Iranian Journal of

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Background: Studies of the metabolic effects of Ramadan fasting on patients with type 2 diabetes mellitus are inconclusive.
Methods: Fifty-seven volunteers with type 2 diabetes underwent anthropometric and biochemical evaluation before and on the 14th and 28th days of Ramadan. Biochemical markers were measured by standard laboratory methods. Anthropometric measurements followed WHO criteria. Statistical analysis was by ANOVA for repeated measurements and Friedman’s two-way ANOVA, using SPSSv6 software.
Results: Daily cholesterol intake increased in all subjects (p<0.03). Body mass index increased (p<0.03) in women, but body mass index (BMI) and waist-to-hip ratio both decreased (p<0.01) in men. Blood pressure, fasting blood glucose and serum fructosamine did not change during the study. Plasma insulin (p<0.05), C-peptide (p<0.01) and insulin resistance (p<0.01) decreased only in men. Total and LDL cholesterol increased significantly in all subjects during the study.
Conclusion: Ramadan fasting does not alter carbohydrate metabolism or tissue insulin sensitivity in type 2 diabetes patients, given appropriate dietary education and rescheduling of oral hypoglycaemic medication. Lipid profile is unfavourably altered due to changes in both diet and biochemical response to starvation. Anthropometric indices improve in men but not women, possibly because of reduced physical activity in the latter.

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Background: Oral glucose tolerance testing (OGTT) is the gold standard for the diagnosis of diabetes mellitus and impaired glucose tolerance (IGT), but is time-consuming and difficult to perform. We investigated the value of glycosylated hemoglobin (HbA1C) in screening for diabetes mellitus and IGT.
Methods: In a cross-sectional study, we measured the HBA1C levels of 497 people referred for OGTT. We calculated the sensitivity and specificity of HbA1C at 1, 2, 3 and 4 SD above the normal mean. We plotted receiver operating characteristic (ROC) curves after assigning our subjects to the diabetic, IGT, ‘diabetic+IGT’, or normal group, based on WHO criteria for OGTT.
Results: HbA1C levels (mean ± SD) in the four groups were 9.2±1.5, 8.4±1.3, 7.9±0.8 and 6.8±0.7 percent in the diabetic, diabetic+IGT, IGT and normal groups, respectively. All differences were statistically significant (p<0.0001). ROC curve analysis showed that HbA1C levels above 7.5% (mean + 1SD) gave the best combination of sensitivity and specificity for the detection of diabetes (97.53% and 73.8%), IGT (66.37 and 69.44%), and diabetes+IGT (80.22% and 86.66%).
Conclusions: An HbA1C level of >7.5% is an optimal cutoff point for diabetes screening programs.

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Introduction: In this study, we compared the level of glycosylated haemoglobin in patients with essential hypertension and healthy controls.
Method: 70 non-diabetic patients with essential hypertension were recruited into the study along with 140 controls without any significant medical history. Persons with a history of metabolic disease, anaemia, renal disease, splenectomy, pregnancy, or on medication were excluded from the study. A blood sample was taken from each participant and immediately sent to the EEMRC laboratory, where fasting blood sugar and glycosylated haemoglobin levels were measured by the glucose oxidase and thiobarbituric acid (colorimetry) method, respectively. The unpaired t-test was used to compare means. A p-value of less than 0.05 was considered significant.
Results: Mean fasting blood glucose was 103.1±16.1mg/dl in the hypertensive group and 92±7mg/dl in controls (p<0.05). Mean glycosylated haemoglobin levels were 7.38±0.78% in the hypertensive group and 6.5±0.85% in controls (p<0.05). Conclusion: People with essential hypertension have a higher level of glycosylated haemoglobin than healthy controls.

