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Background: Diabetes mellitus is a common chronic disorder with multiple disabling long- and shorter-term complications, the majority of which can be controlled if not prevented. The management of diabetic patients is a major drain on both health budgets and time.
Methods: We reviewed the records of 101 patients with diabetic foot ulcer, who had received treatment at either Doctor Shariati or Imam Khomeini hospital.
Results: Out of 101 patients (56.4% male and 43.6% female) with diabetic foot ulcer, 34.7% had eventually undergone amputation.
Conclusion: Our findings highlight the need for control and prevention programmes aimed at reducing the risk factors for and complications of diabetic foot ulcer.

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There are more than 140 million people with diabetes in the world. Iran’s share is estimated at 1.5 million people. The increasing prevalence of diabetes and the longer life expectancy of diabetic patients mean that an increasing number of patients with diabetes are undergoing surgery, and not just for diabetes and its complications, such as end-stage renal disease, retinopathy, peripheral vascular disease, and diabetic foot ulcers. The metabolic stress caused by general anaesthesia and the operation itself makes blood glucose control even more difficult. Stricter pre- and intra-operative glycaemic control reduces the risk of sepsis, cardiovascular events, disability and death, accelerates wound healing and decreases hospital stay. Improved outcome requires pre-operative ascertainment of the type of diabetes, quality of metabolic control, and detection of complications, as well as optimal metabolic and haemodynamic management during the operation. Local anaesthesia is the preferred option in this group of patients because it least interferes with metabolic control. The diet recommended to achieve normoglycaemia will depend on the type of diabetes, pre-operative glycaemic control, and the extent of the planned procedure. In all type 1 diabetic patients and type 2 diabetic patients on insulin or oral hypoglycaemic agents who are to undergo surgery under general anaesthesia, the glucose-insulin-potassium (GIK) regimen is the one recommended by most authors to achieve tight intra-operative blood glucose control, conditional upon blood glucose measurements being available every one or, at most, two hours. Intra-operative blood glucose levels in the 120-180mg/dl ranges are considered satisfactory. Failing this, it is recommended that 50% of the daily NPH requirement be given subcutaneously on the morning of the operation, together with an intravenous glucose infusion intra-operatively. Type 2 diabetic patients with unsatisfactory metabolic control, time permitting, should be admitted several days before the operation and switched to and stabilised on insulin.

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Background: In current medical practice and medical research, most prophylactic, diagnostic and therapeutic procedures involve risks and burdens, ethical standards protect and promote health and rights of human subjects. It is required for researchers and as well as research providers and users of research results to be aware of these standards.
Methods: In this article, international regulations including Nuremberg code (1974), declaration of world medical association of Helsinki, CIOMS Guidelines briefly be reviewed at the first then after some questions about it and answers and, national ethical regulation will be reviewed.
Results: The Nuremberg code (1974) is the first and the Helsinki Declaration (1964) is the most important and valid international ethical standards. That 5th amendment of the latter performed at October 2000 and WHO/CIOMS Guidelines prepared (1982, 1992 and 2000) for its performance in different countries with different situations. The first national ethical regulation for medical researches in Iran is perhaps "medical research regulation" in 1992. Establishment of the "National Ethical Committee in Medical Research" (1998) and compiling the "Codes for Protecting Human Subjects involved in Medical Research" (2000) can help medical research providers for ethical decision making.

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Background: Glucokinase serves as a glucose sensor in pancreatic β-cells and plays a key role in glucose homeostasis and glucose-stimulated insulin secretion (GSIS). In the present study we examined the effect of glucosamine, a glucokinase inhibitor, on the pancreatic glucokinase and hexokinase activities and on insulin secretion from freshly rat pancreatic islets of Langerhans. Insulin concentration was measured by rat insulin ELISA kit. Methods: The pancreatic islets from normal and type 2 diabetic (nSTZ) rats were isolated by collagenase digestion method. Glucose phosphorylation was quantitated by measuring the rate of glucose-6-phosphate formation in the fluorometric assay. Insulin secretion from hand-picked islets was evaluated in static incubation system. Insulin concentration was measured by rat insulin ELISA kit. Results: Our findings demonstrate that glucosamine in a dose dependent manner, reduced glucokinase activity in islet extract, but had no effect on hexokinase activity. The glucose-stimulated insulin secretion, was inhibited by glucosamine but it had no effect on the basal insulin secretion. In diabetic rats glucokinase was decreased while the basal insulin secretion and the activity of hexokinase were higher than normals. Conclusion: Based on results obtained from the present study, the assumption could be made that the decrease in the activity of glucokinase of pancreatic islets could be related to the impaired glucose stimulated insulin secretion. The increase in basal insulin secretion of diabetic rats may be due to an increase in pancreatic hexokinase activity.

