Iranian Journal of

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Background: Estimation of cost effectiveness and cost benefit are intrinsic to the design and evaluation of healthcare systems. The aim of most studies of gestational diabetes screening has been to modulate screening parameters to reduce the eligible population and therefore costs. We analysed the findings of a cross-sectional study of gestational diabetes mellitus carried out in Tehran to determine the screening method best suited to the socio-economic profile of our population.
Methods: 2416 pregnant women were universally screened in Tehran teaching hospitals. Each patient’s risk factors and laboratory results were recorded. The 50gGCT was used to screen and the 100gOGTT to confirm a diagnosis of GDM.
Results: Switching from the 130mg/dl to the 140mg/dl threshold, case-detection sensitivity declined by 12% (to 88%), with the per-pregnancy cost dropping from 30,410 to 25,641 Rials (from US$3.80 to 3.20) [-15.6%], and the cost per detected case from 644,488 to 619,500 Rials (from US$80.56 to 77.43) [-3.87%].
Conclusion: We recommend adoption of the universal screening approach in Iran for 4 reasons: (1) The high prevalence of gestational diabetes in the low-risk group (2) The poor level of healthcare provided in Iran compared with societies that have opted for the selective approach (3) The lower cost of screening and diagnostic tests in Iran compared with the aforementioned and (4) The high cost of treating the complications of diabetes.

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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: The American Heart Association used the findings of the Framingham Heart Study to design an equation that quantifies the risk of coronary heart disease (CHD).
Methods: The variables in this equation are age, total cholesterol, HDL-cholesterol, systolic blood pressure, cigarette smoking, diabetes mellitus and evidence of left ventricular hypertrophy on electrocardiography. We calculated the CHD risk of 139 patients, with type 2 diabetes mellitus, who attended our diabetes clinic. We also assessed risk factors not taken into account by the Framingham equation, such as obesity (body mass index (BMI) or waist-hip ratio (WHR)), plasma triglyceride, LDL-cholesterol (LDL-C), and diastolic blood pressure (DBP). We used the linear regression and one-way ANOVA functions on the SPSS.v6 software to analyze our data.
Results: Ninety-one women and 48 men enrolled in the study. Men had a higher five- and ten-year CHD risk than women. 36.4% of our subjects had plasma HDL-C <35mg/dl. The TC:HDL-C ratio was 6.18±1.76 in men and 5.97±2.21 in women. We found no significant correlation between two- and five-year CHD risk and WHR, BMI or triglyceride levels. There was a significant correlation between two- and five-year CHD risk and DBP (p=0.0006 and p=0.0001) and LDL-C (p=0.005 and p=0.001).
Conclusion: Patients with diabetes mellitus have a higher, but smaller than expected, risk of CHD. The value of the Framingham equation in diabetic patients is equivocal, given the absence of correlation between obesity markers and CHD risk. Larger, prospective, studies are needed to clarify the matter.

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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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Introduction: The prevalence of type 2 diabetes is increasing daily all around the world and is a serious threat to the well-being of the community in terms of renal failure, cardiovascular disease, blindness, and neuropathy. The assessment of difference screening approaches is of great importance in this disease. We compared ADA and WHO criteria for the diagnosis of type 2 diabetes.
Methods: 982 individuals (age range: 30 to 64 years), residents of the city of Bushehr, were chosen by systematic random sampling for this study, each providing a fasting blood sample for a standard oral glucose tolerance test. Plasma glucose was measured by the glucose oxidase-peroxidase method, using a Technikon RA1000 autoanalyser. Data was analysed with the Chi-squared and Student’s t tests and, when required, Fisher’s Exact test.
Results: 354 (36%) men and 628 (64%) women took part in this study. 42.9% were in the 30-39 age group. 69 (20 men and 49 women) of the 982, that is 7% of the sample, had known diabetes before recruitment into the study. The crude prevalence of type 2 diabetes and impaired glucose tolerance using WHO criteria was 13.6 and 15.6 percent, respectively. The crude prevalence of type 2 diabetes using ADA criteria was 13.4 percent. 51% of patients were already aware of their disease. The sensitivity of fasting blood glucose testing for detecting diabetes was 45.8% using WHO and 62.5% using ADA criteria. Both sets of criteria were equally specific.
Conclusion: Given the overall prevalence of glucose intolerance (impaired glucose tolerance and type 2 diabetes) in Bushehr, it should be considered as a high-prevalence area for diabetes. Accordingly, we recommend screening with fasting plasma glucose and oral glucose tolerance testing.

