Iranian Journal of

---

Background: Despite the existence of very effective drugs in controlling blood sugar in diabetic patients, unfortunately, a small proportion of patients follow their medication. Several factors may affect in drug adherence. In this study, the effect of drug-related beliefs on medication adherence in diabetes was investigated.
Methods: In a cross-sectional study using available sampling method, 248 patients with type 2 diabetes referred to the specialized diabetes clinic in Hamedan in 1400 were selected. Medication compliance was checked with MMSQ-8 and medication belief was checked with BMQ questionnaire. Data were analyzed using chi-square, ANOVA, Kruskal-Wallis and Spearman's correlation at significance level of 0.05.
Results: The mean age was (16.9) 52.6 years. 51.6% were women, 61.3% were men. poor, moderate, and good medication adherence rate were 53.2%, 25.8% and 21%, respectively. In patients with poor, moderate and good drug treatment, the mean (SD) of the belief score for the Specific Necessity were 17.9 (5.8), 17.2 (3.7) and 17.7 (1.2), respectively. Belief of Specific concern 16.6(0.6), 17.6 (2.3) and 1/17(1.8), belief of General overuse 13.2 (2.2), 12.6 (2.6) and 12.2 (2.3), belief in General harm were 10.6 (2.9), 10.2 (3.5) and 8.5 (0.3) and the total score of belief in drug treatment were 58.3 (1.8), 57.6 (6.8) and 55.5 (4.7) and which only the belief of General harm was statistically significant (P<0.05).
Conclusion: More than half of patients do not follow appropriate medication adherence. Belief about harmful side effects of diabetes drugs were significantly associated with a decrease in medication adherence.

---

Background: mTOR and CREB proteins are two important factors in cellular pathways and regulating fat tissue metabolism. Therefore, the aim of this research is the effect of endurance training on the amount of mTOR and CREB proteins in the adipose tissue of type 2 diabetic rats.
Methods: In this experimental study, 18 rats 2-month-old male Sprague-Dawley rats with a mean weight of 270±20g were selected. 12 rats became type 2 diabetic by intraperitoneal injection of Streptozotocin solutions. These rats were randomly divided into 2 groups: diabetic training and diabetic control (6 heads per group); A healthy control group (6 heads) was also considered. The training group practiced endurance training 4 days a week for 6 weeks. Data were analyzed using SPSS software version 23 and one-way ANOVA and Tukey post hoc tests.
Results: mTOR protein content showed a significant change after 6 weeks of endurance training (P=0.0001); Tukey's post hoc test showed that this change was significant between the pairs of diabetic training groups to healthy controls (P=0.004) and diabetic control groups to healthy controls (P=0.0001). CREB protein content showed a significant change (P=0.0001); this change was significant between the pairs of diabetic training to diabetic control groups (P=0.02), diabetic training to healthy control (P=0.0001), and diabetic control to healthy control groups (P=0.0001).
Conclusion: mTOR and CREB proteins decreased after Endurance Training, which can be effective in regulating adipose tissue metabolism; however, more training conditions should be considered.

---

Background: Type 2 diabetes is the most common metabolic disease, a chronic and progressive disorder that causes permanent complications and increased cardiovascular, cerebrovascular, peripheral vascular disease, nephropathy, retinopathy, neuropathy, diabetic foot, amputation and death in patients.The aim of the present study was to examine the predictor role of negative repeating thoughts, emotion regulation strategies and self-care in remedial acceptance and adherence of patients with type 2 diabetes.
Methods: The method of the present study was descriptive, correlation type, and the population was from all the patients with type 2 diabetes who were members of Diabetes Association in Chahar-Mahal-o Bakhtiyari. Among this group, using the convenience sampling method, and on the basis of Morganʼs table, 300 patients with type 2 diabetes were recruitment. Using MackEuy and othersʼ negative repeating thoughts questionnaire (2014), Mans & Malouf emotion regulation­ strategies questionnaire (2009), Toobert & Glasgow self-care questionnaire (2000) & Modanloo acceptance and treatment follow-up questionnaire (2014), the experiment group was investigated. The data were analyzed by SPSS software.
Results: Our findings have shown that negative repeating thoughts, emotion regulation strategies and self-care predict the remedial acceptance and adherence of patients with type 2 diabetes significantly.
Conclusion: With pay attention to identify of the predictor role of negative repeating thoughts, emotion regulation strategies and self-care in remedial acceptance and adherence of patients with type 2 diabetes, and high prevalence of this disease too, it seems that psychological intermediations, with pay attention to role of mentioned variables to decrease of psychological problems and increase of adherence in them, pay attention to role of negative repeating thoughts too, compatible and incompatible strategies of emotion regulation and adhere to self-care could be taken as prevention of deterioration type 2 diabetes and better controlling.

