Iranian Journal of

---

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.

---

Background: Diabetes Mellitus is a common chronic disease with severe of complications. Proper glycaemic control can prevent these complications considerably. Evaluation of effectiveness of community based and patient centered interventions on glycaemic control, quality of life, patient satisfaction, patient knowledge and reported symptoms were the main aims of this research.
Methods: In a clinical trial, patients referring to Iranian Diabetes Association, who were more than 18 years old, divided to intervention and control group randomly. After three months of general interventions in both groups, including diabetes education and specific interventions including telephone calls, continuous corresponding and sending educational issues in intervention group, changes in variables were studied. Results: Among 52 patients in each group, 17 were male and 42 had type 2 diabetes. The average age was 49 in intervention and 51 in control group. Two groups had no significant difference in age, sex, type of diabetes, treatment method and duration of diabetes, other diseases and education. Both groups showed significant improvement in glycaemic control. The mean reduction in HbA1c was 1.45 in intervention and 0.86 percent in control group the difference is statistically significant (P= 0.02). Patient satisfaction increased in both groups. The satisfaction is significantly higher in intervention group (P=0.000). Knowledge has increased significantly in both groups the difference in groups is not significant. The improvement in Quality of Life was just significant in intervention group. The reported sign and symptoms have not changed in both groups.
Conclusion: Community based and patient centered interventions with emphasis on continuous education and support can improve glycemic control, quality of life, patient satisfaction and patient knowledge in diabetes mellitus.

---

Background: Myocardial infarction is the most important cause of mortality all over the world. Complications may increase with some risk factors including stress hyperglycemia. The aim of this study was to evaluate the correlation and importance of hyperglycemia in acute intrahospital complications after AMI.
Methods: Prevalence of stress hyperglycemia among 160 patients with acute myocardial infarction (Q wave MI) was determined. These patients were divided into normoglycemic and stress hyperglycemic groups. These were compared according to complications such as heart failure, cardiogenic shock and mortality.
Results: 61% were normoglycemic and 7.5% had stress hyperglycemia. 25% had history of diabetes and 4.4% were not aware of diabetes. Among 18 patients with stress hyperglycemia, 6 patient (50%) and among 101 normoglycemic patients 18 (17.8%) were affiliated with cardiac failure that the difference were significant (P=0.02 and χ 2= 6.25). There were no cases of cardiogenic shock in both groups. Three patients died during first hours of admission (2.97%). They hadn't have history of diabetes. We could not assign them to normoglycemic or stress hyperglycemic groups since blood sampling had not been done yet.
Conclusion: Stress hyperglycemia can increase complications of AMI, significantly stress hyperglycemia caused increased incidence of heart failure in this study.

---

Background: The purpose of this study was to investigate the effects of endurance training on muscle NHE1 and NBC1 gene expressions in type 2 diabetic rats. Methods: Male wistar rats (n=40), 4weeks old and 93.7±9.8g, were randomly selected and divided into control, diabetic control and diabetic training groups. The Endurance training was performed for 7 weeks on diabetic training groups (running on treadmill forrodent). NHE1 and NBC1 gene expression were determined by Realtime-PCR technique. The differences between groups in variables were determined by an independent t-test using REST Software. Results: NHE1 mRNA expression reduced significantly in EDL and Soleus by 25% and 19% in the diabetic control group compared with the control group, respectively (P<0/05).NHE1 mRNA expression also reduced significantly in EDL and Soleus by 35% and 29% in the diabetic control group compared with the control group, respectively (P<0/05).Endurance training increased NHE1 and NBC1 geneexpressions in both EDL and Soleus in the diabetic training group. Conclusion: The present study showed that NHE1 and NBC1 mRNA expressions decreased significantly in the diabetic control group and endurance training increased NHE1 and NBC1 mRNA expressions in the diabetic trained group leading to normalizing the mRNAs in diabetic trained group.

---

Background: The aim of this study was to investigate the Belief related to Rejection of Insulin injection among type 2 diabetic patients based on Health Belief Model (HBM).

Methods: This cross-sectional study was carried out on 400 diabetic patients referred to Kermanshah Diabetes Research Center who were recruited with available sampling method. The participants completed a self-administered questionnaire including demographic characteristics, and HBM construct. Data was analyzed by SPSS-16 using coefficient correlation, Mann-Whitney, Kruskal-Wallis statistics.

Results: The maximum scores of  Participants in perceived susceptibility, perceived severity, self-efficacy, perceived benefits, perceived barriers, cues to action was 66/95%, 60/7%, 59/95%, 51/97%, 68/04%, 74/74%respectively. Results showed that, in diabetic patients (II) require insulin level Susceptibility, severity and perceived benefits were intermediate, and the barriers to acceptance of insulin therapy were more.

Conclusion: Preparing training packages for promoting knowledge and self-efficacy and removing related berries of insulin therapy acceptance in diabetic patients are necessary.

