Iranian Journal of

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Background: Type 2 diabetic patients have 2 or 4 fold risk of coronary heart diseases. According to researches, all types of dyslipidemia independently have atherogenic properties so it seems small dense LDL has the most effects in this case. To investigate whether glycemic control, which is assessed by concurrent HbAlc, has any favorable impact on LDL size we determined the relation between LDL size and HbAlc in diabetics.
Methods: In this study, LDL size was determined by non-denaturing polyacrylamide gel electrophoresis in 81 type 2 diabetics 50 to 70 aged. BMI was calculated in all participants as weight (Kg) divided by height (m2). TG and HDL-C were measured using enzymatic kits. HbAlc was determined using immunoturbidometric method.
Results: Based on results obtained LDL size in diabetics was significantly correlated with TG (r=-0.281, P<0.05), sex (r=-0.276, P<0.05), HbAlc (r=-0.232, P<0.05) and HDL-C (r=0.215, P<0.01). In linear regression analysis TG (standardized =-0.192 p<0.054), HDL-C (standardized =0.214 p<0.05) and female sex (standardized =0.196 p<0.056) were the independent determinants of LDL size (although they showed borderline significance). HbAlc showed high co linearity with HDL-C and was excluded from the model.
Conclusion: HbAlc is inversely correlated with LDL size in diabetics. However it is not an independent predictor of LDL size. It is likely that decrease in HDL-C levels due to poor glycemic control results in decrease in LDL size.

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Background: Metformin is usually using for glycemic control in type 2 diabetes mellitus. The drug is the first line for obese patients without renal or liver failure. Different pharmaceutical types of Metformin are available. As a clinical trial, we compared effects of Aria Metformin (product of Aria pharmaceutical company, Iran) with Merck Metformin or Glucophage (product of Merck pharmaceutical company, France), in diabetic patients.
Methods: This double blind randomized clinical trial study performed with 60 non- pregnant diabetic patients, in order to comparison of therapeutic effects of combination therapy (Glibenclamide + Metformin "Aria or Merck") in a 12 weeks period. We evaluated FBS, BS 2hpp, HbA1c, lipid profile, liver function tests, weight, BMI and common or uncommon side effects.
Results: Not only each of two pharmaceutical types of Metformin had the same therapeutic effects for controlling of glycemia, lipid profile and weight, but also there were not difference between them in side effects. Distention was the most common side effects of two types products (33%). There is not significant difference between them in common side effects. 70% of patients were satisfied with each two kinds of Metformin.
Conclusion: It seems, in view of beneficial therapeutic effects of Aria Metformin, low rate of side effects, and finally low cost, Aria Metformin is a good choice.

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Background: To determine the importance of type 2 Diabetes mellitus as a risk factor for osteoporosis in postmenopausal women, this study was designed in endocrine clinic of zanjan in 2003.
Methods: As a case-control study, 40 diabetic and 40 healthy menopause women have been recruited. These two groups were matched in terms of their age, length of their menopausal period and body mass index. Serum Calcium, Phosphorus, Alkaline phosphatase and Estradiol were measured in all the cases and bone densities in three sites (Femoral neck, lumbar spine and forearm) were evaluated with DXA. All data were analyzed using T-test, analysis of variance, chi-square and multiple regression tests.
Results: The frequency of osteoporosis and osteopenia in diabetic women were not significantly different from non diabetics. The mean bone density in femoral neck was higher in diabetic group (P= 0.013). In both groups there was a significant relationship between bone density and length of menopause (P<0.01) .The relationship between BMI and Bone density was significant only in femoral neck (P<0.01) in both groups. In diabetic women, the higher HbA1c accompanied with the lower bone density in lumbar spine.
Conclusion: Although the level of HbA1c as a marker of blood glucose control, has a relationship with lumbar spine density in diabetics, Diabetes type 2 is not a risk factor for osteoporosis, So screening, diagnosis and management of osteoporosis in diabetes type 2, Should be done independently and according to other risk factors.