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Introduction: In patients with type 2 diabetes, triglyceride (TG) is usually increased, HDL decreased, and LDL normal. This pattern is associated with an increased risk of coronary heart disease. More recently, dense-particle LDL has been identified as an important risk factor for coronary heart disease.
Methods: 298 patients with type 2 diabetes attending the diabetes clinic at Doctor Shariati University Hospital underwent anthropometric and biochemical assessment. Anthropometric measurements followed WHO criteria. Biochemical indices (apoB100, TG, cholesterol, LDL, LDL particle size, HDL, and apoA1) were measured using standard laboratory methods. One-way ANOVA was used to analyse data with SPSSv6 software.
Results: Mean patient age was 55±13.2 years. Mean duration of diabetes was 9.5±6.1 years. The majority of patients were moderate to severely overweight. 73.2% of patients had some form of hyperlipidaemia. 20.7% had isolated hypertriglyceridaemia, 21% isolated hypercholesterolaemia, and 31.5% mixed hyperlipidaemia. Mean apoA1 concentration was higher than normal in this group, and mean apoB100 concentration lower. LDL particle size generally followed a small and dense pattern.
Conclusion: This study shows that LDL particles in both men and women with type 2 diabetes undergo both qualitative and quantitative changes. 35.5% of patients had smaller, denser LDL particles than normal. It appears that dyslipidaemia and B-pattern LDL particles are important risk factors for atherosclerosis in this group.

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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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Introduction: Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance occurring or detected for the first time during pregnancy. Hypertension occurring as a result of pregnancy is called pregnancy-induced hypertension (PIH), which is itself divided into two groups: gestational hypertension and pre-eclampsia. The aim of this study is to compare the incidence of hypertensive disorders in patients with GDM and controls.
Methods: This is a case-control study of 2416 pregnant women attending 5 antenatal clinics attached to Tehran University of Medical Sciences. The universal two-step screening approach was used: first, all women underwent a 50-gram 1-hour glucose challenge test second, all women with a 1-hour blood glucose concentration higher than 130mg/dl underwent a 100-gram, 3 hour oral glucose tolerance test. Carpenter and Coustan’s criteria were used to diagnose GDM. 220 women with a normal glucose challenge test were chosen as controls. GDM cases and controls were matched for age, body mass index, parity, and gestational age.
Results: 114 women overall were diagnosed with GDM. Mean age, BMI, and parity in GDM and control groups were 29.09±6.13 and 28.64±6.00 years, 27.43±4.33 and 26.64±1.8 kg/m2, and 1.79 and 1.52 births, respectively. Women with GDM had a higher prevalence of essential hypertension, PIH, and pre-eclampsia than matched controls.
Conclusion: Our results show that hypertensive disorders are more common in women with GDM than in normoglycaemic controls of similar age, parity and BMI.

