Iranian Journal of Diabetes and Lipid Disorders

Associations of Adipocytokines with Insulin Resistance and Type 2 Diabetes: A Review Study

Masoumeh Nezhadali

Background: Type 2 Diabetes Mellitus (T2DM) is a chronic metabolic disease characterized by insulin resistance and inadequate insulin secretion by pancreatic beta cells. Insulin resistance is the most important characteristic of T2DM, in which the peripheral tissues, including the liver, skeletal muscles, and adipose tissue, shows a lower response to the presence of insulin and insulin function is impaired. Adipose tissue, in addition to storing fat, synthesizes and secretes several bioactive peptides called adipokine and cytokine, which play an important role in regulating metabolism, inflammation, obesity and diabetes.
Methods: In the present study, searches were conducted in the Persian and Latin databases PubMed, Science Direct, Google Scholar, SID, and Magiran using keywords such as Diabetes, Insulin Resistance, Adipokine, Adiponectin, Leptin, Resistin, TNF-α, IL-6, RBP-4, Chemerin, Vaspin, Visfatin, Omentin, and Aplin to retrieve articles published from 2011 to 2024.
Results: The results indicated that adiponectin levels are reduced in patients with T2DM and insulin resistance. Elevated levels of leptin and retinol-binding protein-4 play a crucial role in the development of insulin resistance and T2DM. According to the evidence, adiponectin, resistin, TNF-α, interleukin-6, vaspin, and visfatin are associated with insulin resistance and T2DM. Contradictory results were found regarding the associations of omentin, apelin, and chemerin with insulin resistance and T2DM.
Conclusion: Adipocytokines may serve as biomarkers for predicting and early diagnosis of insulin resistance and T2DM.

Holistic Management of Diabetes Mellitus: Key Points for Better Understanding and Adherence to the Consensus Guidelines of the American Diabetes Association Diabetes 2025: A Review Article

Ali Noursina

Diabetes mellitus (DM) is a chronic and multi-organ disease that affects a large population worldwide, and its incidence is increasing despite the preventive measures taken globally. Despite effective guidelines for managing DM, healthcare professionals and patients/caregivers often struggle to understand and follow these recommendations. Therefore, this study presents a comprehensive approach to diabetes management based on the American Diabetes Association's latest guidelines, aiming to facilitate the process of adherence to these guidelines within the Iranian population. The study's focus encompassed recommendations pertaining to patient communication, structured patient education and support, psychosocial factors, social determinants of health, avoidance of therapeutic inertia, individualized patient pathophysiology, continuous and effective management and care organization, mitigation of hypoglycemia risk, continuous monitoring and surveillance, modification of health-affecting behaviors, screening, ongoing management and care for diabetes-related complications, shared decision-making, and the components of the disease care. The most recent updates to the American Diabetes Association guidelines for diabetes management were also briefly explained.

The Effect of a Period of Endurance Training Along with Electrical Stimulation on the Gene Expression of Some Sex Markers in the Testicular Tissue of Fasted Obese Rats

Mohammad Malekipooya

Background: Obesity is a multifactorial disease whose incidence and burden on societies around the world is increasing. Sexual performance in these patients is an important aspect that is often ignored. Therefore, the aim of the present study was to investigate the effect of a period of endurance training along with electrical stimulation on the gene expression of some sex markers in testicular tissue of fasted obese rats.
Methods: In this experimental study, with a control group of 40 male Wistar rats (8 weeks old, weighing 200±19 grams), after induction of obesity and weight gain, randomly divided into 5 groups of 8: control, fasting-obese, fasting-endurance exercise, fasting-electrical stimulation and Fasting-endurance training-electrical stimulation were divided. Intervention groups for a period of 4 weeks under endurance sports activity (with a speed of 10 to 20 m/min and duration of 20 to 40 minutes), electrical stimulation (foot shock device for 0.5 mA and 20 minutes) and fasting (8 to 16 hours) were placed. After exercise and anesthesia, tissue sampling was done and after molecular processes, gene expression was measured using Real time-PCR machine. For data analysis, two-way analysis of variance test was used at a significance level of P< 0.05 and GraphPad software.
Results: The results showed that endurance training led to a significant increase in the expression of 5αR and aromatase genes in fasting obese rats compared to the obese group (P= 0.0001). Also, electrical stimulation and its combination with endurance training led to a significant increase in the expression of 5αR gene (P= 0.0001), but this increase was not significant in Aromatase gene (P= 0.377).
Conclusion: It seems that endurance training and electrical stimulation during fasting by increasing the expression of 5-alpha reductase and aromatase genes in obese samples is effective in their sexual health and leads to its improvement. Also, a combination of electrical stimulation and exercise can have positive effects on this process, but more studies are needed.