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Background: The aim of this study was to determine the best Anthropometric indices for prediction of the risk of type 2 Diabetes in lower and higher 60 years old population in Tehran.
Methods: As a prospective study among 4479 non-diabetic men and women over 20 years from the participants of Tehran Lipid and Glucose Study (TLGS) who had complete data of blood pressure, plasma glucose in the fasting state and 2 hours after ingestion of 75 g glucose (2-hPG) as well as fasting serum lipids, anthropometric measurement including body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and demographic data at baseline and were followed for a mean duration of 3.6 years. Subjects reevaluated for measurement of fasting Glucose and 2-hPG at follow-up. Diabetes and its associated risk factors were defined according to the ADA criteria. Different measurements of general and central obesity were defined based on the WHO criteria. Logistic regression analysis with stepwise conditional method was used to estimate the Odds Ratio (OR) with 95% CI. Results: A total of 166 new cases of type 2 diabetes (3.7%) were diagnosed during 3.6 years of follow-up, with an approximately one percent per year incidence rate (men=3.7% and women =3.7%, P= 0.95). Diabetic subjects of follow-up were significantly more obese than nondiabetics considering their BMI, WC and WHR. In subjects aged< 60 years high WC was a predictor of diabetes only in model 1 and 2, while general obesity and high WHR predicted diabetes risk in all the 3 models. In these 3 models the OR of general obesity were 5.3(2.9-9.5), 3.4(1.8-6.3), 2.4(1.1-5.1) and the OR of high WHR were 3.5(2.1-5.8), 3.4(1.4-5.8) and 2.6(1.3-4.9), respectively. In subjects aged≥ 60 years general obesity predicted diabetes only in models 1 and 2, while high WHR was a predictor of diabetes risk only in model 1. In this age group, high WC predicted diabetes in all models 1, 2, 3 with the OR of 4.6 (2.3-4.1), 4.5 (2.3-8.9) and 3.8 (1.8-7.7), respectively.
Conclusion: General obesity and high WHR in young Iranian subjects (< 60years) and high WC in older ones (≥ 60 years) are the important anthropometric indices for prediction of type 2 diabetes. Age should be considered when using different anthropometric indices for predicting the risk of type 2 diabetes.

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Background: Glucokinase serves as a glucose sensor in pancreatic β-cells and plays a key role in glucose homeostasis and glucose-stimulated insulin secretion (GSIS). In the present study we examined the effect of glucosamine, a glucokinase inhibitor, on the pancreatic glucokinase and hexokinase activities and on insulin secretion from freshly rat pancreatic islets of Langerhans. Insulin concentration was measured by rat insulin ELISA kit. Methods: The pancreatic islets from normal and type 2 diabetic (nSTZ) rats were isolated by collagenase digestion method. Glucose phosphorylation was quantitated by measuring the rate of glucose-6-phosphate formation in the fluorometric assay. Insulin secretion from hand-picked islets was evaluated in static incubation system. Insulin concentration was measured by rat insulin ELISA kit. Results: Our findings demonstrate that glucosamine in a dose dependent manner, reduced glucokinase activity in islet extract, but had no effect on hexokinase activity. The glucose-stimulated insulin secretion, was inhibited by glucosamine but it had no effect on the basal insulin secretion. In diabetic rats glucokinase was decreased while the basal insulin secretion and the activity of hexokinase were higher than normals. Conclusion: Based on results obtained from the present study, the assumption could be made that the decrease in the activity of glucokinase of pancreatic islets could be related to the impaired glucose stimulated insulin secretion. The increase in basal insulin secretion of diabetic rats may be due to an increase in pancreatic hexokinase activity.

