Iranian Journal of

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Background: Diabetes Mellitus is a common chronic disease with severe of complications. Proper glycaemic control can prevent these complications considerably. Evaluation of effectiveness of community based and patient centered interventions on glycaemic control, quality of life, patient satisfaction, patient knowledge and reported symptoms were the main aims of this research.
Methods: In a clinical trial, patients referring to Iranian Diabetes Association, who were more than 18 years old, divided to intervention and control group randomly. After three months of general interventions in both groups, including diabetes education and specific interventions including telephone calls, continuous corresponding and sending educational issues in intervention group, changes in variables were studied. Results: Among 52 patients in each group, 17 were male and 42 had type 2 diabetes. The average age was 49 in intervention and 51 in control group. Two groups had no significant difference in age, sex, type of diabetes, treatment method and duration of diabetes, other diseases and education. Both groups showed significant improvement in glycaemic control. The mean reduction in HbA1c was 1.45 in intervention and 0.86 percent in control group the difference is statistically significant (P= 0.02). Patient satisfaction increased in both groups. The satisfaction is significantly higher in intervention group (P=0.000). Knowledge has increased significantly in both groups the difference in groups is not significant. The improvement in Quality of Life was just significant in intervention group. The reported sign and symptoms have not changed in both groups.
Conclusion: Community based and patient centered interventions with emphasis on continuous education and support can improve glycemic control, quality of life, patient satisfaction and patient knowledge in diabetes mellitus.

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Background: Experimental studies have shown that walnut (Juglans regia) intake decreases the risk of coronary heart disease (CHD). Walnut decreases the levels of atherogenic lipids such as TG, LDL-C and VLDL-C. Mainly the effect is induced via 3- Poly Unsaturated Fatty Acids (3-PUFA). Walnuts are a rich source of these fatty acids, especially -Linolenic acid (C18:3 9, 12, 15).
Methods: We assigned 20 hypercholesterolemic male Rats (200-250g) to four groups, and fed with four diet concentration of oil extract Persian walnuts(J. regia)(Lavasanate) (w/w ) as complementary diet: control group (0% oil extract) and cases 5%(1g oil extract/1g weight/1 day) ,7.5%(1.5g oil extract/1g weight/1 day),10%(1g oil extract/1g weight/1 day) for eight weeks.
Results: Results revealed there is a positive effect on the decreasing of TG(14%) ,TC(7.8%) , LDL-C(11%),VLDL-C(12%) serum concentrations, with increasing consumption of oil extract Persian walnuts (5% ,7.5% and 10%).
Conclusion: In view of the positive effect of oil extract Persian walnuts (J. regia) consumption on decrease serum concentration of TG, TC, LDL-C and VLDL-C known as atherogenic lipids and lipoproteins, it may be suggested as a CHD protective dietary supplement.

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Background: Diabetes is a chronic disease which requires patient participation in treatment process. The outcome of the treatment depends on the patient health belief and the cognition about illness. The aim of this study was to clarify the effect of educational intervention focusing on Health Belief Model in health beliefs and awareness of diabetic patients.
Methods: As a clinical trial 64 diabetic patients were selected from 4 hospitals in Tehran in 2006. Patients randomly assigned to two equal number groups, as case and control groups. After determine of education needs using the health belief model, education program were performed in intervention group. Data from each patient was collected by using questionnaire, at the initial visit and two month after education. Parametric and nonparametric tests were used for statistical analysis.
Results: Independent t test didn’t show a significant difference between two groups in the HBM's domains before the educational program (p>0.05). After education the same test indicated a significant difference between two groups (p<0.05), except in perceived barriers and perceived benefits domains (p>0.05). In the intervention group awareness from 11 to 15(p<0.0001), perceived susceptibility from 27 to 30 (p<0.05), perceived severity from 20 to 25 (p<0.0001), self efficacy from 19 to 22 (p<0.0001) and self care behaviors from 95 to 117 (p<0.0001) increased.
Conclusion: Educational intervention focusing on changing health beliefs and increasing awareness may be effective in promoting self care behaviors in diabetic patients.