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Background:  Pemphigus vulgaris is the most common autoimmune blistering disease. Corticosteroid is treatment of choice for it. Medication can affect many organs and causes metabolic difficulties which steroid- induced diabetes (SID) is one of the most important side effects. Determining risk factors not only help identify diabetes in early stages but also let continuing treatment of underlying disease.                                                

Methods:  Sixty eight patients with recently diagnosed pemphigus vulgaris were recruited. After admitting in hospital they were evaluated for positive family history of diabetes, blood pressure, body mass index (BMI), FBS, HbA1c, TG and HDL. Then they followed with FBS twice per week for 8 weeks.       

Results: Ninety patients (27.9%) developed diabetes. In comparison with non-diabetic group, diabetic group had a significantly higher   HbA1c>6% (NL: 4.5-6.8) or: 8.39 (CI: 1.46- 48.05), TG > = 200 or: 6.56 (CI: 1.64-28.18) and IFG or: 3.11 (CI: 1.04-9.31). There were no differences between the groups in respect of age, positive family history, blood pressure, BMI, HDL.

Conclusion: These findings suggest that HbA1c,TG and IFG are independent risk factors so patients with pemphigus vulgris who are candidates for steroid treatment should be evaluated for HbA1c, TG and IFG before  treatment.                                                    

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Background:  This study was planned to investigate the effectiveness of a short Cognitive Behavioral Group Intervention for Diabetes Mellitus Disease (CBGI-CHD) on quality of life and illness Perception in patients with type 2 diabetes disease.

Methods: Twenty eight patients with type 2 diabetes mellitus who were the members of Iran Diabetes Association, were selected through voluntary accessible sampling .Type 2 diabetes patients were randomly assigned in a 12-week (2.5 –h sessions) cognitive behavioral group intervention for Diabetes Mellitus Disease (n=14) or to a control group (n=14) that received usual care. Quality  of life were  measured  using a Persian version quality of life questionnaire(WHQOL-BREF)  , illness Perception  were measured Using a brief  Illness Perception Questionnaire( brief IpQ ) before and directly after intervention. Data were analyzed with SPSS 19 software, descriptive statistics, covariance analysis and

Results:  Experiment group showed significant increases in quality  of life and illness Perception at post–test, compared with control group (p< %5).In addition ,intervention in, quality of life dimensions  was significant for The experimental group .(p< %5).except the environment dimension.(P>%5).

Conclusion: The results indicate that CBGI-CHD can improve quality of life and illness Perception in patients with type 2diabetes mellitus. The future researches with longer pursuing periods for reviewing efficacy continuation is suggested

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Background: Inflammation plays an essential role in the insulin resistance process, and chemokines, such as chemerin, seem to play a pivotal role in the pathogenesis of insulin resistance. The aim of this study was to compare the effects of aerobic exercise and caloric restriction on chemerin levels and insulin resistance index in women with type 2 diabetes.
Methods: In a quasi-experimental study, 30 type 2 diabetes women were recruited (Mean age: 49.3±5.4 yr; weight: 78.8±7.3kg). Subjects randomly were divided into three groups: caloric restriction (experimental group 1 or CR), aerobic exercise with caloric restriction (experimental group 2 or EX+CR) and control group. In CR group, subjects follow a diet with 25% caloric restriction for 12 weeks. Subjects in CR+EX group used a training program including aerobic exercise and running on treadmill and diet with 50% caloric restriction of CR group (12.5% caloric restriction+12.5% increase in energy expenditure). Before and after 12 weeks, blood sampling for measurement of chemerin, IL-6, glucose and insulin was carried out. Data were analyzed by paired sample t-test and one way ANOVA at significant level of p<0.05.
Results: Results showed that body mass index (BMI), waist to hip ratio (WHR), insulin resistance index (HOMA-IR) and interleukin6 decreased significantly in experimental groups. chemerin levels were increased significantly in CR (P=0.001) and EX+CR groups (P=0.001). Significant correlation were seen between changes of chemerin with changes of BMI, WHR, HOMA-IR and interleukin6 (P<0.05).
Conclusion: According to the relationship between chemerin and insulin resistance and also, its effectiveness of aerobic exercise and caloric restriction, decreased levels of chemerin may play a special role in reduction of insulin resistance.