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Background: Retinopathy is one of the microvascular complications of diabetes which is strongly related to the glycemic control and duration of the disease. According to results of other studies, the prevalence of retinopathy has been reported 5-30% in newly diagnosed patients whit type 2 diabetes (T2DM). The aim of this study was to determine the prevalence of idabeteic retinopathy among newly diagnosed T2DM patients in Isfahan, Iran.
Methods: From july 2001 to March 2004, 710 newly diagnosed patients with T2DM were recruited in this study. Patients with duration of diabetes less than 1 year were considered as newly diagnosed ones. Along with physical examination and laboratory measurment for FBS, HbA1c, lipid profile, urea, Creatinin, and 24 houre urin examniation for albumin, retinoscopy was performed by an experienced ophttalmologist.
Results: In this study, 286 men and 424 women were investigated. The mean age of patients at presentation and the mean duration time of diabetes were 48.8 ±9.8 years (range 31-72years) and 8.6±5.4 months respectively. The prevalence of retinopathy was 9 % (9/8% in males and 8.5% in females). Logistic regression analysis revealed that BMI, diastolic blood pressure and 24 hour urine albumin, were independent risk factors for developing retinopathy.
Conclusion: Nevertheless of relatively moderate prevalence of diabetic retinopathy in our study as compared with other studies, it is necessary to perform retinal examination in newly diagnosed T2DM patients in order to prevent the sight-threatening outcomes of diabetic retinopathy.

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Background : Women with polycystic overy syndrome (PCOS) are sussceptible for developing type 2 diabetes (T2DM) and cardiovascular diseases. In view increased prevalence of T2DM in patients with PCOS and priority of prescription agents capable to decrease insulin resistances for them, It is important to diagnose PCOS in T2DM patients. The aim of this study was to evaluate the prevalence of PCOS in T2DM women.
Methods : Using ‘1990 National Institute of Child Health and Human Development Conference of PCOS’ criteria, 157 premenopausal women with T2DM were assigned into PCOS and non – PCOS groups after they were examined for the evidences of clinical PCOS. A questionnaire on reproductive history was completed and the waist circumference, weight, height and BP were measured for each participant. Biochemical tests were performed in both groups, but hormonal measurements were requested only for PCOS group.
Results : The prevalence of PCOS was high (about 8%) among subjects. Patients with PCOS had significantly lower age at the onset of diabetes, higher BMI and waist circumference. The differences in BP, serum TG, HDL, LDL, cholesterol and HbA1c were non – significant between 2 groups and insulin resistance is more.
Conclusion : PCOS is prevalent in diabetic women and Insulin resistance is more likely in those with both PCOS and T2DM resistant than whom with diabetes alone. Emphasis on reducing insulin resistance may be of benefit to achieve a better diabetes control in these patients.

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Background: Diabetes is one of the chronic diseases need continual medical care and self care education, and nutritional therapy account as an integral part of dietary management. This study carried out to investigate the effect of diabetes dietary counseling on quality of life in type II diabetic patients.
Methods: As a Randomized Clinical Trial, 144 patients with type II diabetes aged 35-65 years were recruited from patients referred to Imam Hossein Hospital dietary clinic and randomly assigned in case and control groups. A dietary schedule consisting 50-60% carbohydrate, 10-20% protein and less than 30% fat was prescribed at the first orally in a 30-minute counseling session then in written form for case group, while the control group was left without any intervention. The quality of life score was estimated in both groups via using the Short-form 36-Item (SF-36), before dietary counseling and one mouth after the dietary counseling, and the quality of life score between both groups were compared. The data were analyzed using SPSS software. Results: Average age was 52.1±10 years. Before dietary counseling, the quality of life among 46% of subjects was assessed to be poor and 52% claimed their health status poorer than the last year. Independent-Samples T-Test with P<0.05 revealed significant difference in weight, systolic blood pressure, diastolic blood pressure, blood sugar before and after breakfast, blood cholesterol and triglyceride, after dietary counseling in both groups. Also, this test with P<0.05 revealed significant difference in the quality of life score in general and in each dimensions, after dietary counseling in both groups. Paired-Samples T-Test revealed significant increase in the quality of life score in general and in each dimensions on pre and post dietary counseling in case group, but didn’t observe in control group. Conclusion: According to the results, it was revealed that dietary counseling can promote the quality of life in patients with type II diabetes in all dimensions. So, it seems dietary counseling program is essential in prevention and decrease of type II diabetes complications.