Design and Evaluation of an Educational Website on Childhood Diabetes Mellitus with the Aim of Improving Maternal Awareness

Roya Naemi

Background: Type 1 diabetes mellitus or juvenile/adolescent diabetes has a significant impact on the quality of life among children and parents. Thus, the development of a deep understanding of the disease of diabetes in childhood and the ways to prevent and treat patients allows health care providers to respond to their specific needs. One of the solutions to improve the knowledge of the patients is online education. Therefore, this study designed and evaluated a childhood diabetes education website with the goal of improving the quality of care for children and reducing mortality.
Methods: This study involved three phases of content collection, website design, and evaluation. The website content information was collected from reliable library sources and created using the WordPress website design tool. Subsequently, the website content, performance, display capabilities, terminology and information retrieval, and ease of learning were evaluated by physicians and nurses.
Results: Comprehensive clinical information about pediatric diabetes was provided on the website. In the evaluation of the website content, the highest average was related to the type 1 diabetes section at a glance and the lowest average was related to the pathology section. In evaluating the website performance, the highest average was related to the overall design and the lowest average was related to the ease of use. Overall, the website performance was of good quality.
Conclusion: To increase the effectiveness of care services and reduce the complications of diseases, providing accurate and reliable information in the form of educational websites should be considered.

The Effect of 8 Weeks of Swimming Training Combined with Soy Extract on the Expression of FN1-ARC-NGFR-BDNF Levels Related to Neurogenesis in Mice with Polycystic Ovary Syndrome Fed a High-Fat Diet and Letrozole

Farzaneh Taghian

Background: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among women and has lifelong health effects. This study aimed to investigate the physiological effects of PCOS on neurogenesis and cognitive symptom improvement through lifestyle changes and the use of complementary and alternative medicine.
Methods: In this experimental study, 30 female C57BL/6 mice with a mean weight of 18±2 kg and an age of 6 to 7 weeks were randomly divided into five groups: control group, polycystic group, polycystic + swimming exercise group, polycystic + soy group, and polycystic + exercise + soy group. Real-time PCR measured gene expression. Genes were selected with the help of bioinformatics software. ELISA evaluated luteinizing hormone(LH ) concentration.
Results: FN1-ARC-NGFR-BDNF genes showed decreased expression in mice with PCOS compared to the control group. On the other hand, the expression of FN1-ARC-NGFR-BDNF genes in mice with PCOS, swimming training, and soy supplement consumption significantly increased compared to the PCOS group. Simultaneous administration of swimming training and soy supplement consumption significantly increased LH concentration (p<0.001) and expression of FN1-ARC-NGFR-BDNF genes (p<0.05).
Conclusion: This study showed that combining swimming training and soy extract consumption can enhance neurogenesis in a PCOS model and improve cognitive symptoms. Our findings confirm that this combination not only enhances the function of the nervous system but also contributes to overall health improvement through hormonal regulation. These results provide a new avenue for complementary therapies in the management of PCOS.

The Effect of Changes Induced by Exercise Training on the Pro-Inflammatory, Inflammatory and Anti-Inflammatory Adipocytokines in Obese Type 2 Diabetic Patients