---

Background: Control of Type 2 Diabetes Mellitus (T2DM) is influenced by lifestyle. The aim of this research was to determine the predictors of treatment adherence behaviors among T2DM based on Social Cognitive Theory (SCT).
Methods: This descriptive-analytical research was done among 500 T2DM patients in Tehran during 2021. Simple random sampling was performed among patients based their medical records in the Diabetes Control Clinic of Tehran's District Five. The data collection tools were written questionnaire based on the SCT determinants. Data were analyzed using descriptive statistics (frequency, percentage, mean, standard deviation) and analytical statistics (Pearson's correlation and linear regression) in SPSS software version 16. Results: The mean score of treatment adherence behaviors was 56.34 [SD: 10.41], ranged from 16 to 80. The outcome expectations, perceived self-efficacy, and social support accounted for 43% of the variation in the outcome measure of the treatment adherence behaviors. Self-efficacy was the strongest predictor (Beta = 0.430 and P<0.001). Increasing age (ß= -0.126 and P= 0.004), insulin treatment (ß= -0.250 and P<0.001) and smoking (ß= -0.146 and P= 0.001) conversely and having health insurance (ß= 0.181 and P<0.001) were positively predictive of treatment adherence behaviors.
Conclusion: The development, implementation and evaluation of educational interventions based on SCT with emphasis on promoting perceived self-efficacy can lead to useful findings in promoting treatment adherence behaviors among T2DM patients.

---

Impaired insulin function with exogenous changes is a major cause of heart failure. The purpose of this study was to investigate the effect of four weeks of high intensity interval training with curcumin supplement on the expression of IRS-1 and IRE-1α gene in the Left ventricle of type 2 diabetic rats.
Methods: In the present experimental study, 30 male mice with diabetes were divided into five groups of 6; high intensity interval training (HIIT), High intensity interval Training+Curcumin(S+HIIT), Diabetic control+curcumin(S+DC), Diabetic Control (DC), Normal control (NC). The High intensity interval training protocol was performed five days a week for four weeks. Curcumin gavage at a dose of 100 mg/kg was performed daily. The expression of IRS-1 and IRE-1α were measured by the qReal-TimePCR method, and data were analyzed by one-way ANOVA at the alpha level of 0.05.
Results: IRS-1 gene expression in the S+HIIT group compared to the DC (P=0.003) and S+DC (P=0.001) groups and in the HIIT group compared to the DC (P=0.002), and S groups +DC had a significant decrease (P=0.019). IRE-1α gene was significantly decreased in S+HIIT group compared to DC (P=0.003), S+DC (P=0.001) and HIIT (P=0.008) groups.
Conclusion: It seems that HIIT with curcumin supplement can reduce the process of myocardial apoptosis in diabetic patients by improving metabolic conditions and genetic factors.

---

Background: During menopause, women are more exposed to the risk factors of many diseases, including metabolic syndrome, and sirtuin-1 may be involved in this disorder. The aim of this study was to investigate the effect of circular resistance training and moderate intensity continuous training on metabolic indices and Sirtuin1 serum level in women with metabolic syndrome.
Methods: This study was conducted as a clinical trial in women with metabolic syndrome in two intervention groups (15 people in resistance training group and 15 people in continuous training group) and a control group (15 people). The intervention group underwent an exercise program for eight weeks and three sessions per week, and the control group had their own routine program. After the last training session, serum levels of Sirtein1 and lipid factors were measured. To analyze the data, t-test and covariance were used at a significant level (P≤0.05).
Results: The results of the t-test showed that there was a significant difference in the intra-group changes of the studied variables (SIRT1, HDL, LDL, TG, FBS, Total Cholesterol) in both exercise groups (P≥0.05), but in No significant difference was observed in the control group (P<0.05). The results of the covariance test showed that there is a significant difference between the three groups in the indices (SIRT1, HDL, LDL, TG, FBS, Total Cholesterol) after the test (P<0.05).
Conclusion: Eight weeks of circular resistance training program and continuous training with moderate intensity has a positive effect on metabolic indices and serum level of Sirtuin1 in people with metabolic syndrome.