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Background: Combination of physical activity and pharmacotherapy in diabetes may augment the effects of the drug and may allow lower doses of medication that can minimize the side effects. The goal of the study was to determine the effectiveness of aerobic training and Glibenclamide combination in type 2 diabetes.
Methods: A total of 28 men with type 2 diabetes were divided to 3 groups randomly: Glibenclamide (5 mg daily) only, Glibenclamide (5 mg daily) plus aerobic training, Glibenclamide (2.5 mg daily) plus aerobic training. Aerobic training protocol was performed for 12 week, 3 days (session) a week, 45 minutes in a session (ergo cycle program at 60-70 % heart rate reserve). Fasting glucose, HbA1c, fasting insulin, c-peptide, and insulin resistance were measured at pre, mid and post treatment periods. Analysis of Variance test (ANOVA) were used to evaluate data.
Results: HbA1c significantly decreased and c-peptide significantly increased in three groups (P<0.05).There were also no between-group differences for c-peptide and HbA1c (P>0.05). Fasting insulin concentration did not alter in three groups, however, insulin resistance decreased ( no significant ) after 12 weeks.
Conclusion: In type 2 diabetic patients, Glibenclamide treatment alone or combination of aerobic training and Glibenclamide treatment, was effective in improving glycemic control in patients with type 2 diabetes .As a result, in patients with type 2 diabetes, the addition of aerobic training to Glibencelamide treatment allow lower doses of Glibenclamide to be used without impairment in glycemic control.

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Background: The relationship between diabetes and periodontal diseases has already been proved, but the effect of non-surgical periodontal therapy on the control of diabetes is controversial. The aim of this study was to determine the effect of this type of treatment on the control of diabetes.
Methods: In this randomized clinical trial 30 type 2 diabetic patients with moderate to severe periodontitis who were referred to the diabetes clinic of Imam Khomeini hospital during 2004-2005 were studied. The treatment procedure was explained for control group and an informed consent was taken. Scaling and root planning was randomly done for 15 patients, while control group were not treated for periodontal disease. The glycated hemoglobin (HbA1C) and clinical attachment loss was measured for all of the patients before and 2 months after treatment.
Results: At the baseline the clinical attachment loss (CAL) was significantly different between two groups. There was no significant difference between baseline HbA1C in the control and the experimental group. After 2 months the HbA1C was reduced in the treated group which was not statistically significant.
Conclusion: In this study non-surgical periodontal therapy had not effect on the control of type 2 diabetes.

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Background: Type 2 diabetic patients have higher risk for death from coronary heart diseases than non-diabetic patients. Studies have revealed showed intensive treatment of hyperglycemia only have a small effect on CVD risk. Other risk factors such as Lipid abnormality play a leading role in the increased CVD risk associated with diabetes. The aim of this study was to assess the quality of lipid control and treatment in type 2 diabetic patient with dyslipidemia. 

Methods: We studied Data from 602 type 2 diabetic patients who had at least four regular clinic visits every year for medical care in outpatient clinics of Isfahan Endocrinology and Metabolism Research Center, 1999-2003. Patients for Classified in three groups according to lipid levels as low, moderate and high risk. ADA )American Diabetes Association) standard criteria were used for appropriate lipid control.

Results: The mean age, duration of diabetes, HbA1c and BMI were 52.2±9.5 years, 6.8±4.6 years, 9.2±1.7% and 29.4±4.2 Kg/m2 respectively at initial registration. Eighty four percent of patient had LDL cholesterol above 100 mg/dl and 71% had triglyceride level >150 mg/dl, of these patients 47.8% and 41.6% had high risk levels and only 12.4% taking statins and 21.5% taking fibrate for treatment  at end of study. Among hyperlipidemic patients levels of LDL-C decreased from 170.8±35.6 mg/dl to119±30.20 (p < .001), triglyceride decreased from 273.8±126 to225.2±97 mg/dl (P<0.004) and HDL-C increased from 43.3±10.6 to 48.4±14.1mg/dl ((P<0.6). Percentage change of lipid level was -35.8%, -17.7% and +7.3% respectively. At the end of fallow-up 50.4% of patients treated with statins and 14.7% with fibrate. Finally, overall control of cholesterol and triglyceride in patients with dyslipidemia was 30% and 37% respectively.