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Introduction: There is as yet no consensus as to the effect of Ramadan fasting on fasting blood glucose. We carried out a study to help clarify the situation.
Methods: This was a semi-experimental (pre- and post-) study of 115 healthy volunteers (67 men and 48 women), who fasted for at least 25 days during Ramadan. Blood samples were taken 7 days before Ramadan (at 7am after a 8-hour overnight fast), and on the 14th and 28th days of Ramadan (1 hour before sundown). The mean duration of daily fasting was 11.5±0.5 hours. Plasma glucose was measured by an enzymatic assay. Statistical analysis was by the paired-t and ANOVA functions on SPSS10.0 software.
Results: Fasting plasma glucose in the group as a whole decreased from 88.4±9.0mg/dl pre-Ramadan to 75.4±15.3mg/dl on day 14 and 62.9±7.7mg/dl on day 28 (p<0.001). Both men [87.5±8.8mgdl (pre-Ramadan)  60.8±6.4mg/dl (day 28)] and women [89.7±9.3mgdl (pre-Ramadan)  65.7±8.4mg/dl (day 28)] experienced a significant decrease in fasting plasma glucose levels (p<0.001 in both). There was a reduction in calorie intake during Ramadan in every volunteer (p<0.001), and there was a direct correlation between reduction in calorie intake and fasting plasma glucose (p<0.01).
Conclusion: Fasting plasma glucose decreases with Ramadan fasting and is associated with a reduction in calorie intake. The decrease in plasma glucose does not seem to be accompanied by any serious adverse effects in healthy volunteers, however.

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Patients with type 2 diabetes have a higher risk of coronary heart disease and a worse prognosis compared with patients without diabetes. In this study, the prevalence of cardiovascular risk factors have been investigated in type 2 diabetic patients.
Methods: A Cross Sectional study with a target population of known type 2 diabetic subjects was conducted in 2002 in Isfahan. From registered patients, 1150 were selected and evaluated for age. sex.duration of diabetes, BMI, hypertension, lipid profile, proteinuria, fasting blood glucose. HbAlc and smoking using convenience sampling methods.
Results: Mean fasting blood glucose and HbAl were 165.16 x 53.4 mg/dl and 9.2+ 3.5 percent respectively. The number of women with 3 cardiovascular risk factors was significantly greater than men (50.7% VS 33.5% PO.001). 19.5% of men and 50.2% of wjomen had high serum cholesterol level (>230 mg/dl). The prevalence of obesity (BMI >30Kg/m2) was 13.6% for men and 30.8% for women. 56.6% were hypertensive and 29.3% had proteinuria (P<0.001).
Conclusion: Cardiovascular risk factors are present in a considerable proportion of studied type 2 diabetic patients. Control of risk factors and life style modifications should be tightly considered in order to decrease the prevalence ofTHD in the up -coming years of their life.

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Background: Hypertension and dyslipidemia are common in patients with type 2 diabetes mellitus. The high prevalence of cardiovascular disease in diabetic patients is, in part, related to these two risk factors. This study was performed to determine the prevalence of hypertension and dyslipidemia in newly diagnosed patients with type 2 diabetes mellitus in Isfahan.
Methods : In this cross – sectional study during 2001 – 2003, 310 newly diagnosed type 2 diabetic patients, in Isfahan endocrine and metabolism research center, were studied. Height, weight, blood pressure, Plasma lipid and lipoproteins, and HbA1c were determined for all subjects.
Results: Mean age at presentation was 489.83 years, and mean BMI was 28.44.62 Kg/m2. Hypertension was present in 32.9%, hypercholesterolaemia in 61.3%, hypertriglyceridaemia in 61.6%, high LDL in 77.3%, and low HDL in 67.8% of these patietns. The mean systolic and diastolic blood pressure were 119.0816.59 and 70.0214.02mmHg, respectively. The mean for total cholestrol was 216.1043.65, for triglyceride 207.46105.67, for LDL 124.7331.45, and for HDL 43.119.29 mg/dl.
Conclusion: Hypertension and dyslipidemia are common in newly diagnosed type 2 diabetic patients. This fact demonstrates the importance of early interventions for proper diagnosis and treatment of these two risk factors in diabetic patients.