---

Background: The health assistant and treatment assistant in the Ministry of Health and Medicine are in charge of educating people with diabetes and empowering them to achieve self-management of diabetes. The present study was conducted with the aim of determining the status of education and support for diabetes self-management in comprehensive health service centers and diabetes clinics in Isfahan province.
Methods: The diabetes education units of 20 comprehensive health service centers and 11 diabetes clinics in Isfahan province formed the sample size. The data collection tool was a checklist with 107 items, which was completed by observing and reviewing 170 paper/electronic files of patients with diabetes.
Results: In more than two-thirds of the files of diabetes centers/clinics, initial assessment were neither performed nor recorded. Educational needs assessment was recorded in 5% of the files and educational planning was not recorded in nearly 100% of them. In more than a third of the files (36.5%), diet education was recorded once when the case was filed. In 3.4% of files, educational effectiveness evaluation was recorded and in three quarters of files (75.78%), continuous support for self-management was not recorded.
Conclusion: There is a significant gap between the status of education and support for diabetes self-management and the process and outcome standards of DSMES in the educational units covered by the provincial health and treatment department. This gap seriously and negatively affects the results of this approach.

---

Background: The prevalence of overweight, obesity and related complications is increasing rapidly in the world. Also, treating this disease in the presence or absence of co-morbidities has become a challenge. In this article, based on the clinical recommendations of the American Endocrinology Association and the American College of Endocrinology, a comprehensive clinical guide has been written for the stages of treating obese patients and its individualization, and it has been tried to be adjusted as much as possible based on the conditions in Iran.
Methods: with a specific search strategy, a complete search was performed in PubMed, Scopus, ISI Web of Science, EMBASE and Google Scholar Cochrane databases. Then, the best clinical guidelines suitable for the Iranian society were selected and using the opinions of specialists and clinical experts, a clinical guideline was prepared for the treatment of obesity in Iranian adults.
Results: In this article, in continuation of the previous article, we answered the questions number 4 to 6 regarding the stages of obesity treatment and its individualization in adults of Iranian society, and presented a total of 60 recommendations in this regard.
Conclusion: In this part of the clinical guide for obesity in Iranian adults, we tried to have a special view on the treatment of these patients and by providing evidence-based recommendations and statements, the treatment process was personalized as much as possible for patients with special conditions so that decision-making in this regard is facilitated for the relevant colleagues in this field.

---

Background: The aim of this study was to investigate the effect of eight weeks of circuit resistance training and saffron supplement on visfatin serum levels and insulin resistance in overweight men.
Methods: In this semi-experimental study, 40 obese and overweight students were randomly divided into 4 groups: exercise, exercise+supplement, supplement and control (10 people in each group). The exercise groups performed circular resistance exercises for eight weeks and three sessions each week for 90 minutes in the evening. The supplement and exercise+supplement groups used saffron tablets with a dose of 30 mg per day as a supplement. Blood samples were collected in two phases of the pre-test and 48 hours after the last training session. The data were analyzed using covariance and paired t test at a significant level of P≤0.05.
Results: Correlated t results showed a significant decrease in visfatin and insulin resistance in the post-test of the training, training+supplement and supplement groups compared to the pre-test (P<0.05). The results of the analysis of covariance showed that visfatin increased and the insulin resistance index decreased significantly in the exercise, exercise+supplement and supplement groups compared to the control group (P<0.05).
Conclusion: It seems that eight weeks of circuit resistance training and the addition of saffron help on visfatin serum levels and insulin resistance can lead to the reduction of these two variables in overweight men. The saffron plant can play a protective role due to the presence of flavonoids and by stimulating the secretion of Visfatin.

---

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.

