Iranian Journal of Diabetes and Obesity
Volume:5 Issue: 2, Summer 2013

Measurement of glomerular filtration rate (GFR) is the best determinant in assessment of kidney function for diagnostic and therapeutic purposes. As extremely accurate methods of GFR measurement (i.e. Inulin clearance) are expensive and Time-consuming and due to limitations of the 24 hour urine collection method, some formula have been developed for the GFR measurement. Here we have compared the GFR calculated via CG or MDRD formulas and that measured by creatinine clearance in 24-hour urine collection method in diabetes patients with chronic kidney disease (CKD). This study was performed on 75 diabetes patients with stage 3 or 4 CKD (15-19 ml/min/1.73m2) in the nephrology clinics of the Yazd medical university. The GFR was measured via CG and MDRD formula and also via creatinine clearance in 24-hour urine collection method. Correlation test and Bland altman plot was utilized to check for the relationship between creatinine clearance and the GFR. Results show a significant correlation of the GFR calculated via creatinine clearance in 24-hour urine collection with GFR calculated via CG (r= 0.75) and with MDRD (r=0.70) formulas. This correlation was even increased when serum levels of creatinine was >1.5 mg/dL or in patients with stage 4 CKD. Comparison of the differences between GFR calculated via CG or MDRD formulas and creatinine clearance in 24-hour urine collection method using Bland altman showed a lower bias (CG: 17.76; MDRD: 10.64 ml/min/1.73 m2) and narrower limits of agreement (MDRD: -11.33 – 32.62, CG: -4.68 – 40.20) to the creatinine clearance in 24-hour urine collection for the MDRD formula compared to that for the CG formula. CG and MDRD correlate well with creatinine clearance in 24-hour urine collection, while MDRD is more accurate in diabetes patients with stage 3 or 4 CKD.

Type 2 diabetes mellitus (DM-2) is a chronic and progressive metabolic disorder known as a serious threatening condition in the individual and society. Type 2 diabetes mellitus is known as the major cause of cardiovascular diseases (CVD). Contradictory evidences about the effect of omega-3 fatty acids on CVD risk factors, particularly hypertension. The aim of this study was to determine the effect of omega-3fatty acids supplementation on blood pressure in DM-2 patients. This is a double-blind, placebocontrolled clinical trial on patients referred to Yazd Diabetes Research Center. Seventy DM-2 patients were randomly assigned to receive either 2 g/day omega-3 soft gels (OG) or 2 g/day placebo (PG) for 6 weeks. At the beginning and end of the study, blood pressure was measured and compaired Fifty nine percepts of patients in OG and 41% in PG had hypertension. Initially, there was no significant difference in the mean of age, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP) and duration of diabetes between two groups. At the end of the study, the mean of SBP, DBP and differences between groups were not significant. Consumption of 2 g/day omega-3 supplement for6 weeks has no significant effect on systolic and diastolic blood pressure in DM-2 patients.

Type 2 diabetes is amongst the most common chronic illnesses in Iran. Its prevalence is increasing and it has significant economic importance. The aim of this study was to estimate direct therapeutic and non-therapeutic costs of type 2 diabetes Patients Referred to the Diabetes Research Center of Yazd in 2012. This cross-sectional study was carried out on 250 type 2 diabetes patients referred to Yazd Diabetes Research Center in 2012. Direct health costs were estimated from costs of physician visit, Nutrition counseling, Anti diabetic agent, Testing, Hospital inpatient care, imaging, wound, Cataract, Physiotherapy, dialysis and other costs included (Insulin, Test tape), as well as direct costs of non-treatment including Cost of travel and accommodation and required data was gathered by questionnaire. Mann-Whitney Test, Kruskal -Wallis Test and T-test analysis was used to identify the Results. The total estimated cost of 250 type 2 diabetes patients in 2012 is 1369913472 rials, including 1258651472 rials indirect costs of treatment (91.87%) and 111262000 rials indirect non-therapeutic (8.1%). The per capita cost is 5479653 rials. The major parts of medical expenditures are hospital inpatient care (28% of the total medical cost), other cost include Insulin, Test tape and etc(23% of the total medical cost), Cataract (10.96% of the total medical cost), imaging (9.77% of the total medical cost),prescription medications to treat the complications of diabetes (8.68%),physician visits (7.04%), Testing (6.31%), dialysis(2.6%), wound(2.1%), Physiotherapy (0.89%) and Nutrition counseling (0.18%). This estimate highlights the substantial burden that diabetes imposes on society. Additional components of societal burden omitted from our study include intangibles from pain and suffering, resources from care provided by nonpaid caregivers, and the burden associated with undiagnosed diabetes.

