Iranian Journal of Diabetes and Metabolism

EFFECT OF ONE MONTH CYSTEINE TREATMENT ON THE GLYCEMIC CONTROL, LIPID PROFILE, GLYCATED AND OXIDIZED LDL, IN THE RAT MODEL OF DIABETES – ATHEROSCLEROSIS

Zahra Bathaie

Background: Diabetes is the most common metabolic diseases and its vascular complications are main cause of death in diabetic patients. Patients with hyperglycemia, dyslipidemia and oxidative stress are prone to diabetes complications. The goal of this study was investigation of the effect of cysteine (Cys) on hyperglycemia, lipid profile, atherogenic index, glyoxal, methylglyoxal, oxidative stress and, glycation and oxidation of LDL in the rat model of diabetes –atherosclerosis. Methods: Diabetes was induced in the rats using Streptozotocin injection then they put on the atherogenic diet. The groups under study were including of control and diabetic rats, and two other similar groups under Cys (0.05 % in dirking water) treatment. After one month, fasting blood sugar (FBS), lipid profile, atherogenic index (LDL/HDL), glycated and oxidized LDL, AGEs, glyoxal, methylglyoxal, Advanced oxidation protein products (AOPP) as an oxidative stress index and weight of rat was measured. Results: Diabetic-atherosclerotic rat groups significantly showed higher level of FBS, triglyceride, cholesterol, LDL, atherogenic index, glycated and oxidized LDL, glyoxal, methylglyoxal and AOPP than control group. These parameters significantly (P < 0.001) reduced in diabetic group treated with Cys in comparison of untreated. Conclusion: Cysteine with improving property on glycemic and lipemic conditions, inhibitory activity on glycation and oxidation of LDL and reduction of oxidative stress in diabetic-atherosclerotic rats could recommended as a drug for prevention of diabetes complications.

THE EFFECT OF ENDURANCE TRAINING ON GENE EXPRESSION OF CDK5 IN SPINAL MOTOR PART OF MALE WISTAR RATS WITH DIABETIC NEUROPATHY

Reza Gharakhankou

Background: Increased and decreased CDK5 gene expression regulation, as a protein kinase, is associated with launching death or survival pathways in the nervous system. According to the chronic effects of endurance training on growth Germination, Neuronal function and improvement of pathological conditions of neurodegenerative diseases, the aim of our study was to investigate the effect of 6 Weeks Endurance Training on Gene Expression of Cdk5 in spinal motor part of Male Wistar Rats with Diabetic Neuropathy. Methods: Twenty eight adult male Wistar rats ten year old in the weight range of 326.3±84gr, were randomly divided into four groups including healthy control (C), healthy training (HT), neuropathic control (N) and neuropathic training (NT). Diabetes was induced with one shut injection of STZ(45mg/Kg) and after confirmation of neuropathic condition with behavior tests, training groups performed 6 weeks endurance training(with moderate intensity and increasing) on the treadmill. CDK5 gene expression in Spinal motor segments forming the sciatic nerve was measured with Real time technique and calculated using the 2-ΔΔCT method. Results: After 6 weeks of endurance training, CDK5 gene expression in spinal motor part of (NT) group was significantly lower than the (NC) group, also, in comparison with neuropathy control, training led to significant decrease in blood glucose levels in neuropathic training group. Conclusion: According to the specific role of CDK5 in neuronal growth or death, our study showed the beneficial effects of Chronic endurance exercise on neural networks leading to reduced gene expression of CDK5 in a pathologic condition.

RESPONSES OF VISFATIN AND INSULIN RESISTANCE INDEX TO DIFFERENT RESISTANCE EXERCISE PROTOCOLS

Sajad Ahmadizad

Background: The aim of this study was to compare responses of Visfatin and insulin resistance index to various resistance exercise protocols. Methods: Ten healthy male subjects performed three resistance exercise protocols including maximal strength (three sets of 5 repetition at 85% of 1-RM with 3-min rest between sets), hyperthrophy (three sets of 10 repetition at 70% of 1-RM with 2-min rest between sets) and strength-endurance (three sets of 15 repetition at 55% of 1-RM with 1-min rest between sets) in three separate sessions. Two blood samples were taken before and after resistance exercise protocol. Responses to different resistance exercise protocols were compared by using repeated measures of ANOVA (3×2). Results: Irrespective of resistance exercise protocol, results showed that plasma visfatin reduced significantly (P<0.05) in response to resistance exercise. Between group comparisons revealed that reductions in visfatin concentration in response to strength-endurance and hypertrophy protocols were significantly higher than maximal strength protocol (P<0.05). Analysis showed that not only glucose, insulin and insulin resistance index did not change in response to resistance exercise significantly, but also there was no significant difference among the responses to different resistance exercise protocols (P>0.05). In addition, there was no significant relationship between changes in visfatin and other parameters (P>0.05). Conclusion: It could be concluded that performing strength-endurance and hypertrophy protocols that cause reductions in visfatin, possibly due to changes in growth hormone during these protocols, could be beneficial in reducing the hyperinsulinemia.