---

Background: The purpose of this study was to investigate the effectiveness of self-compassion training on distress tolerance, anxiety sensitivity and emotional self-control in women with type 2 diabetes.
Methods: This research was experimental and semi-experimental using the pre-test-post-test method with a control group. The statistical population of the intended research included all women with type 2 diabetes in 1402 who visited endocrinologists' offices in Sari, who were selected using a targeted method and then were placed randomly divided into two experimental and control groups. The data were collected using the Distress Tolerance Questionnaire of Simmons and Gaher (2005), anxiety sensitivity of Reis et al. (1986) and emotional self-control by Tanji (2004). Then, the data were analyzed using multivariate and univariate covariance methods in SPSS-24 software.
Results: The results showed that the treatment focused on compassion is effective on distress tolerance, anxiety sensitivity and emotional self-control of women with type 2 diabetes.
Conclusion: In fact, the treatment focused on compassion makes the person distance himself from blaming, condemning and self-criticism, which are all examples of lack of emotional self-control, and instead stabilizes his emotional self-control in the first stage and gradually be strengthened. Focused training on compassion can be one of the effective options in improving the quality of life and psychological distress, along with other medical interventions.
 

---

Background: Diabetes can disrupt the balance of cell death through different cell pathways, and exercise or consumption supplements can be effective in maintaining the balance of cell death types; Therefore, the purpose of this research is the effect of magnesium supplementation and exercise training on the content of CREB2 and C/EBP homologous protein (CHOP) in the left ventricle of the heart of type 2 diabetic rats.
Methods: In this experimental study, 24 2-month-old male Sprague-Dawley rats with an average weight of 280±20 grams were selected. Type 2 diabetes was induced by injecting nicotinamide and streptozotocin solutions. The rats were randomly divided into four groups, 1) control, 2) supplement, 3) training and 4) training+supplement; Resistance training consisted of 8 weeks and 3 weekly sessions of climbing a ladder. Magnesium supplement was given to rats once a day. To analyze the data, one-way ANOVA and Tukey's post hoc tests were used in SPSS version 29.
Results: Eight weeks of magnesium supplementation and resistance training led to a significant change in the content of CREB2 and CHOP proteins between groups in the left ventricle of the heart (P= 0.001). A significant decrease was observed in the groups of resistance training + magnesium supplement and magnesium supplement compared to the control group (P≥ 0.05); But the resistance training group had increased compared to the control group (P≥ 0.05).
Conclusion: The increase and decrease of CREB2 and CHOP proteins in the left ventricle of the heart can lead to improvement and physiological adaptation, like a bilateral mechanism.

---

Background: Vitamin D (vitD) deficiency is common in Iran. Although there are several studies on therapeutic doses of vitD, the optimal dose is to be evolved. we compared the effects of high dose supplemental vitamin D versus its recommended dose on the serum level of 25(OH)D.
Methods: This clinical trial was performed at Endocrine & Metabolism Research Institute in Shariati Hospital, Tehran, Iran within 2008-2009. The subjects were osteopenic women older than 50 years who had been referred to Bone Densitometry laboratory. They were received either (group P) 50000u vitD3 weekly for 3 months then monthly for another 9 months, or (group M) 800u vitD3 daily for one year. 1000 mg calcium carbonate was given to both groups. Serum 25(OH)D, calcium, phosphorus, and PTH was checked at base, 3rd, 6th and 12th month. 24h Urine for calcium was collected before and at the end of trial.
Result: Serum 25(OH)D level was significantly higher in group P at 3rd month (P< 0.05), but it gradually declined and there was not statistically difference to group M. PTH decreased in both groups. Urine calcium to creatinine ratio did not rise in both groups.
Conclusion: vitD supplement at doses of 50000u weekly for 3 months then monthly for another 9 months as compare to 800u vitD3 daily for one year increases serum 25(OH)D at higher level without causing hypercalcemia and hypercalciuria, but it seems that more frequent doses in monthly period would be required to maintain the optimal 25(OH)D level.
 