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Background: Constipation is the most common gastrointestinal complication in diabetic patients. Erythromycin mimics the effects of the gastrointestinal hormone Motilin in gastric contractile activity and insulin secretion. In this study, we compared the effects of Erythromycin and Metoclopramide on glycemic control and constipation in type 2 diabetic patients. Methods: As a clinical trial, thirty-nine type 2 diabetic patients with constipation were divided into two groups. Patients in group 1 (n=24) were treated with erythromycin (400 mg/day before sleep) and participants in the second group (n=15) received metoclopramide (10mg 3 times / day before each meal) for 3 months. FBS, 2hPP BS, HbA1c and the frequency of defecations during a week were measured and compared before and after the intervention. Results: In Erythromycin treated group, 2hPP BS decreased from 199.7 ± 47.0 before treatment to 174.0±46.3 after intervention (P=0.01) and a significant improvement in constipational symptoms was observed in both groups. Conclusion: It seems that Erythromycin not only can improve symptoms of constipation but may have a role in glycemic control in type 2 diabetic patients.

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Background: Polycystic ovary syndrome(PCOS) is the most endocrinopathy in women and the most common causes of anovulatory infertility. Women with this disorder moreover the common manifestations such as,irregular menses, hirsutism and infertility, are susceptible to serious consequences like increase risk of endometrial carcinoma, dyslipidemia, hypertention, glocose intolerance, diabetes, cardiovascular problems and probably breast cancer. This study was conducted to demostrate the demographic, clinical,metabolic and hormonal conditions of the PCOS patients. Methods: A case-control study was performed on females with PCOS age group 15-40 years referring to endocrine and gynecology clinics. A control healthy woman was selected for each patient. The diagnosis of PCOS was made based upon the prescence of chronic anovolation and hyperandrogenemia .Other causes of hyperandrogenism were excluded by appropriate clinical and laboratory evalution .In all patients with PCOS and control women, appropriate medical history was taken and physical examination was done.Blood pressure ,body weight, height ,BMI,waist/hip ratio,score of hirsotism,acne, and other signs of androgen excess were determined.A venous blood sample were obtained at morning after 12_14hours fasting for measuring FBS, TG, Chol., LDL, HDL and hormonal profile,souch as:PROL,17_OH Progestrone,Te,DHEA-S and TSH.Case of late onset adrenal hyperplasia ,hypotyroidism and pituitary prolactinoma were excluded.The diagnosis of dyslipidemia was made upon the base of NCEP guidelines.Data was analyzed with Mann_Whitney U,T tests and Fisher’s and Chi_Square Tests with SPSS-11. Results: Mean age were similar in both patients and controls.Mean of BMI and diastolic pressure were significantly higher in PCOS women in comparison with controls . Hirsutism and oligomenorrhea were the most frequent clinical features(72.7% and 69.1% respectively). SerumTG level was significantly higher in PCOS women in comparison with controls.There were no significant difference in FBS,Chol,LDL and HDL between patients and controls. The prevalence of high triglyceride ,high cholesterol and high LDL levels were significantly higher in PCOS women in comparison with controls,but there were no significant difference in the prevalence of IFG and low HDL levels. The prevalence of high TG and high Chol level were significantly higher in obese PCOS women in comparison with non obese patients.There was no significant difference in the prevalence of high LDL and low HDL levels between obese and nonobese patients. Serum level of total Testostrone was significantly higher in PCOS women in comparison with controls.There were no significant difference in serum levels of DHEA-S,17-OH Progestrone, Prolactine and TSH between patients and controls. Conclusion: The prevalence of obesity and dyslipidemia were higher in PCOS women in comparison with healthy women. For obese women with PCOS ,behevioral weight management is the main component of overall treatment strategy and these patients counseling about the importance of life style management ,diet and exercise shoud be emphasized. The patients should screened for dyslipidemia, diabetes and hypertension. In this study there was no significant difference in FBS between two groups and IGT and DM may be better detected by OGTT. In all PCOS women for detecting dyslipidemia a fasting lipid profile is indicated