Obesity is a worldwide and major public health problem including Iran and other countries. Available data indicates that the prevalence of obesity has significantly increased among the Iranian population over the past 30 years. The aim of the present study was to evaluate the prevalence of obesity in Yazd (central province of Iran) population. This was a cross-sectional population-based study and performed by census method on Yazd population aged 30 years old or above. Height, body weight and Body Mass Index (BMI) were measured. Statistical analyses were performed with Chi-Square test. Totally, 8448 subjects aged>30 years from both sexes were evaluated. Data showed that the rate of BMI above 25kg/m2 for women and men was 43.9% and 32.2% respectively. In both genders, the rate of obesity and overweight raised by increasing of age up to 50 years old. Overall, the prevalence of obesity was higher in women compared with men in all ages. The prevalence of obesity and overweight were 9.5% and 29%, respectively. This study indicated a high prevalence of obesity and overweight in the central area of Iran, especially in urban people.

Psychological factors such as the health locus of control play an important role on health behaviors such as adherence to diet regimen. The purpose of this study was to examine the role of health locus of control in predicting adherence to diet regimen among a group of patients with type 2 diabetes. Research sample was recruited from several clinics in Shiraz using convenient sampling method. Participants consisted of 140 patients with type 2 diabetes. Patients completed the Multi-dimension Health Locus of Control Scale (MHLC: Internal, External, Chance) and the Summary of Diabetes Self-Care Activities Questionnaire (SDSCA). Nearly half of the patients with type 2 diabetes adhered to their diet regimen. The results also showed that external locus of control significantly predicted adherence to diet regimen (P<0.05). Furthermore, chance locus of control predicted non-adherence to diet regimen significantly (P<0.001). Internal locus of control, age, education and illness duration had no significant role in predicting adherence to diet regimen. Patients with type 2 diabetes who perceived their illness as a destiny or fate were less likely to adhere to diet regimen, while those believed that powerful others such as doctors determine their health were more likely to adhere to recommended diet regimen. The present study highlighted the role of perceived control on adherence to diet regimen.

This study aimed to estimate the prevalence of lichenoid reactions to Anti Hyperglycemic Agents. In this cross-sectional descriptive and analytic study, we examined the oral mucosa of 411 patients at the age of 29 to 85 in 3 groups who consumed various antihyperglycemic agents. In overall, 31 patients had lichenoid reactions (12 patients taking glibenclamide, 1 patient taking metformin and 18 patients taking glibenclamide with metformin) and there was a significant difference between the groups (P = 0.013). The most of the lesions were at the age's upper than 60 years. From 31 patients with lichenoid reactions, 14 subjects (45%) were male and 17 subjects (55%) were female. Prevalence of lichenoid reactions in this study was 7.5% approximately. By considering the significant difference among the groups in the incidence of lesions, the significant effect of glibenclamide in inducing lichenoid reactions can be considared.

Obesity is a major health problem. Overweight and obesity have been identified as one of the 10 leading health indicators. This study was designed to evaluate the Body Mass Index in Iranian university student sample. This was a cross-sectional study on 911 Iranian university students aged 18-25 years who were selected by simple random sampling. Weight, height and BMI were measured for all subjects. Body mass index was calculated as weight divided by the square of height. The measurements were compared between two genders. Subjects were classified according to their BMI into underweight, normal, overweight, obese, and extreme obese. Data was analyzed by SPSS (Ver. 19). A total of 911 Iranian university students (475 males and 436 females), 18-25 years old entered the study. Most subjects (639 persons) had normal weight. Five percent were underweight, 20.9% overweight and 3.8% obese and only one subject suffered from morbid obesity. In this study the prevalence of abnormal weight in university students was lower than general population, and this prevalence was higher among males than females.

Six months administration of bromocriptine mesylate significantly decreased glycated hemoglobin (HbA1c), fasting blood sugar, postprandial blood sugar, and weight of 22 Indian obese patients with type 2 diabetes mellitus with no serious adverse events. Therefore, the novel mechanism of action, efficacy and acceptable safety profile makes this drug an attractive option for treatment of obese type 2 diabetic patients.