Iranian Journal of

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At least 2 million people are affected by type II diabetes mellitus in Iran. Neuropathy is one of the commonest complications of diabetes affecting the quality of life of patients and can result in foot ulcer and amputation. The current study aimed to examine possible factors that could alter development of diabetic neuropathy.
Methods: In this case-control study, 110 diabetic patients were selected from Shariati hospital diabetes clinic. Michigan Neuropathic Diabetic Scoring (MNDS) was used to distinguish cases from controls. The neuropathic status of patients was confirmed with EMG-NCV. Multiple factors were compared between the two groups including ACE-I consumption, blood pressure, serum lipid level, sex, smoking, method of diabetes control and its quality.
Results: Statistically significant relations were found between neuropathy and age, gender, quality of glycemic control and duration of diabetes (P values: 0.04, 0.04, 0.000 and 0.005, respectively). No correlation existed between atherosclerotic risk factors (high BP, hyperlipidemia, cigarette smoking) and diabetic neuropathy.
Conclusion: In this study, hyperglycemia was the only modifiable risk factor for diabetic neuropathy. Glycemic control can decrease the incidence of neuropathy and delay its progression leading to improvement in the quality of life in diabetics. Aged and male diabetic patients and those with poor diabetes control are groups in most need of regular foot exam and more practical educations.

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Depression is one of the most prevalent mental disorders in diabetics, which affects treatment course and disease prognosis. This study focuses on the association between diabetes and depression as well as depression and glycemic control.
Methods: 375 diabetic patients (type I and II) of diabetes clinic of Doctor Shariati Hospital and diabetes association of Iran participated in this cross-sectional study.Patients were screened for depression with Beck Depression Inventory. Then depressed subjects were
evaluated with DSM IV criteria for determination of the depressive disorders category.
Results: Depression was diagnosed with Beck Depression Inventory in 41.9% of patients. Of these patients major depressive disorder was defined in 23.7%, dysthymic disorder in 9.3% and association of two disorders in 0.8% of patients. Major depressive disorder was more prevalent in 31-59 year old group and dysthymic disorder in more than 60 year age group. Also depression was more prevalent in
women, diabetics with uncontrolled blood glucose and patients with diabetes complications.
Conclusion: Depression is a prevalent psychiatric disorder in diabetics, which is associated with female gender, poor glycemic control and diabetes complications. Therefore, glycemic control and prevention and treatment of diabetes complications can prevent depressive disorders in diabetics.

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Background: Gliclazide is a second generation sulfonylurea which its efficacy and safety in the treatment of diabetes has been established. Diamicron MR (30 mg) is a new formulation of gliclazide with modified release which offer once daily dosage administration. This study was designed to assess the effect of combination therapy with diamicron and metformin in the treatment of type 2 diabetes. Methods: 16 patients with type 2 diabetes (2 males, 14 females) more than 35 years old who despite treatment with glibenclamide and metformin had poor diabetes control participated in this clinical trial.HbA1c, lipid profile, liver and renal function tests at the end of study were compared with before. Results: No significant changes was found in FBS, BS2hpp, lipid profile and renal and liver function tests at the end of study. Patients' weight was stable during the study.
Conclusion: Regardless of well efficacy of diamicron in the treatment of new diabetics cases, it is not recommended for patients with poor diabetes control despite of combination therapy with metformin and glibenclamide.

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Background: Cardiovascular disease is one of the major leading cause of death in Iran. There is a strong association between parental history of cardiovascular disease clustering of risk factors in the offspring. Detection and treatment of cardiovascular risk factors since childhood is essential to reduce the incidence of disease in adulthood. This study was performed to identify major cardiovascular risk factors in middle school-aged children and their parents in high risk compared to control families.
Methods: The middle schools of the 6th of Tehran were divided randomly into two groups. A total of 169 high-risk children with their families were recruited from the first group while 105 control children with their families were recruited from the second group of schools. Coronary risk factor survey was performed in the participants.
Results: Prevalence of increased total- and LDL-cholesterol and high FBS were higher in high-risk parents and children. Prevalence of increased BMI was higher in fathers and children of high-risk families. More fathers in high-risk families were smoker. The means of waist circumference and WHR were significantly higher in high-risk fathers. The means of total- and LDL- cholesterol were significantly higher both in parents and children of high-risk group. The means of FBS were significantly higher in fathers and offspring of high-risk families. Conclusion: Cardiovascular risk factors are more prevalent and clustered in high-risk families. Screening of these families is essential to prevent progression of cardiovascular disease since childhood and reduce its burden in adulthood.

