Iranian Journal of

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Background: Overcoming barriers associated with diabetes is considered a logical infrastructure to empower diabetic patients in management of living with diabetes and identify factors which affect these barriers. This study aimed to determine the effect of an educational intervention based on the BASNEF model on barriers to awareness, lifestyle, adaptation, and support in living with diabetes in patients with type 2 diabetes and it's related factors.
Methods: This was a quasi-experimental study which. Performed among 168 patients with type 2 diabetes referred to health centers of Beheshti University of Medical Sciences from August to September 2014. Before the educational intervention, questionnaires of life barriers and the BASNEF structures were completed. After pre-test, the patients were randomly allocated to the case and control groups based on randomizing four block design. Only in the intervention group patients received six education sessions of 45 to 60 minutes that fifth education session with their families, and related staff. The educational program was designed based on the BASNEF constructs (Knowledge, attitude, subjective norm, enabling factors and behavioral intention), and educational content was developed based on the barriers to living with diabetes (awareness, lifestyle, adaptation, and protection). Data analyzed Spss stafware version 20 utelized to data analysis using statistical tests such as independent sample t-test, paired t test, Wilcoxon, McNemar test, and Mann-Whitney U
Results: Our findings showed that there was a significant difference between a score received on components of barriers to of living with diabetes (awareness, lifestyle, adaptation, and protection) and variable of the BASNEF model (knowledge, attitude, subjective norm, enabling factors and behavioral intention) before and after the educational intervention the significant level was set less than 0.05 (P<0.05).
Conclusion: Education in type 2 diabetic patients based on BASNEF, as a model for effective education, can lead to dimensions barriers reduction in (awareness, lifestyle, adaptation, and protection).

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Background: Improving self-care behaviors happened by self-efficacy which result in better quality of life. Current study aimed at assessing the perceived coping self-efficacy predictors among patients with type 2 diabetes referees to health centers affiliated to Tehran University of Medical Sciences.
Methods: In this cross sectional study which was descriptive and analytical one, perceived coping self-efficacy and its effective factors assessed among 536 type 2 diabetic patients referee to Tehran University of medical Sciences using random sampling based on 11-likert scale questionnaire. This questionnaire included 11 items in demographic variables and 24 items in perceived coping self-efficacy. Collected data analyzed by SPSS version 23 using MANCOVA.
Results: Study findings revealed that age (P=0.013), level of education (P<0.036), and HbA1c (P=0.004) had significant relation with total score of perceived coping self-efficacy. But, variables such as gender, occupation, disease duration, marital status, family history and history of chronic disease had no relation with scales of perceived coping self-efficacy.
Conclusion: Planning theory based intervention programs to improve coping self-efficacy among diabetic patients in low socioeconomic status population and poor diabetes control is recommended.
 
 

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Background: Patient’s adherence to treatment regimen can predict treatment plan and decrease intensity and symptoms of sickness. This study aimed at determining the effect of educational intervention based on AIM (Ability, Information, Motivation) model on improving adherence of patients with type 2 diabetes.
Methods: This semi experimental interventional study was performed on 180 patients with type 2 diabetes as intervention and control groups. The patients selected using simple random sampling. Study instrument was a questionnaire including demographics (14 items) and AIM model questionnaire (10 items about information, 9items about motivation, 6 items for ability). After baseline, educational intervention was performed in intervention group and post test conducted after six months for both groups. Collected data was analyzed with SPSS software version 23using Mann–Whitney U, Wilcoxon and chi-squared tests. The significant level was considered less than 0.05.
Results: There was no significant difference in demographics and AIM model constructs between two groups (p>0.05). After educational intervention, intervention group revealed a significant difference with control group in terms of information (P<0.001), motivation (P<0.001), ability (P<0.001) and level of HbA1C (P<0.001).
Conclusion: study results revealed AIM model based educational intervention has an important role on treatment adherence among type2 diabetic patients.  With increasing patient information and belief regarding disease patient’s motivation will be improved.
 

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Background: Adherence to diet is one of the basis of diabetes management in patients with diabetes. Regarding to diabetes control, healthy lifestyle including nutritional behaviors, play an important role in preventing and managing diabetes. However, compliance with a diabetic diet is one of the most important challenges in diabetes control. This study aimed at determining the effect of educational intervention on promoting nutrition adherence among patients with type 2 diabetes referee to south health center of Tehran University of Medical Sciences based on Health Belief Model.
Methods: This interventional study was performed with216 type 2 diabetes patients as population study who referred to health centers in south of Tehran. Participants were randomly allocated to intervention and control groups.
Questionnaires were completed by both groups at baseline, three and six months after intervention. Intervention group received intervention including during the month, six training sessions for 45 to 60 minutes for group training and Q & A With the package held at meetings to assess the diabetes-related complications. SPSS software version 22 utilized to data analysis using t-test and repeated measure analysis. Significance level was set less than 0.05.
Results: Before the intervention, demographics and HBM constructs model were not significantly different in two groups. In intervention group, there were statistically significant differences between all parts of HBM after educational intervention (perceived susceptibility (p <0.001), perceived severity (p <0.001), perceived benefits (p <0.001), perceived barriers (p <0.001), cues to action (p <0.001)), also nutrition adherence (p <0.001) and HbA1c. there was no significant differences in control group after intervention.
Conclusion: According to study results, it can be concluded that education through Health Belief Model can be effective to follow in terms of improved nutrition among patients with type 2 diabetes.
 

