Iranian Journal of

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Background: Diabetes type 2 is one of the most prevalent reasons of Hyperglycemia. Different areas experience varying degrees of epidemic intensity. Diabetes is one of the most important causes of death and disability in most countries and imposes heavy financial burdens on people and governments. Although much research has been conducted on its prevention and treatment. It has been recognized as a hereditary disease, the genes causing it or its mode of inheritance are not yet known. Because of the significant role they play in metabolism of glucose, several genes have suggested, but the main cause of the disease has not yet been identified. Our objective is to investigate the epidemic aspects of the hereditary diabetes in people aged 20 years and over.
Methods: A cross sectional study was conducted on 14687 subjects, in the urban setting of east Tehran between 1379 and 1380. Of 407 families, 180 agreed to and completed related questionnaires and underwent the necessary tests 180 diabetic families, with at least one member suffering from diabetes type 2, were studied closely in order to clarify the degree of spread and family background. Analysis was performed using Chi Square and t-test.
Results: Of 1612 subjects, 497 had diabetes, including 802 women and 792 men (p<0. 001). Most of the diabetics (approx. 79%) were between the ages of 41-70 years old with the highest (55.3%) and lowest (6.2%) rates in the age groups of 51-60 and 20-30 years respectively. Diabetes was more prevalent among siblings with 53% in comparison to the prevalence among offsprings-44%. The prevalence of Diabetes type 2 in first-degree relatives was more frequent between sister and brother (52.7%), followed by that between father and daughter (36%). Conclusion: It is recommended that the related authorities implement strategies, including screening of families, with a view to identify those at risk and reduce related complications.

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Background: Type 2 diabetes is a hereditary disease but the inheritance and responsible genes have not been clearly clarified yet. According to the most studies, diabetes is one of the most common causes of mortality and morbidity in populations. Diabetes occurs in 30% of first degree family members of diabetic patients, But most people are not aware of their disease.
Methods: We studied first degree relatives of type 2 diabetes and screened them for diabetes, IFG and IGT.174 families(1556 people) of Tabriz residents were studied, among them 1232 persons grater than 30 years were alive and FBS and OGTT were done in this group .
Results: According to this study, 1232 persons were alive and 324 persons had died and DM was found in 343 (27.9%) and 82 (25.3%) of them respectively. We found 179 (14.5%) persons with IFG and 89 (7.2%) with IGT.The percent of diabetes in offspring and siblings were 32.9% and 22.1% respectively. The majority of patients had 41 – 50 years old. Risk of diabetes among offspring who had diabetes in both parents was more than the ones who had diabetic father or mother. In this study, women with diabetes were more than men (32.4% vs. 22.2% respectively). The prevalence of Diabetes type 2 in first-degree relatives was more frequent between sister and brother (41.95%), followed by that between father and son (10.9%).
Conclusion: Prevalence of diabetes in most populations is 8 – 10 %. If diabetes occurs in someone, risk of development of diabetes will increase to 30% in their family members. Therefore, screening must be done in all family members of diabetic patients to recognize the problem and to prevent from diabetes complication.

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Background: Diabetes mellitus is the most common cause of renal failure, blindness, non- traumatic amputation and neuropathy. Homocysteine, a sulfurated amino acid, has a close correlation with Methionine and Cysteine. The conversion of Methionine to Homocysteine and Cysteine is required coenzymes like vitamin B6, B12 and Folate. The effect of Metformin on serum Homocysteine level by decreasing vitamin B12 level in patients with type 2 diabetes mellitus was described previously. Methods: This is a prospective clinical trail study among patients with type 2 diabetes mellitus in Shiraz. 76 patients were divided into two groups (38 patients in each group). First group treated with Metformin 500-2000 mg/day and the second group treated with Glibenclamide 5-20 mg/day with follow up period of at least 6 months. Hb and MCV were used in follow up to detect megaloblastic anemia, indicator of B12 and folate deficiency. Fasting plasma Homocysteine level Hb A1C and blood sugar were measured in baseline and at 3 and 6 months follow up periods. Results: There was no significant difference between age, sex, weight, height and BMI and baseline serum profile between the two groups. Homocysteine level increased significantly in Metformin group at 3 and 6 months(P=0.003 and 0.001 respectively). Mean plasma homocysteine level after 6 months were 10.98±0.58 μmol/l in Metformin and 10.0± 0.88 μmol/l in Glibenclamide group, with significant difference between the two groups (P=0.001). Conclusion: Metformin increases the plasma Homocysteine level. Metformin will accumulate highly in gastrointestinal wall and cause malabsorption of vitamin B12, therefore we can conclude that the use of Metformin for 6 months can cause vitamin B12 malabsorption and increase in plasma homocysteine level. Increase in plasma homocysteine level was 7.54% in our study that is higher in comparing to the other studies. It can be explained by longer duration of Metformin therapy in our study. Rising in Homocysteine levels may have detrimental effect on vessels that need further study.