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Introduction: Mental disorders are common in the elderly.The purpose of this study was to assess the general health status and its related factors among people ≥ 65 years in different districts of Tehran. Methods: This study has used data of the participants ≥ 65 years old in urban health equity and response tool (Urban-HEART) study. Finally the data of 1313 elderly were considered for this study. Variables included demographic characteristics (gender, age, education level, family size, marital status and employment status) and mental health using the Persian GHQ -28 questionnaire (domains: somatic, depression, insomnia and anxiety) and quality of life using the SF12. Results: The mean age of participants was 73.68 (5.91) (women=627 and men=686). GHQ-28 median of scores the participants were 24.00 (22.00)[20.00 (27.00) in women and 19.00 (19.00) in men (P<0.01)].Based on GHQ-28 cut-point 23, 50.2%of the participants had mental health problems, [61.2% women and 40.1% men (P<0.01)].The residents of third municipality districts had the best mental health (26.3% of men and 38.5% of women had mental health problems) and the aged of 20th municipality district had the worst health status (65.7% of males and 84.2% of women had mental health problems).In multivariable logistic regression model, for each year of increment age, 2.9% chance of mental health problems increased (P<0.01). With increasing level of education, mental health status was improved (P trend < 0.01). The relationship between family size and mental health was not significant (P =0.06). Conclusion: Mental health status of the elderly in Tehran was worse than the many other countries. The elderly lived in 20th municipal district, had the worst and the dwellers in the 3th district had the best mental health status.

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Background: Although several tools for evaluating and screening of cognitive status have been introduced, most of them are not applicable in Iranian elderly population because of cultural differences and high illiteracy rate. This study is report of "Brief Cognitive Assessment Tool"(BCAT) was developed as a cognitive status-evaluating test and reported psychometric characteristics.
Methods: the BCAT tool includes memory assessment using three words recall test with a rating similar to Mini-Cog and the functional status including "ability to dress", "ability to use the phone," " ability to manage own medications", among both two sexes and financial management capabilities in men and ability to prepare food in women. Functional rating is different in educated and non-educated people. Diagnosis of dementia is considered, when memory impairment is accompanied by the dysfunction. Eighty-six residents of a nursing home (41 men and 45 women) among who had inclusion and no had exclusion criteria also consent to participate were randomly enrolled. Concurrent validity was shown as correlation coefficient between the BCAT categorization and score of mini meAntal state examination (MMSE). Criterion validity, sensitivity and specificity of BCAT were evaluated based on global deterioration scale (GDS). Reliability of two raters results within two weeks was indicated by Kappa coefficient.
Results: The sensitivity and specificity and accuracy rate of the BCAT based the GDS was 88.6%, 82.6%, and 84.9%, respectively. The correlation between the MMSE score and results of the BCAT classifying was significant. The Kappa coefficient between the results of two raters was 81.1%.
Conclusion: It seems that the BCAT has good psychometric properties to recognize cognitive impairment among Iranian older adults.

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Background: Diabetes is one of the most prevalent chronic illness that is closely associated with some psychological problems, particularly stress. In this case, psychological interventions can be useful. The aim of this study was to investigate effectiveness of Mindfulness Based Stress Reduction (MBSR) on psychosocial adjustment to illness in patient with type 2 diabetes.
Methods: In this study, semi-experimental method (pre-posttest) with control group was used. Population of the study included patients with type 2 diabetes that were member of Iranian Diabetes Society of Tehran. For sampling, 60 patients with type 2 diabetes were considered and then divided in two groups based on random sampling method. Psychosocial Adjustment to Illness Scale was used.
Results: ANCOVA showed that MBSR significantly effect on psychosocial adjustment to illness. Additionally, the results showed that MBSR significantly effect on attitude towards the disease and the social environment (P<0.05).
Conclusion: Findings revealed that MBSR can be effective on increasing psychosocial adjustment to illness in patients with type 2 diabetes. These findings have been inferred that patients with type 2 diabetes need to increase their psychosocial adjustment to illness.
 