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Background: Cardiac X Syndrome is the occurrence of angina pectoris in spite of a normal coronary angiogram, probably due to a disorder of the cardiac sensory nervous system (pain perception). The insulin resistance (metabolic X) syndrome is an important determinant of coronary artery disease. There is a dearth of research on the association between insulin resistance and cardiac X syndrome. We compared the hormonal status of three groups of postmenopausal women: those with cardiac X syndrome, those with coronary artery disease, and healthy controls.
Methods: 149 postmenopausal women (age range 48-58 years), matched for duration of menopause, were recruited for this study. Gonadotrophin and fasting insulin levels as well as blood pressure and body mass index were measured in all three groups.
Results: LH, FSH, oestradiol and progesterone levels were similar in all three groups. Women in the first two groups (that is, those with angina pectoris regardless of the result of coronary angiography) had a significantly higher BMI than controls. Fasting insulin levels were significantly higher in the first two groups compared with controls (p<0.01). There was no difference in fasting insulin level between the normal and abnormal angiography groups. There was no significant correlation between fasting insulin and any of the other variables, even though the association between fasting insulin and BMI in the abnormal angiography-confirmed CAD group very nearly approached statistical significance (p=0.059).
Conclusion: Women with angina pectoris, regardless of the outcome of coronary angiography, have hyperinsulinism and a higher BMI than controls. It seems that hyperinsulinism is the fundamental mechanism by which both the cardiac X and metabolic X syndromes occur. Further research is needed to elucidate this matter.

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Background: Diabetes is a hidden epidemic and the most common metabolic disorder in the world. Immune dysfunction (cellular and humoural) is one of the consequences of diabetes, including defects of phagocyte function, notably in chemotaxis, phagocytosis, and killing. Results of studies on phagocyte respiratory burst activity, however, have been contradictory. We studied the respiratory burst of peripheral blood neutrophils and monocytes separately in response to formyl-met-leu-phe (fmlp) and phorbol-12,13-myristate acetate (PMA).
Methods: 36 patients with type 2 diabetes (mean age 53±7 years) and 20 healthy controls (mean age 50±5 years) each provided a 15ml blood sample. Peripheral blood neutrophils and monocytes were separated and purified (>95%) using specific density gradients and short-term culture. We then separately assessed respiratory burst activity in response to fmlp and PMA by the semi-quantitative nitroblue tetrazolium (NBT) test.
Results: Following stimulation with PMA, diabetic neutrophils showed reduced respiratory burst activity compared with normal neutrophils (p=0.097). Following stimulation with fmlp, too, diabetic neutrophils showed reduced respiratory burst activity compared with normal neutrophils, which this time was statistically significant (p=0.027). There was no difference between diabetic and normal subjects with regards to monocyte response to either fmlp or PMA.
Conclusion: It appears that the diminished response and reduced effectiveness of the phagocyte system in people with diabetes can facilitate the onset, exacerbation, and persistence of infection.

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Diabetes mellitus is characterized by several adverse consequences among which diabetic foot is a major complication. With a life long incidence of 15%, diabetic foot is accountable for more than 50% of non-traumatic lower limb amputations. Regular care, proper footwear and early treatment, but, have proved effective measures in preventing such outcome. The problem and features as infection, ulceration, or gangrene. Neuropathy, poor circulation, and decreased resistance to infection are the three major contributors to the development of diabetic foot which when present, foot deformities or minor trauma can readily lead to ulceration and infection. Not all diabetic foots are preventable, but appropriate preventive measures can dramatically reduce their occurrence.

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Background: Diabetes type 1 is characterized by autoimmune destruction or primary dysfunction of pancreatic  cells. The more common form is the autoimmune type, which can be associated with other endocrine malfunction such as adrenal insufficiency and Hashimoto’s thyroiditis. Autoimmune thyroiditis is characterized by presence of anti TG, anti TPO and anti TSH antibodies in the plasma. This study has investigated the prevalence of autoimmune thyroid disorders in type 1 diabetic patients.
Methods: 200 type 1 diabetics and 200 age/sex matched non-diabetic controls were recruited. Blood samples were taken to determine serum levels of thyroid hormones (T3RU, T3, T4, and TSH) and antithyroid antibodies.
Results: TG-Ab and TPO-Ab levels were significantly higher (P<0.001) in diabetics compared to controls (mean TG-Ab: 955.7±495.5 in diabetics and 451.0±189.5 in controls mean TPO-Ab: 463.2±182.3 in diabetics and 112.4±38.3 in controls). Clinical and subclinical hyperthyroidism was four times more common in diabetics. Conclusion: It seems reasonable that type 1 diabetic patients, especially those at younger ages, be screened for thyroid hormones and anti-thyroid antibodies