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Background: Diabetes mellitus is the most common human metabolic disease. Chronic hyperglycemia and carbohydrate metabolism disorder accompany with plasma lipid and lipoprotein disorder. Cardiovascular disease is one of the macro vascular complications of diabetes type 2 which leads to high morbidity and mortality. Dyslipidemia is one of the major risk factors of cardiovascular diseases in diabetic patients. High TG and low HDL-C levels are the most prevalent type of dyslipidemia. Low levels of HDL-c considered as a risk factor for cardiovascular diseases. Methods: In this study 40 type 2 diabetic patients (13 male - 27 female) were included. Lovastatin and Gemfibrozil were recommended separately for 2 months and HDL-C were measured at the baseline and after taking drugs. In all patients BS, TG and TC at the baseline before and after these drugs were normal and so were not any change in their diet. Laboratorial findings gathered and analyzed. The relationship between increase level of HDL and decrease of TC with taking Lovastatin and Gemfibrozil were studied. Results: The averages of TC and HDL-C before taking drug as linear were 36.5mg/dl and 174.56 mg/dl and after taking Lovastatin as linear were 43.3 mg/dl and 150.44 mg/dl. The average of TC and HDL-C after taking Gemfibrozil were 43.33mg/dl and 146.36mg/dl. 18.54 % increase in HDL-C and 13.82% decrease in TC were seen with Lovastatin and 18.54% increase in HDL-C and 16.05% decrease in TC were found with Gemfibrozil. Conclusion: In this study no difference was observed between the effect of Lovastatin and Gemfibrozil in increase of HDL-C (P=0.449). Also there was no difference between the effect of Lovastatin and Gemfibrozil in decrease of TC (P=0.992). The increase of HDL-C after taking Lovastatin had relation with sex and HDL-C increased in females (P=0.006) Also the increase of HDL-C after taking Gemfibrozil had relation with sex and females had more affected (P=0.035).

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Background: The role of nucleus tractus solitarius in cardiovascular system regulation is controversial. On the other hand, study on the problem of hypertension in diabetic animals is the subject of many research programs. The aim of the present study was to determine wheather inactivation of nucleus can affect blood pressure in diabetic rats.
Methods: To this end , stereptosotocin-induced diabetic rats were anesthetized with Urethane and a cannula was inserted above nucleus. Blood pressure and heart rate were monitored using an intraarterial cannula. The cannulas were filled with L-glutamate (78 pmol/60 nL, to functionally identify the NTS see below), L-NAME(1nmol, to inhibit the nitric oxidergic neurons) and sodium nitroprusside (100mmol,as a NO-donor) .
Results: The results indicated that inactivation of nucleus in diabetic rats, had no effect on systolic and mean arterial pressure but enhanced diastolic blood pressure (P<0.05). There was no significant difference in heart rate between control and test groups. Conclusion: Glucose affect on increasing blood pressure in rats with induced diabetes, in part, is caused by nitric oxidergic neurons resided in neucleus tractus solitarius.

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Background: Adiponectin and leptin are hormones which are related to body fat tissues and body weight. In pregnant women, conflicting associations have been reported between the role of serum concentrations of adiponectin and leptin with infant birth weight. The aim of this study was to determine the association between maternal and cord blood adiponectin and leptin concentrations with birth weight. Methods: As a cross-sectional study 86 pregnant women referred to university hospital clinics were recruited. Maternal and umbilical cord blood samples were obtained in delivery room just after birth. The maternal and umbilical cord serum samples were analyzed for adiponectin and leptin. Their birth weight and height were measured at labor.
Results: The mean of maternal BMI, birth weight, and gestational age was 23.8±4.8 kg/m2, 3.13±0.14 kg, and 38.15±2.6 week, respectively. No correlation between adiponectin and birth weight were found. Birth weight positively correlates with leptin.
Conclusion: leptin concentrations in cord blood may be reflected the alternation of body fat tissue in infant and independently associated with infant birth weight.