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Background: Effect of mobile text message on blood glucose (HbA1c) control in providing type 2 diabetes care (diabetes mellitus non insulin dependent).

Methods: The present study is a systematic review with meta-analysis. A search of the most important electronic medical databases of medical resources from December 1992 to January 2017 in a systematic manner, including: CRD, Ovid Medline, PubMed, Cochrane Library, and moreover, by referring to the resources found in the articles and manual search on the site. Related to this technology and, if necessary, contacting experts. All randomized clinical trials and cohort studies were reviewed.
Results: Participants included nine studies (818), all randomized clinical trials, and quality assessment. The average decrease in Mobile SMS Services users compared to the control group (SMD-0.324, 95% CI, -0.526 to -0.121; I2 = 51.0). The analysis of subgroups showed that young patients are more likely to use diabetes programs, and the size of the effect increases with short intervals of interventions and the size of large samples.
Conclusion: Mobile SMS services may be considered as an effective component for helping control glycosylated hemoglobin and as a side intervention for the care of patients with type 2 diabetes.

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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: Adrenomodoline (ADM) is a multifunctional peptide involved in a wide range of physiological processes and cardiovascular function. The purpose of the present study was to compare the effect of physical activity on ADM and nitric oxide (NO) levels and insulin resistance in athletes and non-athletes.
Material and
Methods: 12 athletes and 11 non-athletes participated in this quasi-experimental study. Study participants were selected by convenience sampling.  Both groups performed the Bruce protocol. Blood samples were collected before and after the training session to study the variables. Data were analyzed using one-way analysis of covariance, paired t-test, independent t-test and Pearson correlation.
Results: The results showed that after one session of submaximal exercise activity, HOMA-IR index decreased in non-athlete group (P = 0.034) and NO values increased in both athlete and non-athlete groups (P = 0.001, P = 0.002) and this increase was greater in the athlete group. Also, serum ADM levels were increased in the non-athlete group (P = 0.001) after the training session.
Conclusion: The single session of physical activity with increasing ADM and NO levels, can lead to better vasodilation and improved endothelial function as well as improved insulin resistance in inactive individuals. Since in athletes, only NO levels increased after the end of the activity, it seems that PA has a greater effect on improving the endothelial function of inactive people.

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Background: In Iran, with the advancement of technology and the development of registration statistics, the need to use data mining methods has attracted more attention from researchers. Regression and classification tree is one of the important methods in Big data modeling, which has attracted the attention of many researchers for community control and prediction. The purpose of this study is to determine the influencing variables on the occurrence of complications caused by diabetes.
Methods: This paper is a cross sectional-analytical study. In this research, all diabetic patients covered by Mashhad University of Medical Sciences in 2017 were extracted from the SINA system. The number of diabetics with complications was 5016 and diabetics without complications were 53613. The method of fitting the regression tree model and classification and measurement criteria of the model is the coefficient of determination and the area of the Rock curve and the Lift diagram.
Results: The rock curve for the fitted tree model is 73.8%, which shows the relatively high power of the model. Based on the Lift chart, the decision-making power of diabetes complications increases 3.5 times for the person who comes to visit.
Conclusion: The results of the regression model and tree classification showed that, in descending order, age, risk assessment factor, FBS, HbA1C, total activity time, cholesterol, FBS and HDL, cardiovascular disease, history of stroke, blood pressure, cholesterol Statin prescription, job with hard physical activity, living area, consumed oil, walking, consumption of vegetables and gender are more effective than other factors in the occurrence of diabetes complications.