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Background: Early detection of carbohydrate intolerance is important to prevent maternal and perinatal complications. This study aims to determine association of symptoms and clinical feature with different degree of carbohydrate intolerance in comparison with healthy pregnant women.
Methods: Two thousand four hundred sixteen pregnant women referred to five university hospital clinics were followed up until delivery. Previously known diabetic patients were excluded from the study. The universal screening was performed with a 50-g 1-hour glucose challenge test (GCT). Those with plasma glucose 130mg/dl underwent a 100-g 3-hour glucose tolerance test (GTT) to diagnose gestational diabetes mellitus (GDM) according to Carpenter and Coustan criteria. Also based on result of GCT and GTT all pregnancy divided to four groups GDM, impaired GCT (IGCT), impaired GTT (IGT) and normal pregnancy. Family and obstetric histories were taken followed by a complete physical examination included: BMI and blood pressure measurements, excess weight gain during pregnancy, proteinuria, glycosuria, polyhydramnios, and edema. Symptoms were considered were as followed: polyuria, polydipsia.
Results: Among the 2416 pregnant women, 114(4.7) were diagnosed with GDM. Of the 114, 42(36.8%) were obese, 39 (34.2%) had glycosuria, 5 (4.3%) had pre-eclampsia, , 22 (19.2%) had abnormal excess weight gain during pregnancy. The most important symptoms were polyuria (14.9%), polydipsia (12.6%). In comparison with healthy group, GDM patients had a significantly higher BMI, glycosuria, polyhydramnios, proteinuria, and excess weight gain. Association of these symptoms in GDM patients was significantly different from that in healthy pregnant women. Out of 114 GDM patients 59 (51.7%) did not have any symptoms or any abnormal clinical features.
Conclusion: The rate of asymptomatic patients in different level of carbohydrat intolerance indicates that symptom – based screening would miss many subjects. Despite clinical feature is not a reliable basis for screening GDM patients, it maybe used to improve maternal surveillance.

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The current challenge in health services research is disability to present comprehensive and effective intervention plans for community health promotion. There are numerous reasons in this regard, some of which can be overcome through performance-based participatory research methods. The Population Research Center (PRC) in Tehran University of Medical Sciences (TUMS) provides the necessary ground: 1) to innovate original methods in participatory research that are compatible with our native culture, and 2) to make the results of the population research applicable to the whole society through target-based executive steps. The steps to implement health promotion (known as Planned Approach To Community Health) include: acquirement of people’s participation, health needs assessment, priority setting for health problems, designing health interventions, and evaluation of the activities. Those parts of this approach, which are mainly concerned with needs assessment in the area of endocrinology and the causal factors of related diseases, have been accomplished. The next step in this field is to plan appropriate intervention projects and to put them into practice through the principles of community participation and community empowerment.

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Introduction: Urbanization, establishment of sedentary life style and unhealthy diet in association with environmental stress has led the cardiovascular risk factors to prevail in the metropolitan city of Tehran. Survey of lifestyle related cardiovascular risk factors is one of the priorities of Tehran university population laboratory in the 17th zone of Tehran.
Methods:1573 inhabitants of 17th zone of Tehran were recruited by one stage cluster random sampling according to the model of WHO MONICA project.
Results: 58.6% of men and 64% of women had BMI ≥ 25 kg/m2. 41.7% of men and 37.6% of women had hypertension. 8.9% of men and 12.2% of women had diabetes. 34.4% of men and 44.6% of women had total cholesterol ≥ 200 mg/dl. 34.1% of men and 32.6% of women had triglyceride ≥ 200 mg/dl. 34.7% of men and 4.2% of women were regular smokers. 21% of participants had positive family history of cardiovascular disorders.
Conclusion: The prevalence of hypertension in this region is high, that of dyslipidemia relatively lower than the other studies performed in Iran. The prevalence of Diabetes and overweight /obesity is high and comparable to other Iranian studies. It seems that the population of this zone is at high risk for stroke and then coronary heart disease. This fact must be considered in the future interventional programs to control cardiovascular risk factors in the region.