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Background: In this study, using anti-human serum albumin (HSA)-conjugated gold nanoparticles (AuNPs) as an electrochemical label and mobile crystalline material-41 (MCM-41)–polyvinyl alcohol (PVA) mesoporous nanocomposite as an immobilization platform, a new immunosensor was established. Methods: Field emission scanning electron microscopy (FESEM), cyclic voltammetry (CV), and differential pulse voltammetry (DPV) have been applied to determine the physicochemical and electrochemical properties of this hybrid film in immunosensor development. Results: A suitable attachment between HSA and MCM-41 and also a thick layer deposition of MCM-41–HSA–PVA film onto the electrode surfaces was observed by FESEM. DPV was employed for quantitative determination of antigen. Conclusion: In optimal conditions, this immunosensor could detect HSA in a high linear range (0.5– 200 µg ml -1 with a low detection limit of 1 ng ml -1 . This new strategy showed acceptable reproducibility, stability, and reliability and could also be applied to detect the other antigens.

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Background: Irisin was identified as a myokine secreted by exercise which plays an important role in energy metabolism and regulation of metabolic diseases such as diabetes. The aim of the present study is to investigate the effects of high intensity interval exercise (HIIE) and moderate intensity continuous exercise (MICE) on serum irisin and Subcutaneous UCP-1 in diabetic male rats.

Methods: In this study, 29 diabetic Wistar rats (12 week- age, 220-240 gr- weight) were assigned to 5 groups: immediately and 2 hours after high intensity interval exercise (HIIE0, HIIE2), immediately and 2 hours after moderate intensity continuous exercise (MICE0, MICE2) and control (C). Both MICE groups performed on the treadmill with intensity 60-65% vo2max for 40 minutes and both HIIE groups with intensity 90-95% vo2max in the 12 interval-one minute period and 1 minute rest intervals. ELISA was used to measure serum irisin and subcutaneous fat UCP-1. One-way ANOVA and Tukey post hoc test has used to data analysis, the level of significance has been considered at P≤0/05.

Results: Data analysis showed serum irisin levels in the HIIE0 group and subcutaneous fat UCP-1 in the HIIE2 significantly increased compared to the control group (p˂0/05). However, there was no significant difference between other research groups (P>0/05).

Conclusion: It seems high intensity of exercise had important roles in significant changes of serum irisin levels and subcutaneous fat UCP-1in diabetic rats.

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Background: The purpose of this study was to compare effects of three combined aerobic-resistance exercise training protocols with different intensities on metabolic control and Visfatin levels in men with type 2 diabetes.
Methods: 43 male patients with type 2 diabetes were randomly divided into 4 groups (three combined aerobic-resistance exercise training groups 1, 2, 3 and control). Training groups performed combined aerobic-resistance exercises for 12weeks, 3 times a week with given intensities )group 1:resistance 50-60% one repetition maximum- aerobic 70-80%maximum heart rate, group 2:resistance 60-70% one repetition maximum- aerobic 60-70% maximum heart rate and group 3:resistance 70-80% one repetition maximum- aerobic 50-60% maximum heart rate). Blood sampling to determine the levels of Visfatin, insulin, HbA1c, fasting glucose before and after 12weeks, were conducted.
Results: Visfatin levels and HbA1c in all training groups and fasting glucose in 2 combined training groups significantly decreased compared with control group (P<0.05). Vo2max was significantly increased in all training groups (P<0.05). No significant difference were observed between groups in body weight, Body mass index, fat mass, insulin levels and resistance insulin.
Conclusion: 12 weeks of combined aerobic-resistance exercise training protocols with were executed intensities through decreasing Visfatin and HbA1c levels and improving aerobic capacity could be helpful in patient with type 2diabetes. In addition to the above benefits, combined exercise training protocols of with intensity of 60-70% maximum heart rate–intensity 60-70% repetition maximum due to reducing fasting blood glucose could give greater benefits to patients.
 
 

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Background: Inflammation plays an important role in the incidence and development of metabolic disorders and exercises along with dietary restrictions for weight loss. It has beneficial effects on reducing inflammatory markers, especially in type 2 diabetes. The purpose of this study was to evaluate the effect of combined exercise (resistance-aerobic) with and without diet restriction on weight loss on some inflammatory markers (CRP, TNF-α and ICAM-1) in elderly men with type 2 diabetes.
Methods: 42 elderly men with type 2 diabetes (age: 67.6 ± 2.2, weight: 85.2 ± 7.4, BMI: 28.2 ± 0.2) after homogenization based on serum levels Glucose and mass index were randomly assigned to one of 3 groups: Combined exercise (15), combined exercise with weight loss diet (14), and weight loss diet alone (n = 13). The combined exercise program included aerobic training with 50-70 percent of reserved heartrate and resistance training included chest press, cable pull-down, machine leg extention and machine lying leg curl on 3 sessions per week for 12 weeks.