---

Background: Considering the importance of chronic diabetes and significant impact on patients' quality of life, A study to evaluate health-related quality of life in type II diabetic patients referred to diabetes clinic in Sabzevar  And factors associated with planning and designing health promotion interventions in the areas studied
Methods: This cross-sectional study in which 197 patients with type II diabetes referred to diabetes clinic participated. Of data through a two-part questionnaire that included demographic characteristics, social and Quality of Life Questionnaire, which has a five physical, psychological, social, economic and disease and treatment, collected and then using SPSS version 16 and using Chi-square tests, ANOVA, t-test and Spearman correlation coefficient were analyzed.           
Results: The findings of the study suggests that most participants in the study were in the age group aged 50 to 60, 77.2% female, 85.8% were married, 74.6 percent were housewives. Average quality of life in terms of physical functioning, role limitations due to emotional problems and emotional health and physical pain was good. There was a significant difference between the score of physical function, feeling well and pain according to education (P≤ 0/05).
Conclusion: The findings of this study have informed us about the impact of diabetes on the quality of life of patients with this disease, which can be used to plan the care of chronic patients and improve their quality of life.

---

Background: Diabetes is one of the most prevalent chronic illness that is closely associated with some psychological problems, particularly stress. In this case, psychological interventions can be useful. The aim of this study was to investigate effectiveness of Mindfulness Based Stress Reduction (MBSR) on psychosocial adjustment to illness in patient with type 2 diabetes.
Methods: In this study, semi-experimental method (pre-posttest) with control group was used. Population of the study included patients with type 2 diabetes that were member of Iranian Diabetes Society of Tehran. For sampling, 60 patients with type 2 diabetes were considered and then divided in two groups based on random sampling method. Psychosocial Adjustment to Illness Scale was used.
Results: ANCOVA showed that MBSR significantly effect on psychosocial adjustment to illness. Additionally, the results showed that MBSR significantly effect on attitude towards the disease and the social environment (P<0.05).
Conclusion: Findings revealed that MBSR can be effective on increasing psychosocial adjustment to illness in patients with type 2 diabetes. These findings have been inferred that patients with type 2 diabetes need to increase their psychosocial adjustment to illness.
 

---

Background: Type 1 diabetes is a chronic disease that children and adolescents do not have the ability to care for themselves, despite having enough information about their self-care (nutrition, insulin, exercise, etc.). Self-care, such as any behavior, can be influenced by the way of thinking, and the philosophy teaching method can be a suitable educational tool for changing thinking. The purpose of this study was to determine the effectiveness of teaching cognitive errors by philosophy for children on increasing the Well-being and reducing the cognitive errors and the level of glucose in children and adolescents with type 1 diabetes.
Methods: The research method was quasi-experiment with pre-test post-test control group (waiting list) design. The sample included 22 children and adolescents of the Iranian Diabetes Association who responded to the cognitive errors scale of children and adolescents Quinn et al., Well-being Questionnaire (WHO-5) and blood glucose (A1C). To test the hypotheses, MANCOVA was used.
Results: The result of MANCOVA was significant. Subsequently, there were significant differences between cognitive errors (F (17,1) =9/01, P=0/008) and Well-being (F (17,1) =7/4, P=0/01) between two groups, but the level of blood glucose (F= (17,1) =0/01, P=0/8) was not significant.
Conclusion: Learning cognitive errors in the philosophy for children and adolescents leads to the growth of reasoning, the rational thinking of children and adolescents, and helps them to take care of themselves in conditions of failure, stress and anxiety, and improves their emotional well-being. However, it seems that it takes longer to effect on blood glucose.

---

Background: Diabetes causes nerve tissue damage and ultimately death of nerve cells, especially in important areas such as the hippocampus. It seems that exercise training and anti-inflammatory supplements can moderate this condition. Therefore, the aim of this study was to determine the effect of aerobic training exercise and L-carnitine consumption on the levels of hippocampus CNTF and CNTFR proteins in diabetic rat.
Methods: 45 Wistar rats between 250 to 300 gr were randomly divided into six groups, including healthy control groups, sham, diabetic control, diabetes + aerobic exercise, diabetes + L-carnitine supplementation and diabetes + aerobic exercise + L-carnitine supplementation. L-carnitine supplements were divided. Diabetic groups underwent subcutaneous injection of 55 mg / kg STZ. supplementary groups received 100 mg of L-carnitine per day orally. The aerobic exercise program was performed for 6 weeks and 5 days a week. The research variables were measured 24 hours after the last training session by the ELISA technics in the hippocampal tissue. The statistical method of one-way analysis of variance and Toki post –hoc test were used to analyze the data.
Results: The present study showed an significant increase in CNTF and CNTFR protein levels of hippocampal tissue after aerobic exercise and L-carnitine consumption (P = 0.001), which greater effect found in combination manner.
Conclusion: Due to the effect of aerobic exercise and L-carnitine supplementation alone and in interaction with each other on hippocampal tissue, the use of this method can be considered as maintaining neural tissue in diabetes.