Conclusion: Our findings showed that many of type 2 diabetic patients with dyslipidemia have inadequate control of lipid and lipoprotein. The prevalence of cardiovascular events due to hyperlipidemia in type 2 diabetic patients is high. This fact demonstrates the importance of early interventions for control and treatment these risk factors for prevention of cardiovascular complication in this patients.

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It is estimated that there are 1.1-1.5 billion Muslims worldwide, and prevalence of diabetes is approximately 4.6%. Many patients with diabetes insist on fasting during Ramadan, thereby creates a medical challenge for themselves and their physicians. These patients are susceptible to diabetic complications such as hypoglycemia and hyperglycemia. It is therefore important that medical professionals be aware of potential risks that may be associated with fasting during Ramadan. Patients who insist on Ramadan fasting be assessed before Ramadan and receive appropriate education and instructions related to physical activity, meal planning, glucose monitoring, and dosage and timing of medications. In this article, management of diabetes in Ramadan is discussed.

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Background: Resistin, an adipocyte secreted factor, has been suggested to link obesity with type 2 diabetes and insulin resistance in rodent models but its relevance to human diabetes remains uncertain. The aim of this study was to investigate the relationship between serum resistin concentrations with insulin resistance and obesity indices in type 2 diabetes and non-diabetic obese subjects.

Methods: As a case- control study 35 obese subjects with type 2 diabetes (age, 44.60 ± 6.39yr BMI, 34.23±3.92 kg/m2) and 35 obese non-diabetics (age, 43.14±9.13yr BMI, 35.54 ± 4.07 kg/m2) are recruited. Fasting lipid profile was measured by enzymatic methods. NycoCard HbA1c Kit was used to measure HbA1c.The Serum resistin, insulin and glucose levels were measured by an enzyme immunoassay using a commercially available kit and glucose oxidase methods respectively. The insulin resistance index was calculated from fasting glucose and insulin by the homeostasis model assessment (HOMA-IR) formula.

Results: The mean of insulin resistance index (HOMA-IR), HbA1c, diastolic blood pressure, triglyceride and fasting glucose in diabetics were significantly higher than non-diabetics subjects (P<0.05). Serum resistin concentrations were not different between diabetics and non-diabetics obese subjects but were significantly higher in women as compared to men (8.15±4.40 vs. 5.97±2.31 in non-diabetic) and (7.46±3.98 vs. 5.51±3.98 in diabetic) in both groups. Serum resistin was not significantly related to variables measured in both groups. In control group only, we observed a significant and negative correlation between diastolic blood pressure and resistin (r = -0.381 P = 0.024).

Conclusion: Serum resistin concentrations were not significantly different between type 2 diabetes and non-diabetic obese subjects and resistin is unlikely to be a major link between obesity and diabetes in humans.

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Background: Increasing number of people with diabetes make it the greatest world-wide epidemy which indicates importance of education in physical and mental health of the patients. Since researches report different results about cognition status of diabetic patients, this study was conducted to determine and compare cognitive status in older people with and without type 2 diabetes.

Methods: In this case- control study 80 patients with type 2 diabetes mellitus compare with 80 persons without diabetes. Cases were selected from the patients refer to diabetes outpatient clinic and control group were patients referred to other clinics. Instruments were questionnaire for gathering demographic data, glucometer, DSM-IR-TR questionnaire, FBS for control group and TSH - T4- HbA1c for cases..

Results: The mean scores of MMSE were 23.3 and 26.8 in case and control group respectively. Difference between two groups was significant in MMSE scores (P<0.01), furthermore between men and women of two groups (P<0.01 for both). No significant difference of MMSE scores between men and women in case group was seen (P=0.45). There was negative association between MMSE scores and age also duration of illness according to the results.