Results: After 12 weeks of intervention, there was a significant decrease in serum inflammatory markers levels (CRP, ICAM-1 and TNF-α) in the post-test compared to the pre-test in all three groups (P<0.001). However, bonferroni post-hoc analysis showed that combined exercise with diet compared to combined exercise and dietary restriction alone had more effects on reducing CRP, ICAM-1 and TNF-α (P<0.001). In addition, reduction of ICAM-1 (P<0.001) and TNF-α (P<0.001) after combined exercise compared to dietary restriction and CRP reduction after dietary restriction than combined exercise was significantly higher (P<0.001).

Conclusion: It suggested that in elderly type 2 diabetic patients, caloric restriction-induced weight loss with combine exercise is more appropriate for modulating of endothelial biomarkers and Inflammation dysfunctional levels than resisted exercise training or aerobic training alone.

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Background: Obesity and type 2 diabetes can impair the function of important cellular pathways. Activation of the mTOR pathway results in regulation of the SREBP1 protein for metabolism and regulation of adipose tissue. The aim of this study was to investigate the effect of 4 weeks of high intensity interval training on the content of mTOR and SREBP1 in adipose tissue of type 2 diabetic rats.
Methods: In this experimental study, 12 to 2-month-old male Sprague-Dawley rats weighing 300 20± 20 g were selected and after being diabetic by induction of STZ and nicotine amide, randomly divided in two groups, diabetic training (6 rats) and diabetic control (6 rats). Exercise group training 4 days a week for 4 weeks according to the training HIIT; The control group had no exercise program. Independent t-test and dependent t-test were used for data analysis.
Results: There was no significant change in mTOR protein content (p=0.12); But the SREBP1 protein content (p=0.001) increased significantly. The weight of control group (P=0.0001) and HIIT group (P=0.010) showed a significant increase. Blood sugar in the control group also increased significantly (P=0.0001), but HIIT mice did not show a significant change (P = 0.14).
Conclusion: 4 weeks of HIIT training did not significantly change weight, blood glucose and mTOR protein content. But it did increase the SREBP1 content, so factors such as duration and intensity of training should be adjusted in order to achieve the best results when administering HIIT.

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Background: Physical activity and exercise training are known as an integral part of weight management and control in overweight or obese people. The aim of this study was to compare the effect of high intensity interval training (HIIT) and intense resistance training on asprosin and C1q/tumor necrosis factor related protein1 (CTRP1) serum levels in overweight and obese men.
Methods: In this semi-experimental study, 31 overweight and obese men were randomly divided into three groups: HIIT training (n=10), intense resistance training (n=11) and control (n=10). The subjects of the experimental groups performed HIIT exercises and intense resistance exercises three times a week for nine weeks. Before and after the intervention, blood samples were taken to measure the serum concentration of asprosin and CTRP1 from the subjects. Analysis of covariance test was used to analyze the data and the significance level was considered as p_value less than 0.05.
Results: The concentration of asprosin in the HIIT group (p=0.013) and intense resistance training (p=0.042) decreased significantly compared to the control group. No significant difference in CTRP1 concentration was observed between groups. However, the concentration of CTRP1 in the HIIT group decreased significantly in the post-test compared to the pre-test.
Conclusion: HIIT training and resistance training in overweight and obese men led to a decrease in asprosin levels. Considering the changes in asprosin, CTRP1 and other anthropometric indicators and lipid profiles, HIIT training seems to have a better efficiency in overweight and obese men.

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Background: Despite the increased use of complementary medicine by diabetic patients, there is no clear estimation of complementary and herbal medicine use by these patients in Iran. This study was conducted to investigate the uses of herbal medicine among patients with type II diabetes in Yazd, Iran, in 2022.
Methods: A cross-sectional study was carried out on 633 patients with type II diabetes referred to the Diabetes Research Center in Yazd City from June to September 2022. A questionnaire-based theory of planned behavior developed and validated by the researcher was used for data collection. In addition to demographics and disease-related information, the instrument included questions about using herbal medicine used. Descriptive statistics, Chi-square, Fisher's exact, and linear regression tests were used to analyze the data.
Results: The most common herb used was cinnamon (34.7%). The majority of patients used herbs daily (56.9%). Using herbal medicine was significantly associated with Attitude (r= 0.48, p< 0.001) Subjective norm (r= 0.39, p< 0.001), perceived behavior control (r= 0.38, p< 0.001) and intention (r= 0.4, p< 0.001). Constructs of the theory of planned behavior 73% predicted intention to use herbal medicine. Subjective norm structure had the highest predictive power of intention to consume herbal medicine (ß= 0.49, p< 0.001).
Conclusion: Subjective norm is the most predictor of intention to use Herbal medicines in patients with diabetes. Therefore, it is very important to pay attention to the beliefs, customs, and culture of the surrounding community in the correct self-management of disease control and the use of effective drug control.