STUDY OF AMYLOID FIBRILLATION OF REGULAR INSULIN: INHIBITION BY AROMATIC COMPOUNDS

Parichehreh Yaghmaei

Background: The flexible structure of proteins is one important factor in the formation of ordered aggregates (amyloid fibril). This is a major problem for therapeutic proteins such as insulin. Study on the induction and inhibition of insulin fibrillation process with specific compounds such as aromatic derivatives may provide useful information about means of stabilization of protein structures. Methods: To induce fibrillation, regular insulin was incubated in phosphate buffer (pH=7.4) during 24 hours. Amyloid formation was investigated by using Congo red absorbance and transmission electron microscopy (TEM). Then nodular amyloidosis was observed in mice upon amyloid fibril injection, after which the excised nodule was studied by Congo red staining and polarized light microscopy. Then, some aromatic compounds effect was investigated on the fibrillation process. Results: Regular insulin form mature amyloid fibrils at pH=7.4, 37°C after 24 hours. Silibinin had the highest inhibitory effect on that process. Furthermore, Amyloid fibril injection in mice caused nodular amyloidosis. Conclusion: Regular insulin has a high potential to undergo amyloid aggregation. Nodular amyloidosis confirms fibril formation by insulin under in vitro condition. Silibinin could be considered as a potential compound capable to increase protein structure stability.

THE EFFECTIVENESS OF MINDFULNESS-BASED COGNITIVE THERAPY ON QUALITY-OF-LIFE IN OUTPATIENTS WITH DIABETES

Sahar Ghashghaie

Background: Diabetes Mellitus is one of the most common and expensive chronic disorders, which produce lots of limitation in patients' activities. The aim of this study was to determine the effectiveness of Mindfulness – Based Cognitive Therapy ( MBCT) in improving the Quality of Life in outpatient with type 2 Diabetes Mellitus. Methods: In this experimental research, 42 outpatients with type 2 diabetes were selected and matched according to age and sex. Then patients were assigned randomly to experimental and control group. Ware & Sherbourne quality of life questionnaire was performed for both groups in pre-test and post-test sessions. The experimental group participated in 8 sessions of MBCT course which was held once a week and each session lasted for 2 hours. Univariate and multivariate analysis of covariance (with controlling for pre-test scores) were applied to data. Results: There was significant difference between experimental and control groups in post test scores of quality of life and all of its scales. Experimental group acquired higher scores. Conclusion: The results of this study revealed that MBCT can improve the quality of life in diabetic patients.

DESIGNING A QUESTIONNAIRE TO EVALUATE DIABETIC PATIENTS’ KNOWLEDGE OF RAMADAN FASTING AND ITS DETERMINANT FACTORS

Mohsen Khoshniat Nikoo

Background: Fasting in diabetic patients is accompanied by various changes in metabolism, lifestyle and medication. Evaluation of diabetic patients’ knowledge in the field of fasting conditions, the fasting-induced changes, complications, and ways to deal with them, is the first step towards efficient and effective diabetes self-management training in Ramadan fasting. The purpose of this study was to design a valid and reliable questionnaire on fasting knowledge of diabetic patients and evaluate the knowledge and determinant factors in diabetic patients. Methods: In this study a questionnaire on diabetic patient’s awareness was designed in 5 sections: 1- fasting conditions in patients with diabetes (fasting status of diabetic patients), 2- drug use, 3- controlling of blood glucose, 4- physical activity and 5- diabetic diet in Ramadan. Validity and reliability (Cronbach's alpha coefficient=0.79) of the questionnaire was confirmed. In a cross-sectional study, the fasting knowledge of 200 diabetic patients of Diabetes and Metabolic disorders clinic were examined, before Ramadan 2012. The association between the knowledge and patients’ age, sex, weight, diabetes duration, educational levels, Ramadan fasting group education, fasting blood sugar, HbA1c and type of diabetes were evaluated. Results: The mean of total correct answers were 46% with the highest scores in dietary information (62.5%) and lowest in physical activity (18%) and drug use (23%). Significant positive association was found between total and each part scores with patients’ educational level. Also group of participating in the Ramadan fasting education study and group of non- participating, showed significant difference in response to questions. Conclusion: Findings of this study revealed (indicated) poor fasting knowledge in diabetic patients. Educational programs before Ramadan can increase awareness and could improve self-management of diabetic patients during Ramadan fasting and decrease complications.