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Background: Zinc-Alpha 2-Glycoprotein (ZAG) has recently been implicated in the regulation of adipose tissue metabolism due to its negative association with obesity and insulin resistance. The purpose of this study is to investigate the effect of eight weeks HIIT on level of ZAG in plasma and adipose tissue in type 2 diabetic male rats.
Methods: Twenty one male rats were divided into the three groups of sham control (healthy), control (diabetic), and interval training (diabetic with training). The training group received 8 weeks of training sessions each with 5-12 repetitions of high intensity training for 15-30 seconds at the speed of 27-34 meters per second on a treadmill followed by one minute of active rest. Twenty four hours after the training session blood and body fat samples were taken to measure ZAG levels. The data was analyzed using one-way ANOVA and Tukey’s post hock test at the significance level of 0.05 (P<0.05).
Results: There were significant differences between the sham control and the control with respect to ZAG contents in adipose tissue, which was lower in the diabetic control group (P<0.001). Moreover, significant differences in ZAG contents of adipose tissue were also observed between the sham control and the group receiving the training, with the sham control having higher ZAG contents in adipose tissue (P<0.005). The eight-week HIIT significantly increased the amount of secreted ZAG in adipose tissue compared to the control diabetic group (P=0.003). No significant differences were recorded between the groups in ZAG plasma levels.
Conclusion: The HIIT increased ZAG content in the adipose tissue of the male diabetic rats. This can reduce insulin resistance in type 2 diabetes.

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Background: Inhibitors of α-glucosidase by interfering with digestion of carbohydrates play a role in controlling diabetes. Thymus vulgaris is an herb belonging to the mint family (lamiaceae). The essence of this plant contain the phenols such as thymol and carvacrol, cymene, linalool, pinene. The aim of this study was to investigate the inhibitory effect of the constituents of the thymus vulgaris extract on the activity of α-glucosidase enzyme by molecular docking.
Methods: In this study, to investigate how the compounds are attached to the active site of the enzyme, mapping of chemical structure of the compounds, energy optimization, docking studies and final analysis were carried out by ChemDraw, HyperChem, AutoDock 4.2, DS Visualizer and Lig Pluto software, respectively.
Results: All of the studied compounds were able to occupy the active site of the enzyme, among all of them, the best results of docking was  related to the combination of Caryophlla-4- (12), 8 (13) -dien-5-β-ol. In fact, this compound has the most negative energy level of connection, the highest affinity for binding to the active site of the enzyme and the interaction site is similar to that of the co-crystal molecule.
Conclusion: considering the high efficacy of plant extract compounds in the bioinformatics study, and for complementary studies, the effect of the extract of this plant can be analyzed in order to control the increase of glucose in vitro and in vivo conditions. 

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Background: Type 1 diabetes is a chronic disease that children and adolescents do not have the ability to care for themselves, despite having enough information about their self-care (nutrition, insulin, exercise, etc.). Self-care, such as any behavior, can be influenced by the way of thinking, and the philosophy teaching method can be a suitable educational tool for changing thinking. The purpose of this study was to determine the effectiveness of teaching cognitive errors by philosophy for children on increasing the Well-being and reducing the cognitive errors and the level of glucose in children and adolescents with type 1 diabetes.
Methods: The research method was quasi-experiment with pre-test post-test control group (waiting list) design. The sample included 22 children and adolescents of the Iranian Diabetes Association who responded to the cognitive errors scale of children and adolescents Quinn et al., Well-being Questionnaire (WHO-5) and blood glucose (A1C). To test the hypotheses, MANCOVA was used.
Results: The result of MANCOVA was significant. Subsequently, there were significant differences between cognitive errors (F (17,1) =9/01, P=0/008) and Well-being (F (17,1) =7/4, P=0/01) between two groups, but the level of blood glucose (F= (17,1) =0/01, P=0/8) was not significant.
Conclusion: Learning cognitive errors in the philosophy for children and adolescents leads to the growth of reasoning, the rational thinking of children and adolescents, and helps them to take care of themselves in conditions of failure, stress and anxiety, and improves their emotional well-being. However, it seems that it takes longer to effect on blood glucose.