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Background: The effects of regular exercise on miRNA profile and oxidative stress indices are less known. The aim of this study was to investigate the changes in expression of  miR-17 and oxidative stress indices in overweight and obese women following high-intensity functional training.
Methods: In this semi-experimental study, 22 overweight and obese women were randomly divided into two groups of high-intensity functional training (n= 10) and control (n= 12). The subjects of the training group performed high-intensity functional exercises 3 times a week for 8 weeks and intensity of rating of perceived exertion≥7. Before and after 8 weeks, blood samples were taken to measure expression of miR-17 gene, malondialdehyde (MDA), superoxide dismutase, glutathione peroxidase (GPx) and total antioxidant capacity (TAC). Analysis of covariance test was used to analyze the data.
Results: After eight weeks of high-intensity functional training, expression of miR-17 in the experimental group significantly decreased compared to the control group (P= 0.001). After eight weeks of high-intensity functional training, TAC (P= 0.0001), GPX (P= 0.007) and SOD (P= 0.001) increased significantly in the experimental group compared to the control group. No significant change was observed in MDA (P= 0.778).
Conclusion: The results of the present study showed that eight weeks of high-intensity functional training may lead to the reduction of miR-17 expression and the improvement of oxidative stress indices and antioxidant enzymes, which may be effective in improving metabolic indices and obesity complications.

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Background: Endoplasmic reticulum stress leads to unfolded or folded protein response, and ATF4 and CHOP proteins play very important roles in this signalling pathway; Therefore, the aim of this research is the effect of resistance training on the content of ATF4 and CHOP proteins in the left ventricle of the heart of type 2 diabetic rats.
Methods: In this experimental study, 12 two-month-old male Sprague Dawley rats were selected and their weight reached an average of 280±20 gr after four weeks. Type 2 diabetes was induced by injecting nicotinamide solutions (110 mg/kg) and streptozotocin (60 mg/kg). The rats were randomly divided into 2 groups, resistance training and diabetic control; Resistance training consisted of 8 weeks and 3 sessions per week of climbing a vertical ladder with an 85-degree slope, one meter long with 26 steps and 2 cm space between each step. To analyze data, independent t-test was used in SPSS version 29 and Graphpad Prism version 10.2.3. A significance level of P≤0.05 is considered.
Results: The content of ATF4 and CHOP proteins after 8 weeks of resistance training showed a significant change compared to the control group in the left ventricle of the heart (P=0.001).
Conclusion: The increase of ATF4 and CHOP proteins can lead to increased cell death of cardiomyocytes in the left ventricle of the heart of type 2 diabetic subjects through increasing the endoplasmic reticulum stress and initiating the unfolded or folded protein response.

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Background: gestational diabetes is one of the most common diseases during pregnancy, and health literacy of pregnant mothers plays an important role in the prevention and management of the disease. The study aimed to examine and compare the health literacy of pregnant women with gestational and non-diabetic diabetes visiting health centers in the city of Yazd in 1402.
Methods: This descriptive-analytical study was conducted on 206 diabetic and non-diabetic pregnant women; the cluster health center sampling method and pregnant mothers were randomized sampling method. The data was collected using a health literacy questionnaire and analyzed using Chi Square tests, independent t-Tests and variance analysis.
Results: The results of the study showed that the average health literacy score of non-diabetic pregnant mothers (74.26 ± 13.75) was significantly higher than the average health literacy score of diabetic mothers (47.527 ± 21.06) (P< 0.001) and the percentage of diabetic women with insufficient health literacy was reported as 69% and 3.9% of non-diabetic women, which indicates a significant difference in the level of health literacy between diabetic and non-diabetic pregnant mothers (P< 0.001). In addition, diabetic mothers showed an inverse relationship between health literacy and the number of pregnancies and their children, while this trend was not observed in non-diabetic mothers (P< 0.001).
Conclusion: The results of this study indicate that non-diabetic pregnant women have higher health literacy than those with gestational diabetes, highlighting the importance of enhancing health literacy in this group of mothers. Additionally, the strong relationship between health literacy and the mother's diabetes status underscores the need for targeted programs and training to improve health literacy among diabetic pregnant women. Therefore, enhancing health literacy can be crucial in better managing gestational diabetes and improving maternal health outcomes.