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Background: Hyperhomocysteinemia may increase blood pressure by inducing endothelial cells dysfunction . The aim of this study was determining the relationship between plasma Homocysteine (Hcy) levels and blood pressure in new cases of type 2 diabetes mellitus.
Methods: As a cross sectional study, 46 new cases of type 2 diabetes mellitus referred to Isfahan Endocrine and Metabolism Research Center were selected by convenient sampling. Basal characteristics of patients were recorded. Systolic and diastolic blood pressure was measured two times with 30 minutes interval on two consequent days. After ten hours of overnight fasting, blood samples were taken to measure fasting plasma glucose, HbA1c, triglyceride, Total cholesterol, HDL-C and creatinine. All data were expressed as mean (SD). Relationship between plasma Homocysteine levels and both systolic and diastolic blood pressure was assessed by Pearson's correlation coefficient. Patients were divided into three groups according to their plasma Homocysteine levels, (Hcy<10mol/L, 10Hcy<15 mol/L and Hcy15mol/L).. Then mean of systolic and diastolic blood pressure between groups were compared by one – way ANOVA and Tuckey-HSD tests.
Results: Mean (SD) of plasma Homocysteine levels was 12.2 (6.8) mol/L and of systolic and diastolic blood pressure was 128.8 (18.1) and 82.3(9) mm/Hg, respectively. There was a significant correlation between plasma Homocysteine levels, and both systolic (r=0.39, P<0.01) and diastolic (r=0.46, P<0.01) blood pressures. Mean (SD) of systolic and diastolic blood pressure in patients with plasma Homocysteine level of 15mol/L was 152.5 (17.7) and 91.8 (7.3) mm/Hg, respectively, so blood pressure in those group with hyperhomocysteinemia was higher than other two groups (P<0.001). There was no correlation between Homocysteine levels and FPG, HbA1c and lipid profile.
Conclusion: There is a significant correlation between plasma Homocysteine levels and both systolic and diastolic blood pressure in newly diagnosed type 2 diabetics. Patients with hyperhomocyteinemia have higher blood pressure.

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Background: Retinopathy is one of the microvascular complications of diabetes which is strongly related to the glycemic control and duration of the disease. According to results of other studies, the prevalence of retinopathy has been reported 5-30% in newly diagnosed patients whit type 2 diabetes (T2DM). The aim of this study was to determine the prevalence of idabeteic retinopathy among newly diagnosed T2DM patients in Isfahan, Iran.
Methods: From july 2001 to March 2004, 710 newly diagnosed patients with T2DM were recruited in this study. Patients with duration of diabetes less than 1 year were considered as newly diagnosed ones. Along with physical examination and laboratory measurment for FBS, HbA1c, lipid profile, urea, Creatinin, and 24 houre urin examniation for albumin, retinoscopy was performed by an experienced ophttalmologist.
Results: In this study, 286 men and 424 women were investigated. The mean age of patients at presentation and the mean duration time of diabetes were 48.8 ±9.8 years (range 31-72years) and 8.6±5.4 months respectively. The prevalence of retinopathy was 9 % (9/8% in males and 8.5% in females). Logistic regression analysis revealed that BMI, diastolic blood pressure and 24 hour urine albumin, were independent risk factors for developing retinopathy.
Conclusion: Nevertheless of relatively moderate prevalence of diabetic retinopathy in our study as compared with other studies, it is necessary to perform retinal examination in newly diagnosed T2DM patients in order to prevent the sight-threatening outcomes of diabetic retinopathy.

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Background : Women with polycystic overy syndrome (PCOS) are sussceptible for developing type 2 diabetes (T2DM) and cardiovascular diseases. In view increased prevalence of T2DM in patients with PCOS and priority of prescription agents capable to decrease insulin resistances for them, It is important to diagnose PCOS in T2DM patients. The aim of this study was to evaluate the prevalence of PCOS in T2DM women.
Methods : Using ‘1990 National Institute of Child Health and Human Development Conference of PCOS’ criteria, 157 premenopausal women with T2DM were assigned into PCOS and non – PCOS groups after they were examined for the evidences of clinical PCOS. A questionnaire on reproductive history was completed and the waist circumference, weight, height and BP were measured for each participant. Biochemical tests were performed in both groups, but hormonal measurements were requested only for PCOS group.
Results : The prevalence of PCOS was high (about 8%) among subjects. Patients with PCOS had significantly lower age at the onset of diabetes, higher BMI and waist circumference. The differences in BP, serum TG, HDL, LDL, cholesterol and HbA1c were non – significant between 2 groups and insulin resistance is more.
Conclusion : PCOS is prevalent in diabetic women and Insulin resistance is more likely in those with both PCOS and T2DM resistant than whom with diabetes alone. Emphasis on reducing insulin resistance may be of benefit to achieve a better diabetes control in these patients.