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Background: Diabetes is a metabolic abnormality in the body caused by the high activity of the α-glucosidase enzyme in the hydrolysis of carbohydrates to glucose. Alpha-glucosidase inhibitors involved in the digestion of carbohydrates, play a key role in controlling diabetes. Thymus vulgaris is a species of flowering plant in the mint family Lamiaceae with a chromosome number of 2n = 30. The essential oil of this plant has phenolic compounds such as thymol, carvacrol, cymene, linalool, and pinene. The aim of this study was to investigate the inhibitory effect of the main compounds found in the thyme extract on the activity of alpha-glucosidase by in vitro methods.

Methods: Extract was used to dissolve thyme powder in distilled water solution. The inhibitory effect of the extracts on the activity of alpha-glucosidase enzyme was investigated. In this experiment, the concentration of each extract that was required to inhibit 50% of the enzyme activity (IC 50) was obtained and compared with the needed acarbose as a positive control.

Results: the results showed that aqueous extract of thyme Thymus vulgaris in all three concentrations (40, 20, 10, and 5 mg/ml) can inhibit the enzyme. And as expected, the concentration of 40 mg / ml was exercised the highest inhibitory effect on the enzyme. IC50 of aqueous extract of thyme Thymus vulgaris was equal to 29%.

Conclusion: Considering the effectiveness of plant extract compounds in in silico and in vitro studies, for supplemental studies, the effect of these plant compounds can be analyzed in vivo conditions.

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Background:  Diabetes mellitus is a group of metabolic disorders that are associated with elevated blood glucose levels due to impaired insulin secretion, insulin function, or both. alpha-glucosidase is a key enzyme in hydrolyzing carbohydrates and raising blood sugar levels. This study aimed to investigate the bioinformatics of inhibition of the alpha-glucosidase enzyme by the main constituents of Salvia officinalis.
Methods: This research was done by descriptive-analytical method. To study how the compounds interact and the amount of binding energy in the active site of the enzyme, the three-dimensional structure of the compounds and proteins were obtained from PubChem and PDB database, respectively. After energy optimization by Hyperchem software, docking studies were performed by AutoDock 4.2 software and the Swiss ADME server was used to obtain Lipinski parameters and physical and chemical properties of the compounds.
Results: The studied compounds were similar to the two positive control compounds, Voglibose and miglitol, in terms of binding energy and how they interact. The best docking results are related to the camphor . In fact, this compound with the most negative binding energy level (-3.95 Kcal / mol) has a greater tendency to bind to key amino acids in the active site of the alpha glucosidase enzyme.
Conclusion: Due to the appropriate interactions of Salvia officinalis.compounds with enzymes, after confirming the results in vitro and in vivo, this plant can be used as a suitable drug candidate in the treatment of diabetes.

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Background: The health and proper functioning of the endoplasmic reticulum in the liver can lead to an increase in the quality of the metabolism of liver cells. Exercise can lead to liver health by regulating liver enzymes and factors related to apoptosis pathway. Therefore, the aim of the current research is to compare the performance of the endoplasmic reticulum chaperone protein of the liver of healthy model rats with the intervention of different training sessions and starvation.
Methods: In this experimental research, 30 Wistar male rats with a weight range of 330 ± 25 grams were selected and divided into six groups: 1) control, 2) starvation, 3) 3 days of training per week, 4) 5 days of training per week, 5) starvation + 3 training days per week, 6) starvation + 5 training days per week. Training consisted of one hour of continuous running on a treadmill for 4 weeks, and starvation was performed for 14 hours when the rats were awake. Data analysis was performed using one-way analysis of variance and post hoc LSD statistical tests in SPSS version 23 software. A significance level of P≤ 0.05 was considered.
Results: Data analysis showed a significant change in the levels of liver enzymes alanine aminotransferase (ALT) and aspartate transaminase (AST) (P≤ 0.05). This change in CHOP gene expression was also significant (P≤ 0.05).
Conclusion: Aerobic training for 3 and 5 days with starvation can lead to liver health by reducing liver enzymes (AST and ALT) and cell death-related factor (CHOP) through the apoptosis pathway.