Mahdieh Akhoundan, Zhaleh Shadman, Nooshin Poorsoltan, Mozhdeh Soleymanzadeh, Mohsen Khoshniat Nikoo, Bagher Larijani,
Volume 13, Issue 4 (5-2014)
Abstract
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.
Nooshin Poorsoltan, Yadollah Mehrabi, Zhaleh Shadman, Mahdieh Akhoundan, Arash Rashidi, Mohsen Khoshniat Nikoo,
Volume 14, Issue 1 (1-2015)
Abstract
Background: Physiological stress may affect eating habits and also foods intake may alter the physiological stress. According to the reports of high levels of serum cortisol as a stress biomarker in type 2 diabetic patients the aim of this study was to investigate the relationship between dietary patterns and serum cortisol concentration in type 2 diabetic patents.
Methods: This cross-sectional study was conducted on 241 type 2 diabetic patients in 2013. Major dietary patterns were obtained by factor analysis. Serum cortisol was measured at 8 am. Serum cortisol level was compared among tertiles of dietary patterns using ANCOVA adjusted for confounders (age, sex, BMI, and fasting blood glucose). Linear regression analysis was performed to assess the association between serum cortisol and scores of dietary patterns.
Results: Three major dietary patterns were identified as Western, healthy and healthy like. None of the variables age, waist circumference, body mass index, physical activity level, duration of diabetes and fasting blood glucose was significantly associated with serum cortisol. After adjustment for confounders, no statistically significant difference was found in mean serum cortisol among tertiles of dietary patterns or no statistically significant association between serum cortisol and dietary patterns scores. Mean serum cortisol was 12.95±5.10 nmol/L which was in normal range.
Conclusion: This study showed that in type 2 diabetic patients, normal levels of serum cortisol were not associated with the adherence to Western, Healthy and Healthy like dietary patterns.