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Background: The purpose of this study was to compare the effects of a 12 weeks interval training with high and moderate intensity on PGC-1α of skeletal muscle in type 2 diabetic male rats.
Methods: 40 male rats were divided into two groups: High fat diet (HFD) (n=32) and standard diet (C) (n=8) for 10 weeks. After inducing type2 diabetes via STZ, 8 diabetic rats (D) and 8 rats in group C rats sacrificed and the remaining 24 Rats were randomly assigned to three groups of diabetic control (DC), moderate intensity interval training (MIIT) and high intensity interval training (HIIT).The MIIT protocol includes 13 bouts of 4-minute activity with equivalent intensity of 60-65% vo2max  and the HIIT protocol includes 10 bouts of 4-minute activity with equivalent intensity of 85-90% vo2max with 2 minute active rest periods that was applied for 12 weeks, 5 sessions per week. Western Blot method was used to measure PGC-1α protein levels.
Results: The results showed that PGC-1α protein levels were significantly lower in the D group compared to the HC group. In contrast, the HIIT protocol resulted in an increase in protein levels of PGC-1α compared to DC2 group. While MICT had no significant effect on protein levels of PGC-1α (P <0.05). Also, there was no significant difference between the two training groups (P<0.05).
Conclusion: It seems that the intensity of interval training plays an important role in the regulation of skeletal muscle PGC-1α and possibly mitochondria biogenesis in type 2 diabetic rats.
 

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Background: The aim of this study was to investigate the effects of high fat diet-induced obesity and interval and continuous exercise training on visceral fat SIRT1 and insulin resistance in male rats. 
Method: Forty male rats were divided into two groups: high-fat diet (HFD; n=32) and standard diet (C; n=8). After 10 weeks inducing obesity, eight rats from the HFD and C groups were sacrificed, and rest of obese rats were randomly divided into three groups: obesity control (OC), moderate intensity continuous training (MICT) and high intensity interval training (HIIT). The HIIT and MICT protocols were performed for 12 weeks and 5 sessions per week. Visceral fat samples were collected to measure protein levels of SIRT1 by western.
Results: Induction of obesity was associated with a significant decrease in visceral fat SIRT1 and an increase in insulin resistance (P˂0.05). In contrast, both HIIT and MICT significantly increased visceral fat SIRT1 protein levels (P˂0.05), whereas HIIT effects were significantly higher (P˂0.05). Also, both HIIT and MICT protocols improved insulin resistance (P˂0.05).
Conclusion: Exercise training is likely to play an important role in regulation of visceral fat SIRT1 and because of that may be effective in improving insulin resistance. The increase in SIRT1 also appears to be dependent on the intensity of exercise training.

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Background: Adipose tissue fibrosis is involved in glucose metabolism disorder and insulin resistance in obesity, but the effect of exercise on the progression of adipose tissue fibrosis is still unknown.
This study aimed to investigate the effect of high intensity interval training (HIIT) simultaneously with high-fat diet on TGF-β1, MMP-9 and MMP-2 in the subcutaneous adipose tissue of male rats.
Methods: 24 male rats were randomly divided into 4 groups: normal diet (ND), high fat diet (HFD), Normal diet + high intensity interval training (ND+HIIT), high fat diet+ high intensity interval training (HFD+HIIT). The HIIT protocol includes 8 bouts of intense activity at 90% of maximum running capacity (MRC) for 2.5 minutes, with active rest periods at 50% of maximum running capacity for 2.5 minutes for 12 weeks (5 sessions per week). 48 hours after the last training session, blood was taken, and subcutaneous fat was removed. Western blot method was used evaluate the TGF-β1 and ELISA method was used to measure levels of MMP-9, MMP-2, insulin.
Results: Induction of obesity was associated with a significant increase in TGF-β1, MMP-9 and MMP-2 and insulin resistance (P˂ 0.0001). In contrast, high-intensity interval with high fat diet compared to the high fat diet group causes a significant decrease in the amount of TGF-β1, MMP-9, MMP-2, and insulin resistance (P˂ 0.0001).
Conclusion: In conclusion, our data indicate that High-intensity interval training may weaken the progression of adipose tissue fibrosis and have a preventive effect on the increase in glucose metabolism disorders caused by a high-fat diet.

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Background: This study aimed to investigate the relationship between stigma associated with type 2 diabetes and subjective well-being measures (life satisfaction and positive/negative affect) mediated by emotional stress and illness perception in people with type 2 diabetes.
Methods: The present research was descriptive based on correlation models. The statistical population included patients with type 2 diabetes who referred to the diabetes clinic of Ayatollah Taleghani hospital in Kermanshah, 207 adults were selected using the convenient sampling method and data were collected using questionnaires Type 2 Diabetes Stigma Assessment Scale (DSAS-2) (Browne et al., 2016), life satisfaction (Diener, 1985), Positive/Negative Affect Schedule (Watson et al., 1988), Illness Perception (Broadbent et al., 2006) then analyzed with SPSS and Amos software.
Results: The results showed that there was a significant relationship between stigma, life satisfaction, and positive/negative affect (P < 0.01). Stigma was also able to predict life satisfaction indirectly and negatively through emotional distress, and negative affect indirectly and positively through emotional distress and illness perception.
Conclusion: The results indicate the need for interventions to reduce the stigma associated with type 2 diabetes and improve the mental well-being of people with this disease.