---

Background: Inflammatory protein C3 and IL-1β are significantly involved in the pathophysiology of type 2 diabetes (T2D) and Alzheimer's disease. Moreover, examining the importance of aerobic exercise timing (light vs. dark phase) can provide a better understanding of how exercise timing affects inflammatory markers associated with neurological diseases in older adult women with T2D. Therefore, this study aimed to investigate the effect of aerobic exercise timing on C3 and IL-1β levels in older adults’ women with T2D.
Methods: In this semi-experimental study, 45 women with T2D with an average age of 60 ± 5.07 years were divided into training groups (light and dark phase) and control (15 people in each group). Aerobic exercise was performed for 12 weeks at a moderate intensity (60-70% of heart rate reserve). Protein levels (C3 and IL-1β) were measured before and after the intervention using the ELISA method. Data were analyzed using SPSS27 software and ANOVA with a significance level of 0.05.
Results: Complement C3 was significantly lower in the dark phase exercise group compared to the control group (P= 0.0083). Additionally, the results showed that dark phase aerobic exercise significantly decreased C3 (P= 0.0028) and IL-1β (P= 0.0045) levels compared to baseline.
Conclusion: Aerobic exercise performed during the dark phase effectively reduced inflammatory protein levels of C3 and IL-1β in older adult women with T2D, suggesting it could be considered as a crucial strategy in managing this disease.

---

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.

---

Background: Insulin resistance plays a fundamental role in disorders such as obesity, diabetes, cardiovascular diseases, and metabolic syndrome. Regular physical activity and the use of medicinal plants are important strategies for its reduction and management. Ginger has attracted research attention due to its phytochemical compounds that influence insulin signaling pathways. Despite numerous studies, a bibliometric analysis examining the effects of exercise and ginger supplementation on insulin resistance has not yet been conducted. Therefore, the present study aimed to analyze the trends in Iranian research in this field.
Methods: In a bibliometric review, the keywords “training,” “ginger supplementation,” and “insulin resistance” were searched in the Magiran database. According to the entry criteria, 13 eligible articles were selected and data extracted from them, including writing pattern, collaboration, prolific authors and institutions, selected journals and study trends, and common keywords were extracted from the database of recipients and analyzed using VOSviewer software.
Results: The results indicated that 36 authors had an average of 3.23 ± 0.89 cooperation in writing articles. Fifty-four percent of the articles were published by public university faculty and 46% by independent universities. The most frequent keywords included "ginger", "insulin resistance", "obesity", "diabetes mellitus", "irisin" and "lipid peroxidation".
Conclusion: The results of this bibliometric study showed that exercise with ginger supplement reduced insulin resistance. In particular, 84% of the articles showed the positive effect of combined exercises (resistance and aerobic exercises) along with ginger supplements on the reduction of insulin resistance. Compared to other types of exercise, these exercises have had the greatest effect on improving the glycemic profile and body composition. In addition, high intensity interval training (HIIT) has also shown positive effects on reducing insulin resistance, but is not as effective as combined training. Also, due to the relationship between insulin resistance and various diseases, it is felt to conduct more studies on diverse statistical populations and people suffering from various diseases.

---

Background: The increasing trend of diabetes patients requires lifestyle interventions to improve the self-management ability of these patients, and achieving this requires the use of valid tools in this field. This study aimed to determine the psychometric properties of the Comprehensive Diabetes Self-Management Scale (CDSMS) in patients with type 2 diabetes.
Methods: The present study was methodological research that was conducted in 2023. At the beginning of the work, the CDSMS questionnaire was translated into Persian using the standard translation-back translation method. Then, face validity, content validity, convergent validity, internal consistency, and instrument stability were determined. Data analysis was performed using descriptive statistics, Cronbach's alpha calculation, Kappa index, Pearson correlation coefficient, and intra-cluster correlation coefficient in SPSS software version 24.
Results: Based on the results, all the items of the instrument were retained. The total content validity index score of the Persian version of this questionnaire was 0.987. Also, the Kuder-Richardson and Kappa indices were 0.704 and 0.730, respectively. The level of agreement at two measurement times, two weeks apart, ranged from 0.503 to 0.990. The intra-cluster correlation index was also observed to be in the range of 0.625 to 0.952 and was significant (P < 0.001). The Cronbach's alpha coefficient of the instrument was also 0.83.
Conclusion: The results of the present study showed that the Persian version of the CDSMS questionnaire with 14 items has good validity and reliability and can be used to evaluate the self-management status of patients with type 2 diabetes in Iran.