Conclusion: Elderly diabetic patients encounter some cognitive impairment which is exacerbated   with increasing age.

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Background: Type 2 diabetes mellitus is the most common type of diabetes which is triggered by various factors such as obesity, hyperlipidemia, hypertension, dietary habits and inheritance. With respect to geographic variation of diabetes prevalence, it is important to know the risk factors regionally.

Methods: As a case-control study, we looked for important risk factors of diabetes in our region. This study consisted of 400 individuals in case group and 400 individuals in control group. All these anthropometric measurements were calculated by standard methods. Blood samples taken from two groups were studied for TG, FBS, Cholesterol and HbA1c. Data are reported as the Mean±SD. P<0.05 was considered as statistically significant.

Results: There was no significant difference between two groups about mean age and sex ratio. Statistically significant difference were found for central obesity, hyperlipidemia, hypertension, polycystic ovarian syndrome (PCOS) and positive family history of diabetes in both groups (P<0.05).

Conclusion: The results showed that central obesity, hyperlipidemia, hypertension, PCOS and positive family history of diabetes are important risk factors of diabetes mellitus in Shiraz. In concordance with the results of this study, screening programme for that risk factor of diabetes in this region is suggested.

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Background: Adiponectin is an adipose tissue-derived hormone that low levels of this hormone are associated with obesity, insulin resistance, and type 2 diabetes. The aim of this study was to compare the serum levels of adiponectin in diabetic and non-diabetic obese individuals.

Methods: As a cross-sectional study 35 obese individuals with type 2 diabetes mellitus and 35 non-diabetic obese subjects were enrolled. Two groups were matched for age, gender and body mass index. Fasting lipid profile was measured via the enzymatic methods. The NycoCard HbA1c Kit was used to measure HbA1c.The Serum Adiponectin, insulin and glucose levels were measured via an enzyme immunoassay, using a commercially available kit and glucose oxidase methods, respectively. The HOMA and QUICKI indices were used to determine insulin resistance and insulin sensitivity, respectively.

Results: The mean of insulin resistance index (HOMA-IR), HbA1c, diastolic blood pressure, triglyceride and fasting glucose in diabetes were significantly higher than non-diabetics (P<0.05). The serum Adiponectin levels was significantly lower in diabetes than non-diabetics (15.74±6.70 vs. 21.52 ± 9.35) and was significantly higher in women than men (19.38 ± 7.33 vs. 12.68 ± 4.28) among diabetic and (24.63 ± 10.52 vs. 17.83 ± 6.21) among non-diabetics groups.

Conclusion: type 2 diabetes mellitus is associated with low serum adiponectin concentrations and probably adiponectin involved in the pathophysiology linking obesity to type 2 diabetes.

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Background: The relationship between diabetes and serum insulin and Zinc (Zn) levels is complex with no clear cause and effect relationships. Since Zn plays a clear role in the synthesis, storage and secretion of insulin as well as conformational integrity of insulin in the hexametric form, the decreased Zn, which affects the ability of the islet cell to produce and secrete insulin, might then compound the problem, particularly in type 2 diabetes. The aim of this study was to determine the changes of plasma Zn in patients with type 2 diabetes mellitus and healthy control in Shiraz city.
Methods: As a case-control study, we determined the serum Zn levels by atomic absorption spectrophotometer, blood HbA1c levels with columnar chromatographic method and Glucose, by enzymatic colorimetric method in auto analyzer. Data are reported as the Mean±SD and P<0.05 was considered as statistically significant Results: Results of this study revealed that levels of Zn in serum of diabetic patients is lower than in the healthy control in Shiraz city (P<0.05).
Conclusion: With respect to the result of this study, dietary educations about consuming enriched Zn foods such as sea foods and corn in diabetic patients is necessitated.