THE EFFECT OF COMBINED AEROBIC EXERCISE AND BARLEY Β-GLUCAN ON LIPID PROFILE AND GLUCOSE BLOOD OF WOMEN WITH DIABET TYPE TWO

Fahime Esfarjani

Background: Physical activity with diet and medication–considered fundamental in the treatment of diabetes. The aim of this study was to determine the effect of combined 12-week aerobic exercise and barley β glucan (BBG) on blood glucose and lipid profile in patients with type 2 diabetes. Methods: Twenty- four female volunteers (49±5 years) were selected, and after completion of questionnaires, were randomly divided into three groups a) aerobic training with diet group (n=8), b) diet group (n=8) and c) control group (n=8). The diet group used one barley bread per day with 4 gram beta glucan during 12 week. The combined group participated in progressive walking training program with intensity of 60-70% of maximal heart rate 2 to 3 times a week, 20 to 60 minutes in each session in addition to diet program. The variables measured included blood sugar, triglyceride, cholesterol, LDL, HDL. For data analysis ANOVA used to compare mean differences between groups. Results: Results indicated significant difference in blood sugar between control and experimental groups while non significant changes was observed in lipid profile. Conclusion: Aerobic exercise and BBG can decrease blood glucose in patients with diabetes Therefore, it should be considered seriously as part of the treatment of these patients.

THE EFFECT OF DASH DIET ON INSULIN RESISTANCE, INFLAMMATION, AND OXIDATIVE STRESS IN GESTATIONAL DIABETES: A RANDOMIZED CONTROLLED CLINICAL TRIAL

Ahmad Esmaillzadeh

Background: There are no available reports indicating the effects of Dietary Approaches to Stop Hypertension (DASH) eating plan on insulin resistance, inflammation and oxidative stress among pregnant women with gestational diabetes mellitus (GDM) We aimed to investigate the effects of DASH diet on insulin resistance, serum hs-CRP and biomarkers of oxidative stress among pregnant women with GDM. Methods: This randomized controlled clinical trial was performed among 32 pregnant women diagnosed with GDM at 24-28 weeks' gestation. Subjects were randomly assigned to consume either the control (n=16) or DASH diet (n=16) for 4 weeks. The DASH diet was rich in fruits, vegetables, whole grains, and low-fat dairy products and low in saturated fats, total fats, cholesterol, refined grains, and sweets, with a total of 2400 mg/d sodium. The control diet contained 40-55% of its energy as carbohydrates, 10-20% as proteins and 25-30% as total fats. Fasting blood samples were taken at baseline and after 4 weeks of intervention to measure fasting plasma glucose (FPG), serum insulin and hs-CRP, HOMA-IR, plasma total antioxidant capacity (TAC) and total glutathione levels (GSH). Results: Consumption of DASH diet, compared to the control diet, resulted in decreased FPG (-7.62 vs. 3.68 mg/dL P=0.02), serum insulin levels (-2.62 vs. 4.32 µIU/ml, P=0.03) and HOMA-IR score (-0.8 vs. 1.1 P=0.03). Increased concentrations of plasma TAC (45.2 vs. -159.2 mmol/L P<0.0001) and GSH (108.1 vs. -150.9 µmol/L P<0.0001) were also seen in the DASH group compared with control group. We failed to find a significant difference in mean changes of serum hs-CRP levels between the two diets. Within-group comparisons revealed a significant reduction in plasma TAC and GSH levels in the control diet, while a significant rise in these biomarkers in the DASH diet. Conclusion: In summary, consumption of DASH diet in pregnant women with GDM had beneficial effects on FPG, serum insulin levels, HOMA-IR score, plasma TAC and total GSH levels. The effects of this dietary pattern on pregnancy outcomes need to be investigated in future studies.