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Background: Microalbuminuria represents the earliest clinical of renal involvement and reflects the progression of diabetic nephropathy and increased risk of mortality in diabetic patients. The incidence of diabetic nephropathy in type 2 diabetes differs widely by race .The aim of this study was to determine the incidence of and risk factors for microalbuminuria in type 2 diabetic patients.
Methods: As a cohort study 505 (22%male, mean age: 57.4±9.5 years and diabetes duration 10.2±4.7 years at initial registration) type 2 diabetic patients with initial normoalbuminuria were followed prospectively for 5 years in isfahan endocrine and metabolism research center. Patients were evaluated for BMI ,HbA1c, blood pressure, lipid profile, serum creatinine and 24 hours urine albumin. Normoalbuminuria were defined as urine albumin excretion less than or equal to 30 mg/24 h and microalbuminuria as 31-299 mg/24 h. Logistic regression model were used to assess the associations.
Results:176 revealed persistently elevated UAE during follow-up, giving an incidence of 82.3/1000 person-years(95%CI:78/3-86/2). Incidence of microalbuminuria were significantly higher in men than wemen(104.4 and 66.2/1000 person-year, P<0.001).The mean values of HbA1c, duration of diabetes, systolic hypertension and serum creatinin during the follow-up period were significantly higher in the microalbuminuric than in the normoalbuminuric patients. Age, BMI, cholesterol and triglyceride were not significantly different in two groups. Logistic regression analysis revealed that duration of diabetes, HbA1c, high blood pressure and retinopathy during follow-up are independent variables that have a statistically significant influence on the development of microalbuminuria.
Conclusion: These result revealed that microalbuminura in this population of type 2 diabetic patients were common and higher than of other studies. These findings suggest that urine excretion of albumin should be monitored routinely in this patients for detection early stages of nephropathy and effective treatment of microalbuminura and associated risk factors are very important.

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Background: Fetal hyperinsulinemia correlated with large birth weight and impaired glucose tolerance test and obesity in second decades of life. In this study we compared the correlation between fetal insulin production (as estimated by amniotic fluid (AF) C-peptide concentration) and AF insulin with macrosomia (as estimated by neonatal birth weight 4000 gr).
Methods: Thirty eight neonates were studied. Ten infants were macrosom and 28 were normal (birth weight < 4000 gr). Amniontic fluid C-peptide and insulin concentration and mother and fetal blood C-peptide and insulin were measured during delivery with radioimmunoassay and mother and fetal glucose were measured at the same time and correlated with neonatal macrosomia within first hour of birth.
Results: There was a significant correlation between infant serum C-peptide level and macrosomia. Amniotic fluid insulin level was higher in the macrosom infants but this correlation was not significant. AF C-peptide was higher in the macrosom group. Also there was a significant correlation between maternal serum C-peptide and macrosomia. Infant and mother serum insulin was higher in the macrosom group.
Conclusion: Our results suggest that fetal insulin (as estimated by AF C- peptide) and mother insulin and C- peptide production, can influence fetal weight and induce fetal macrosomia.

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Background: The aim of this study was to determine the prevalence of cardiovascular disease (CVD) risk factors among type 1 diabetic patients referring to Isfahan Endocrine & Metabolism Research Center.

Methods: In this cross-sectional study, the prevalence of CVD risk factors including dyslipidemia, smoking and hypertension was determined in type 1 diabetic patients aged 15-30 years.  Serum cholesterol <170 mg/dl, LDL<100 mg/dl , HDL>35 mg/dl , TG<150 mg/dl, systolic blood pressure<120 mmHg and diastolic blood pressure<80 mmHg were considered as optimal control levels.

Results: Among 219 studied diabetic patients (mean age=22.5±10.3, female/male=120/99), the mean cholesterol and HDL-C level was higher in women (176±34.9, 46.4±34.1) than men (162.9±32.4 vs. 41.5±10.1) (P<0.05). The prevalence of smoking, hypercholesterolemia, LDL>100 mg/dl, HDL<35 mg/dl, hypertriglyceridemia and hypertension was 6.9% (n=15), 47.4% (n=104), 53.5% (n=117), 22.8% (n=50), 18.3% (n=40) and 7.7% (n=17), respectively. HDL<35 mg/dl was more prevalent among men as compared with women but cholesterol> 170 was more frequently detected in women (P<0.05).