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Introduction: Metabolic syndrome includes obesity, hypertriglyceridemia, glucose intolerance, hypertension and lipid profile abnormalities. The risk of cardiovascular diseases with this syndrome is higher than every components alone. In view of its burden and high mortality rate, this syndrome should be noted.
Methods: The 25-64 aged individuals in 17th zone of Tehran were studied. It was designed according to the WHO MONICA (Multinational Monitoring of Trends and Determinants in Cardiovascular Disease) project using the ATP III criteria. The parameters have been used for the risk analysis were Waist Circumference (WC), fasting serum triglycerides (TG), high density lipoprotein-cholesterol (HDL-C), blood pressure (BP) and fasting plasma glucose (FPG).
Results: The crude prevalence rate of the metabolic syndrome was 29.9% and the age-adjusted prevalence was 27.5%. The prevalence increased with age. The highest prevalence among different age-groups was seen in women aged 55-64 years. In the whole population, the most metabolic abnormalities were hypertriglyceridemia and hypertension that were present in more than half of the population. The people with metabolic syndrome had higher BMI than rest.
Conclusion: Results demonstrate high metabolic syndrome rate among target population specially in women. In view. of correlation between metabolic syndrome and cardiovascular disease, it must be the priority of interventional preventive measures. Improving the diet, changing the lifestyle and increasing physical activity can be helpful.

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Introduction: Nutrition plays an important role in the protection and promotion of health. To plan and implement programs aiming at improving community nutritional status, a knowledge of the existing situation is essential. The aim of this cross-sectional study was to determine food and nutrient intakes of the inhabitants in Tehran University of Medical Sciences population laboratory.
Methods: In a sample of 310 women and 185 men, selected by clustered random sampling, food intake was determined using the 24-hour dietary recall (on two non-consecutive days). Weights and heights were also measured on the first visit. For analysis of data, Dorosti Food Processor, Diet Analysis plus and SPSS software were used.
Results: The average (mean ± SD) intakes of energy, protein, carbohydrate, total fat, saturated fat, cholesterol, vitamin A, B2 ,B6 ,B12, folic acid, zinc, iron, and calcium were 2902±336cal, 88±15gr, 461±69gr, 80±19gr, 27±7gr, 272±112mg, 943±319µgr RE, 1.2±.35mgr, 1.2± .37mg, 2.9±2.67µgr, 294±73.7µgr, 10.48± 2.25mg, 28.90±5.81mg, and 537±123mg in men, and 2226±234cal , 66±11gr, 344±41gr, 70±14gr, 22±6gr , 205±85mgr ,882±291µgr RE, .88±.22mg, 1.14± .24mg, 2.2±2.07µgr, 270±60.7µgr, 8.65±1.62mg, 22.66±4.27mg, and 433±113mg in women, respectively. The average (mean +SD) daily numbers of servings of the food guide pyramid main groups, namely, grains, fruits, vegetables, dairy, and meat were 12.74±3.80 ,1.52±1.44, 4.30±2.74, .97±.72 , and .9±.98 in men, and 9.8±3.3, 2.87±2.06, 2.88±2.40, .82±.60, and .86±.84 in women, respectively. Most of these intakes are under current recommendations. Thirty eight percent of the men and 23% of the women had a daily cholesterol intake of at least 300 mg. In addition, the proportions of the men and women with a daily total fat intake of at least 75 gram was 43% and 35%, respectively.
Conclusion: The findings show that while the intake of most micronutrients is lower than respective RDAs, the intake of fat and cholesterol are higher than the current recommendations. This indicates that the community is undergoing nutrition transition. It is recommended that further studies be conducted to identify more comprehensively nutritional problems of the community in question, so that appropriate programs can be prepared and implemented.

