorie foods. Therefore, the use of low-calorie foods such as fruits and vegetables can help reducing the incidence of diabetes in pregnant women.

Abstract Diabetes and hypertension are among the commonest diseases in developed countries, and the frequency of both diseases rises with age. By progression of diabetes the incidence of hypertension become higher than the age-matched general population. A cross-sectional study was carried out on 300 type 2 diabetic patients who were admitted to medical ward of Moosabne Jafar hospital in Quchan for follow-up from April 2011 to August 2012. The structured questionnaire was used to gather information on sociodemographic variables, history of hypertension, use of anti-hypertensive medications and duration of diabetes. Anthropometric measurements including weight and height were measured by trained staff. Blood pressure was measured using standardized sphygmomanometers. Two hundred and ten out of 300 subjects had hypertension, thus giving a prevalence rate of 70%. One hundred males (47.6%) were hypertensive compared with 110 (52.4%) females, but this difference was not significant (χ2=0.1, df=1, P>0.05). The mean age of them was 62.9 years. One hundred and fifty subjects (50%) had reported at least one problem in past history like heart disease, CVA, DVT, CRF, retinopathy, diabetic foot and paresthesia. The most common problem in past history was heart disease (37%). According to the results, 70% of the diabetic patients had hypertension. It is necessary to inform the patients to control their diabetes in order to prevent its complications.

Abstract In health economics, one of the important methods of economic evaluation is cost-effectiveness analysis. The usual procedure in this method is to consider effectiveness of Disability-Adjusted Life Years (DALYs) as a measure criterion. This was a cross sectional study of economic assessment type or Cost-Effectiveness. All over 30 years old population of Shiraz (543,820 people) were target population of the study. Indeed, in this study, all over 30 years old population being screened for diabetes in any governmental health centers and health stations in Shiraz (69 health stations and 30 healthcare centers) and 10 clinics related to Shiraz University of medical science, were included. Costs in this study included screening and surveillance costs and effectiveness was DALYs created for diabetes and its complications and finally, the results were analyzed using Incremental Cost Effectiveness Ratio (ICER). The rate of DALYs due to diabetes, in the absence of screening and identifying diabetic patients was 748.0745 years. The rate due to diabetic retinopathy was 10.3886 years, in diabetic neuropathy was 29.5624 years, in diabetic foot was 0.0343 years and in diabetic nephropathy was 83.8728 years. In this study, total screening and surveillance costs were 42,821,873,941 Rials. The obtained ICER was 49,111,444 Rials. From governmental view, in this study, the plan saved 871.9327 years of individual lives covered by the program. According to the World Health Organization criteria, screening in this study is cost-effective.

Abstract This study was carried out for investigating the religion orientation relationship with coping with diabetes in type 2 diabetic patients in Yazd, Iran. The present study is a kind of scientific-comparative description. The research subjects comprised of all type 2 diabetic patients admitted to the hospitals in Yazd. The study sample was consisted of 160 people (103 female and 57 male) who were randomly selected. Allport’s questionnaire and the questionnaire of coping with diabetes were used as the instruments. The results of the study revealed that there is a significant correlation between internal religion orientation and coping with diabetes in women who are suffering from type 2 diabetes (r=0.18, p=0.04). There was also a positive significant correlation between internal religion orientation and relationship with friends in diabetic women (r=0.25, p=0.01). The relationship between external religion orientation and coping with diabetes in women was not significant. There was also no significant relationship between coping with diabetes and any aspects of the orientation (internal and external) in men. Therefore, the scientific role of religious beliefs and its dimensions on coping with diabetes and how much the main psychological variables have effect on diabetes are of high importance.

Abstract Diabetes mellitus is one of the major metabolic disorders. Diabetes is recognized for severe complications including diabetic nephropathy, neuropathy and retinopathy. Long-lasting effect of hyperglycemia results in increased oxidative stress. Oxidative stress results from an imbalance between radical-generating and radical scavenging systems. Increased oxidative stress has been shown to be increased in both insulin-dependent (IDDM), and noninsulin-dependent (NIDDM) diabetes mellitus and it could cause initial β cell damage in type I diabetes, or impaired insulin production, release or function in type II diabetes. Therefore, people with diabetes may also have greater antioxidant requirements because of increased production of free radicals in hyperglycemia. In this article, oxidative stress, free radicals, antioxidants and various mechanisms of reactive oxygen species (ROS) formation such as polyol pathway, protein oxidation, advanced glycation endproducts and lipid peroxidation in diabetic patients will be surveyed.