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Background: the aim of this study was to investigate the effect of seven weeks endurance training on RBP4 gene expression in Soleus and Extensor Digitrum Longouse (EDL) Muscles, liver, visceral and subcutaneous fat in type 2 diabetic rats. Methods: 50 male wistar rats (5 weeks years old, weight = 93.7 ± 8.9) were purchased and randomly divided into four groups: Control (n=10) (C), Trained (n=10) (T), Diabetic Control (n=15) (DC) and Trained diabetic (n=15) (TD). Diabetes was induced by injection of low dose of streptozotocin (STZ) and feeding with high fat diet. Insulin resistance accuracy was confirmed by HOMA-IR index and Real-time PCR was used for mRNA content. Results: After seven weeks of diabetes induction, the RBP4 mRNA content of the liver (2.37-fold P < 0.01), visceral fat (2.33-fold P < 0.01), and subcutaneous fat (1.83-fold P < 0.05), soleus (1.21-fold P < 0.05) and EDL (2.03-fold P < 0.05) were increased. After seven weeks of endurance training significant decrease in RBP4 mRNA content was found in visceral fat (P < 0.05), subcutaneous fat (P < 0.05) and EDL (P < 0.05) between DC and CD. In addition, significant difference between T and TD groups was found for RBP4 mRNA content in liver (p < 0.01), subcutaneous fat (P < 0.01) and EDL (P < 0.01) after seven weeks of endurance training. Conclusion: Type 2 diabetes considerably increases skeletal muscle RBP4 expression in isoform- specific manner. This increase is also seen in liver, subcutaneous and visceral fat. In addition, endurance training decreases the RBP4 expression in EDL, subcutaneous and visceral fat.

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Background: Cognitive and emotional deficits in alexithymia lead to various problems in somatic disorders and other medical conditions for example Diabetics. The aim of this study was to examine the effect of alexithymia on relationship between self-care and control of blood sugar in type 2 diabetes patients within the Iranian social and cultural context. Methods: The present study was a cross-sectional investigation. The study sample consisted of 100 (60 females and 40 males, aged 40 to 70 years) type 2 diabetic outpatients visiting Labbafinejad hospital during the year 2012. Measures for data collection included demographic, anthropometric and clinical questionnaires, the short scale for diabetes self-care activities and the diabetes-related quality of life. Blood tests were performed to obtain HbA1c levels and other laboratory measures related to the study. Data were analyzed using SPSS16 software. Results: Pearson product correlation results yielded significant negative associations between self- care activities and alexithymia as well as HbA1c levels in type 2 diabetes patients. Results of hierarchical regression analyses indicated that diabetes-related self-care activities explained 40% of HbA1c variance and alexithymia added explanatory variance above and beyond self-care, to jointly explain 58% of HbA1c variance. Conclusion: Based on the present findings, diabetes-related self-care and alexithymia predicted HbA1c levels in patients with type 2 diabetes. Given the evidence on the additive validity of alexithymia in the prediction of HbA1c levels found in the present study, attention to emotional competencies and disorders of Iranian diabetic patients may effectively contribute to their control of diabetes.

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Background: Patient education as an integral aspect of communication between health care providers and patients plays an important role in patient health management Teach Back (TB) is a method of interactive education. Using the teach-back technique not only improves patient’s knowledge and understanding, but also increases patient’s adherence to disease management. Furthermore, self-care education to diabetic patients has always been a key strategy for successful control of diabetes. The aim of this study is assessment the effect of self care education based on Teach Back method on promotion of self care behaviors in type II diabetic patients of Hamadan city, 2012. Methods: This interventional quasi-experimental study was performed by choosing 70 type II diabetic patients Random permutation divided into two experimental (n=35) and control (n=35) groups. Educational programs base on TB designed for patients in the intervention group included four sessions. Before and one month after the educational intervention, the results were evaluated. Participants responded to the knowledge and SDSCA questionnaires. Information was collected through interviews and self report, and then data were analyzed by SPSS-20. Results: The results indicated a positive impact of TB on knowledge (p< 0.001) and self-care behaviores (p<0.001) among patients of the intervention group. Conclusion: The results showed the positive effect of education program based on Teach Back method to increase self management among diabetic patients, while implementing such programs seem to be effective in the treatment and prevention of diabetes complications.