Saleh Afrasyabi

Background: Today, obesity is closely related to metabolic syndrome and especially type 2 diabetes, which changes the secretion and release of adipocytokines, and different training programs have different results on these indicators. Therefore, the aim of the present study is to investigate the durability of changes caused by exercise programs on adipocytokine indices of obese type 2 diabetic patients.
Methods: In this semi-experimental study, 45 obese men with type 2 diabetes were randomly divided into a control group (no exercise) and 4 exercise groups (aerobic, combined, resistance and high-intensity interval). The exercise program of the groups was considered based on the calories consumed in each session. The participants performed 12 weeks of training programs and 12 weeks of non-training. Physiological, anthropometric indicators and inflammatory and pro-inflammatory indicators (IL-6, TNF-α, resistin and leptin) and anti-inflammatory indicators (adiponectin and SFRP5) were measured before the program and at weeks 6, 12, 18 and 24. became.
Results: After 12 weeks of combined, aerobic, high intensity and resistance training, anti-inflammatory indices (adiponectin and SFRP5) showed a significant increase compared to the baseline (before starting the training program) (P< 0.05). Regarding pro-inflammatory and anti-inflammatory indicators (IL-6, TNF-α, resistin and leptin), a significant decrease was observed in all groups after 12 weeks of training program (P< 0.05). In this study, a significant improvement in weight loss and blood glucose was observed after 12 weeks of exercise program in all 4 exercise groups (P< 0.05). In the second part of the findings (non-training or durability of training effect), it was resistance training that showed a lower percentage decrease (P< 0.05) in anti-inflammatory indices and an increase in pro-inflammatory and inflammatory indices after 12 weeks of non-training, which showed the durability It shows more recovery in obese type 2 diabetic patients (P< 0.05).
Conclusion: The findings of the research showed that high-intensity interval training after 12 weeks can cause a greater effect on inflammatory, pro-inflammatory and anti-inflammatory indicators compared to aerobic, combined and resistance training. But this is the resistance exercise that caused the reduction in inflammatory, pro-inflammatory indicators and increase in anti-inflammatory indicators in obese type 2 diabetic patients to be more permanent. Therefore, the effectiveness of resistance training in non-training conditions from three methods of high-intensity interval training, aerobic and combined (aerobic + resistance) has a greater effect on low-grade inflammation and results in a longer recovery in obese type 2 diabetic patients.

The Effect of Endurance Training on PGC1α Protein Content, Glycosylated Hemoglobin and Metabolic Syndrome Indices in Obese Rats with Type 2 Diabetes

Eskandar Rahimi

Background: Metabolic syndrome is characterized by a cluster of conditions such as abdominal obesity, high triglycerides, high blood pressure, high blood sugar, and low levels of healthy fat. Therefore, this study aimed to investigate the effect of endurance training on PGC1α protein content, glycosylated hemoglobin and metabolic syndrome indices in obese rats with type 2 diabetes.
Methods: Eighteen male Wistar rats with an average weight of 200±20 g were selected and placed on a high-fat diet for four weeks. Then 12 rats were randomly selected and induced type 2 diabetes by injecting nicotinamide (110 mg/kg) and streptozotocin (50 mg/kg) solutions. Diabetic rats were randomly divided into two groups of training and control patients. The samples of the training group performed endurance training on the treadmill for 8 weeks and 5 sessions every week with an intensity of about 50 to 70% of the maximum speed. 48 hours after the last training session, mice were sacrificed and variables were measured. To analyze the data, one-way ANOVA and Tukey's post hoc tests were performed in SPSS software version 29.
Results: Endurance training led to a significant decrease in fasting blood sugar levels, HbA1c and triglyceride levels (P= 0.0001). On the other hand, it did not show any effect on HDL levels (P= 0.087). On the contrary, it led to an increase in the intracellular amount of PGC-1α (P= 0.0001).
Conclusion: The results show that endurance training can be considered as an adjuvant drug by regulating the factors related to metabolic syndrome.

In-Vitro Studying Toxicity of Herbal Extracts Mixture in Normal Environment and Protective Effect of Mixtures in High-Glucose Environment

Mahdi Goudarzvand

Background: Diabetes is one of the most common disorders of the endocrine glands, the main characteristic of which is an increase in the concentration of glucose in the serum of patients. Herbal medicines are widely accepted by people due to less side effects. The purpose of this study is to investigate the protective effect of the silybum marianum, melissa officinalis, vaccinium arctostaphylos, trigonella foenum, urtica dioica and citrullus colocynthis extracts mixtures in the PC12 cell model in a high glucose environment.
Methods: After 24, 48, and 72 hours of adding different concentrations of plant extracts (silybum marianum, melissa officinalis, vaccinium arctostaphylos, trigonella foenum, urtica dioica and citrullus colocynthis) in the normal culture medium of PC12 cells and the medium with high glucose (25 mg/ml, 13/5), cell viability was measured by MTT method.
Results: The results showed that the viability of PC12 cells did not change in 24, 48 and 72 hours after treatment with a mixture of plant extracts. The survival rate of cells in the high dose glucose group was significantly reduced compared to the control group, and the mixture of plant extracts in high doses significantly reduced cell death in these conditions.
Conclusion: Based on the available findings, glucose with a concentration of 25, 13.5 mg/ml caused the death of PC12 cells and the mixture of plant extracts was able to reduce the cell death caused by high glucose after exposure with nerve cells.