Conclusion: Considering the rather high prevalence of CVD risk factors in type 1 diabetic patients in Isfahan, and in view of modifiability of these risk factors, educating patients on appropriate glycemic control and increasing physical activity is necessary as well as close monitoring of these risk factors.

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Background: Type 2 diabetic patients have higher risk for death from coronary heart diseases than non-diabetic patients. Studies have revealed showed intensive treatment of hyperglycemia only have a small effect on CVD risk. Other risk factors such as Lipid abnormality play a leading role in the increased CVD risk associated with diabetes. The aim of this study was to assess the quality of lipid control and treatment in type 2 diabetic patient with dyslipidemia. 

Methods: We studied Data from 602 type 2 diabetic patients who had at least four regular clinic visits every year for medical care in outpatient clinics of Isfahan Endocrinology and Metabolism Research Center, 1999-2003. Patients for Classified in three groups according to lipid levels as low, moderate and high risk. ADA )American Diabetes Association) standard criteria were used for appropriate lipid control.

Results: The mean age, duration of diabetes, HbA1c and BMI were 52.2±9.5 years, 6.8±4.6 years, 9.2±1.7% and 29.4±4.2 Kg/m2 respectively at initial registration. Eighty four percent of patient had LDL cholesterol above 100 mg/dl and 71% had triglyceride level >150 mg/dl, of these patients 47.8% and 41.6% had high risk levels and only 12.4% taking statins and 21.5% taking fibrate for treatment  at end of study. Among hyperlipidemic patients levels of LDL-C decreased from 170.8±35.6 mg/dl to119±30.20 (p < .001), triglyceride decreased from 273.8±126 to225.2±97 mg/dl (P<0.004) and HDL-C increased from 43.3±10.6 to 48.4±14.1mg/dl ((P<0.6). Percentage change of lipid level was -35.8%, -17.7% and +7.3% respectively. At the end of fallow-up 50.4% of patients treated with statins and 14.7% with fibrate. Finally, overall control of cholesterol and triglyceride in patients with dyslipidemia was 30% and 37% respectively.

Conclusion: Our findings showed that many of type 2 diabetic patients with dyslipidemia have inadequate control of lipid and lipoprotein. The prevalence of cardiovascular events due to hyperlipidemia in type 2 diabetic patients is high. This fact demonstrates the importance of early interventions for control and treatment these risk factors for prevention of cardiovascular complication in this patients.

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Background: The prevalence of depression in diabetic patients is 2-3 times more than general population. The quality of life (QOL) and glycemic control are two important outcome measures of diabetes management. The aim of this research is to study the relationship between depression, glycemic control and QOL in a sample of Iranian diabetic patients.

Methods: One hundred diabetic patients who were referred to diabetes clinic of Dr. Shariati Hospital were included in the study consecutively. The depression subscale of Hospital Anxiety and Depression Scale (HADS-D) were used to determine depression. The World Health Organization Quality of life brief version questionnaire (WHOQOL-BREF) was used to measure QOL. The status of glycemic control was evaluated through measuring HbA1c. Other measured variables included:  demographic variables, smoking, diabetes type, body mass index, duration and complications of diabetes and previous history of depression. The linear regression method was implemented to analyze the data.

Results: Depression was observed in 28% of the patients. Glycemic control had a reverse significant correlation with diabetes complications. No significant relationship was found between HbA1c and scores of HADS-D. WHOQOL-BREF subscales scores had no significant relationship with glycemic control. There was a significant relation between scores of HADS-D and WHOQOL-BREF subscales.

Conclusion: Improving quality of life (QOL) is one of the main outcomes in the management of diabetes. According to the result of this study, depression had a prominent relationship with QOL. Thus, careful management of depression may be necessary to improve QOL of diabetic patients.

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Background: In the event of damage to the skin, the epidermis of which goes to the disintegration of the body, is a wound that is common in diabetics. The purpose of this study was to evaluate microscopic effects of Aqueous extract of curcumin on wound healing in diabetic male rats.

Methods: In this study 48 male Wistar rats were divided into 4 groups (control, sham, experimental, empirical two) were tested. The extra pawn injured area of 3 cm to the left of the spine created. Wound healing was examined microscopic.