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Background: Cardiovascular Diseases are becoming increasingly prevalent due to urbanization and industrialization of our country. Therefore Screening of the Cardiovascular Risk Factors is one of the most important health system priorities. The aim of this study was to evaluate a screening method implementing family history for cardiovascular risk factors.
Methods: We chose 10 Junior-high schools in the 6th district of Tehran using simple random sampling. Then a questionnaire asking about family history of cardiovascular disease in the first degree relatives (including grand parents) was distributed between them and was completed – with contribution of parents. Then high-risk and low-risk families were invited separately to Dr Shariati Hospital for further evaluation. SPSS software version 10 using student T-test, Chi-Square and descriptive tests were applied for data analysis
Results: Approximately 40% of families had positive family history (high risk). From this group, 72% participated for follow-up. From the low-risk group, only 34% participated. Total cholesterol and LDL-C levels were significantly higher in high risk (HR) group. FBS was also significantly higher in fathers and children of the HR group (P<0.05). High TC, LDL-C and FBS levels were more prevalent among the HR families (P<0.05). No significant differences were observed in age, BMI, BP, TG and HDL-C between the 2 groups.
Conclusion: Families with a history of cardiovascular disease participated in greater numbers in the screening process and the prevalence of risk factors in this group was significantly higher. The findings confirm the usability of family history in screening programs.

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Endocrinology and Metabolism Research Institute (EMRI) was established in 1993. EMRI has progressed step by step from the beginning and has reached maturity in the last 25 years. EMRI has expanded, advanced in human resources and infrastructures (laboratories and new technologies) and gained first rank in endocrine research in various fields. It has also worked with regional and international organizations such as the World Health Organization (WHO), the International Osteoporosis Foundation (IOF), and the American Clinical Endocrine Society (AACE). This article provides an overview of EMRI activities over a quarter of a century.

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Background: Endocrinology and Metabolism Research Institute (EMRI) is one of the largest research institutes in Iran, which has been established to develop research strategies and manage endocrine and metabolic diseases such as diabetes. The purpose of this report is to review and summarize research activities related to diabetes over a quarter of a century at EMRI.
Methods: A comprehensive search of PubMed, Scopus and EMBASE was conducted to find diabetes-related studies in EMRI. After extracting the data, the articles were classified according to the type of article, the level of evidence, the types of diabetes and their subject.
Results: After eliminating duplicates and screening, finally 228 articles were classified. Most diabetes research conducted at the Diabetes Research Center (DRC) was on type 2 diabetes (37%). By article type, most of the articles were original. In addition, clinical studies provided the most evidence in the obtained documents. By topic, most of the articles were related to the basic sciences and factors related to diabetes, followed by studies on the management and prevention of diabetes.
Conclusion: Most of the research conducted in the Diabetes Research Center in the past quarter of a century is of original studies in the field of basic sciences in the field of type 2 diabetes and most of the evidence produced is related to observational studies.

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Sodium-glucose transporter-2 (SGLT-2) inhibitors are a relatively new class of anti-diabetic drugs with potent effect in glycemic control and weight loss, as well as beneficial effects in the prevention and control of cardiac and renal complications in non-pregnant patients with type 2 diabetes. However, there is no enough clear and strong evidence about the beneficial or adverse effect of SGLT-2 inhibitors usage during pregnancy for management of gestational diabetes (GDM) in human. This short letter discusses challenges in application of SGLT-2 inhibitors in management of GDM.