---

Background: Type 2 diabetes is a common chronic metabolic disease whose effective management requires attention to psychological and interpersonal factors. This study aimed to examine the relationship between the Perceived Spousal Sacrificial Behavior and self-efficacy with behavior management in patients with type2 diabetes.
Methods: This descriptive-correlational and cross-sectional study was conducted among married patients with type 2 diabetes who were referred to endocrinology and metabolism centers and primary health care units in Sari, Iran. Based on inclusion and exclusion criteria, 97 participants were selected using purposive sampling. The research instruments included the Perceived Spousal Sacrifice Scale (Harper & Figuerres, 2008), the Diabetes Self-Efficacy Scale (Fappa et al 2016), and the Behavioral Management Scale (Toobert et al., 2000). Data were analyzed using SPSS version 24 through descriptive statistics (mean, standard deviation) and inferential statistics (Pearson correlation coefficient and multiple regression analysis).
Results: Perception of the Perceived Spousal Sacrificial Behavior and self-efficacy showed a significant positive correlation with behavioral management among diabetic patients (p < 0.01). Together, these variables explained 30% of the variance in behavioral management, with Perceived Spousal Sacrificial Behavior making a greater contribution to prediction.
Conclusion: The findings highlight the significant role of Perceived Spousal Sacrificial Behavior and self-efficacy in improving behavioral management among patients with type 2 diabetes. Enhancing spousal support and strengthening patients’ self-efficacy through educational and psychological interventions may promote better self-care behaviors and disease control.

 

---

Background: Sexual dysfunction is a prevalent, underdiagnosed, and impactful complication of type 2 diabetes in men, involving multiple physiological, psychological, and social dimensions. This narrative review aimed to comprehensively examine the current evidence regarding the role of exercise interventions in improving sexual function among men with type 2 diabetes through a multidimensional lens.
Methods: A narrative review was conducted based on a systematic search of PubMed, Scopus, Web of Science, and Google Scholar databases. Eligible studies included clinical trials, systematic reviews, and basic research focused on exercise and sexual function in men with diabetes. The analysis addressed physiological mechanisms, clinical outcomes, psychological factors, and research gaps.
Results: The evidence suggests that exercise improves sexual function in men with type 2 diabetes through multiple pathways, including enhanced insulin sensitivity, increased testosterone levels, improved penile vascular function, and psychological benefits such as reduced performance anxiety, depression, and improved body image. The type, intensity, and duration of exercise were found to be crucial in determining the outcomes. This review also identified significant research gaps, such as the lack of long-term trials and limited focus on neurohormonal mechanisms.
Conclusion: It seems that exercise is a safe, non-pharmacological, and effective intervention with substantial potential to improve sexual function in men with type 2 diabetes. The findings of this review can inform integrated therapeutic protocols and guide clinical practices aimed at enhancing sexual health in this population. A personalized exercise approach, supported by a multidisciplinary team, is recommended as part of formal care for diabetic men experiencing sexual dysfunction.
 

---

Background: Childhood obesity is linked to adult obesity and chronic diseases. Therefore, this study investigates the effects of High-intensity functional training (HIFT) and High-intensity interval training (HIIT) on physiological variables and functional capacity in overweight and obese, untrained adolescents.
Methods: Thirty overweight and obese adolescents were randomly assigned to three equal groups: control [14.30 ± 0.82 years, body mass index (BMI)= 30.23 ± 2.11], HIIT (14.10 ± 0.87 years, BMI= 29.17 ± 2.51), and HIFT (13.40 ± 0.82 years, BMI= 29.42 ± 2.56). Participants in the experimental groups followed an HIIT and HIFT training protocol for six weeks. Before and after the intervention, anthropometric indices and serum levels of leptin and omentin were measured. Data were analyzed using mixed ANOVA and Tukey’s post hoc tests.
Results: HIFT significantly reduced body weight and BMI compared to the control group (P< 0.05), while HIIT showed no significant effect (P> 0.05). Serum leptin levels were significantly lower in both experimental groups compared to the control group (P< 0.01). Notably, only HIFT significantly increased omentin levels compared to the control group (P< 0.001). No significant effect was observed on the waist-to-hip ratio (P> 0.05).
Conclusion: The present study demonstrates that both HIFT and HIIT can lead to improvements in anthropometric indices and serum levels of omentin and leptin in overweight and obese adolescents. However, HIFT appears to be a more effective intervention.