Iranian Journal of

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The incidence and prevalence of type2 diabetes mellitus is increasing worldwide. Many believe that type 2 diabetes mellitus is a disease that can be prevented by appropriate interventions in individuals at high risk for the disease. A number of studies have therefore looked at primary prevention during the past decade. Iran’s diabetic population of approximately 2 million people and the warning by the World Health Organisation that diabetes is on the rise in developing countries make the primary prevention of diabetes mellitus in Iran doubly important. Researchers have been increasingly focusing on identifying the risk factors for type 2 diabetes and, through these, appropriate strategies to prevent the rapidly growing incidence of this disease in the population at risk. Genetic predisposition (a positive family history), insulin resistance, obesity, impaired glucose tolerance, a history of gestational diabetes mellitus, physical inactivity and an unsuitable diet are among the most important recognised risk factors for type 2 diabetes other factors have also been found to contribute. Most of the available research has evaluated the effect of behavioural or lifestyle modification, in the form usually of dietary education and increased physical activity, in the primary prevention of type 2 diabetes. The second most common approach has been pharmacological manipulation. The information available indicates that type 2 diabetes will come to be considered as a preventable disease within the next decade. The weight of research behind this problem will undoubtedly discover even more effective methods of preventing type 2 diabetes in the near future than behavioural/lifestyle modification.

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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: Family satisfaction in subpopulations referred to the endocrine clinic including diabetic and non diabetic patients and their spouses are compared in the present study. This study also assesses the correlation between family satisfaction and variables such as age, sex, educational level, economic status, type of diabetes, duration of the disease, type of therapy and dosage of drugs. A comparison of the frequency of sexual dysfunction between diabetics and non-diabetic pairs was also done.
Methods: In this case- control study, 400 subjects were selected as simplified non-randomized method from outpatients referred to the Shahre Kord endocrine clinic in 2002. We assigned samples to group I (diabetic patients, n=100), group II (diabetic patients spouses, n=100), group III (non-diabetic patients, n=100) and group IV (non-diabetic patients spouses, n=100). Groups I and II were similar in sex, socioeconomic status and educational level. GRIMS family relationship questionnaire was used to evaluate family satisfaction.
Results: Family satisfaction for diabetics in comparison with non-diabetics (P=0.05), diabetics in comparison with their spouses (P=0.003), and non-diabetics in comparison with their spouses (p=0.002) were significantly less. There was no significant difference between family satisfaction in diabetic and non-diabetic patients spouses (p>0.05). Relative frequency of sexual dysfunction was 76% and 29% and relative frequency of decreased libido was 32% an 12%, in diabetic and non- diabetic couples, respectively. Family satisfaction was less in patients with diabetes type I and whom using higher dosage of drugs.
Conclusion: This study emphasized on the attention to the family as a part of approach to the diabetic patients. According to our results, it is recommended to focus the most attention in this field to the patients with type I diabetes and who consume more amounts of drugs.

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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