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Introduction: Elevated plasma total homocysteine is an independent risk factor for cardiovascular disease and a sensitive marker of vitamin B12 and folate insufficiency. Folate and vitamin B12 have a protective effect on cardiovascular disease. This effect may be partly explained by mechanisms independent of homocysteine. This survey is the first population based study to evaluate the plasma total homocysteine, folic acid and vitamin B12 in 1214 healthy Iranian persons.
Methods: This study which was a part of the Cardiovascular Risk Factors Survey in the Population Lab region, has been designed and conducted based on MONICA/WHO project. A total of 1214 people have been recruited and assessed on serum homocysteine, folic acid and vitamin B12 with interview, questionnaires, examination and blood sampling. Blood samples were gathered in Venoject tubes and analyzed according to standard methods.
Results: The variables were assessed in 1214 participants include 428 men (35.3%) and 786 women (64.7%). Prevalence of hyperhomocysteinemia was 96.4% in men and 83.3% in women (p<0.0001). Geometric mean of serum homocysteine was 19.02 ± 1.46 µmol/l in men and 14.05± 1.45 µmol/l in women (p<0.004) and increased with age. Folic acid deficiency was seen in 527 (98.9% )men and 833 women (98.0%). 161 (30.1%)men and 232(27.2%) women had vitamin B12 deficiency.
Conclusion: These results revealed that the prevalence of hyperhomocysteinemia, folic acid and vitamin B12 deficiency was higher than other communities considerably. Preventive interventions as food fortification with folic acid is necessary.

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Background: Diabetes is one of the most common chronic diseases worldwide. The number of diabetic patients in Iran is estimated 1.5 million. This survey has been conducted to evaluate diabetes and impaired fasting glucose status among 25-64 aged inhabitants of 17th zone of Tehran, selected as Population Lab region.
Methods: This study is a part of the Cardiovascular Risk Factors Survey in the Population Lab region. This survey has been designed and conducted based on MONICA/WHO project. A total of 1573 people have been recruited and assessed on age, weight, height, waist and hip circumferences. Body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) were determined for comparing between groups. The known diabetic cases were found as history of taking antihyperglycemic agents or report of their family physician and new cases were diagnosed as FPG≥126mg/dl according to the ADA 2004criteria.IFG was determined by 100≤FPG≤126.Adjusted prevalences are calculated according to the 1375 census data.
Results: type 2 diabetes prevalence was 10.9% and the prevalence of IFG was 5% in this population. The age adjusted prevalences were 9.3% and 4.5% respectively. prevalences were higher in women than men in all age groups. people with diabetes had higher body mass index, waist, waist to hip ratio, mean systolic and diastolic blood pressure(p<0.05).9/8% of diabetic patients were unaware of their disease.
Conclusion: These results revealed that the prevalence of diabetes among women was higher than men. This finding may be in part because of little physical activity .Proper and effective planning to achieve the applied strategies for improving the social knowledge and awareness and also improving the life style of the people is highly necessiated.

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Celiac disease and typel diabetes mellirus have been linked to the same HLA markers and chromosomal loci, which may account for the concurrence of the two disorders in a significant number of patients. This study was designed to investigate the frequency of anti-gliadin antibodies, a marker for celiac disease, in diabetic patients.
Methods: In this study, 182 diabetic patients (52 with typel and 130 with type2 diabetes) were screened for anti-gliadin IgG by indirect immunofluorescence. Age range was 3-29.5 and 42-65 years for type 1 and type 2 diabetes groups.
Results: Anti-gliadin IgG was found in 1.9% and 1.5% of patients with type land type 2 diabetes. In Tehran, 0.02% of healthy blood donors have been reported to be seropositivitive for anti-gliadin IgG.
Conclusion: The prevalence of anti-gliadin seropositivity in type 1 and type 2 diabetics, was respectively 30 and 24 times higher than the general population of Tehran. This concurs with other reports indicating higher occurrence of celiac disease in diabetic populations. The rather low sensitivity and specificity (both around 80%) of the antigliadin antibody test has made it a suboptimal diagnostic test. However, it is quick and inexpensive and can be suitable for screening programs. We recommend the test in all at-risk populations including diabetics.