Results: The streptozocin diabetic wound healing compared to the control group later showed and wound healing in experimental groups treated with Aqueous extract of curcumin was faster than the control group.

Conclusion: The results showed that the Aqueous extract of curcumin skin accelerates wound healing in normal and diabetic samples.

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Background: The purpose of this study was to compare effects of three combined aerobic-resistance exercise training protocols with different intensities on metabolic control and Visfatin levels in men with type 2 diabetes.
Methods: 43 male patients with type 2 diabetes were randomly divided into 4 groups (three combined aerobic-resistance exercise training groups 1, 2, 3 and control). Training groups performed combined aerobic-resistance exercises for 12weeks, 3 times a week with given intensities )group 1:resistance 50-60% one repetition maximum- aerobic 70-80%maximum heart rate, group 2:resistance 60-70% one repetition maximum- aerobic 60-70% maximum heart rate and group 3:resistance 70-80% one repetition maximum- aerobic 50-60% maximum heart rate). Blood sampling to determine the levels of Visfatin, insulin, HbA1c, fasting glucose before and after 12weeks, were conducted.
Results: Visfatin levels and HbA1c in all training groups and fasting glucose in 2 combined training groups significantly decreased compared with control group (P<0.05). Vo2max was significantly increased in all training groups (P<0.05). No significant difference were observed between groups in body weight, Body mass index, fat mass, insulin levels and resistance insulin.
Conclusion: 12 weeks of combined aerobic-resistance exercise training protocols with were executed intensities through decreasing Visfatin and HbA1c levels and improving aerobic capacity could be helpful in patient with type 2diabetes. In addition to the above benefits, combined exercise training protocols of with intensity of 60-70% maximum heart rate–intensity 60-70% repetition maximum due to reducing fasting blood glucose could give greater benefits to patients.
 
 

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Background: In the event of damage to the skin, the epidermis of which goes to the disintegration of the body, is a wound that is common in diabetics. The purpose of this study was to evaluate Effect of alcohol extract of Nigella Sativa on wound healing in diabetic male rats
Methods: In this study 48 male Wistar rats were divided into 4 groups (control, sham, experimental, empirical two) were tested. The extra pawn injured area of 3 cm to the left of the spine created. Wound healing was examined macroscopically.
Results: The streptozocin diabetic wound healing compared to the control group later showed and wound healing in experimental groups treated with alcohol extract of Nigella Sativa was faster than the control group.
Conclusion: The results showed that the alcohol extract of Nigella Sativa skin accelerate wound healing in normal and diabetic samples.
 

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Background: Peripheral neuropathy is one of the most common problems in diabetic patients. The increased risk of Diabetic Foot Ulceration (DFU) and amputation would be a complication of diabetic neuropathy. The aim of this study was to compare the DFU healing in different severity classification of neuropathy.
Methods: This is a retrospective study that was conducted over a two-year period from April 2016 to March 2018 according to the information of patients records with Diabetes Mellitus (DM) referred to clinic of diabetes and metabolic disorders of Endocrinology and Metabolism Research Institute of Tehran University of Medical Sciences. Wound healing criteria including area, depth and healing duration were studied. Accordingly, changes in the area and depth of wounds were evaluated and reported during the first, third and sixth months after baseline. Data were analyzed using descriptive and inferential statistics using SPSS software version 16.
Results: The results of the study of patients with neuropathic ulcer showed that males and age group of 56 to 65 years had the highest frequencies. In addition, most of these patients suffered from type 2 DM (79%). The rate of wound healing, which was measured by area and depth of wound in three time periods, differed in different severity classification of neuropathy; at mild level of neuropathy the area and depth of wound decreased faster but in severe neuropathy, duration of wound healing in both mentioned criteria has increased. Regarding to the increase in the duration of DM, the healing time increased too. However the rate of wound healing decreased with increased age (p-value = 0.001).
Conclusion: Evidence suggests that early identification of neuropathy can reduce the incidence of DFU and amputation. Due to the slow healing of the size and depth of the wound in diabetic patients with severe neuropathy, it is necessary to prevent DFU by conducting preventive care and educational interventions.