Iranian Journal of

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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.

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Background: Diabetes leads to numerous side effects in the cardiovascular system and also to improper functioning of the body's antioxidant system. The aim of this study is to investigate the effect of six weeks of high-intensity interval training with coenzyme Q10 supplementation on the values of Nrf2 and NQO1 in heart muscle of elderly diabetic rats.
Methods: In this experimental study, 48 elderly male rats (18 months old) were randomly divided into four groups of intense aerobic exercise with coenzyme Q10 supplementation, intense aerobic exercise group, coenzyme Q10 supplement intake group, and control group. Induction of diabetes was done by injecting a single dose of streptozotocin in the amount of 60 mg/kg intraperitoneally. The program of high intensity interval training was done for six weeks. Coenzyme Q10 supplement group received orally at a dose of 200 mg/kg. Western blot method was used to measure Nrf2 and NQO1 values. The data were analyzed by one-way analysis of variance and Tukey's post hoc test at a significance level of P <0.05.
Results: The results showed taking coenzyme Q10 supplement (P= 0.014), intense intermittent exercise (P= 0.001) and intense intermittent exercise with coenzyme Q10 supplement (P= 0.001) significantly increased Nrf2 values in the hearts of diabetic elderly rats. Also, the use of coenzyme Q10 supplement (P=0.0366), intense intermittent exercise (P= 0.014) and intense intermittent exercise along with coenzyme Q10 supplement use (P= 0.002) significantly increased the amount of NQO1 in the hearts of diabetic aged male rats.
Conclusion: Intermittent intense training along with supplement consumption improves heart function in elderly diabetic patients through increasing endogenous antioxidant enzymes.

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Background: Diabetic nephropathy is the main cause of end-stage kidney disease in diabetic patients. Several inflammatory markers related with diabetic nephropathy have been investigated so far. It is necessary to identify easily available and cost-effective indices. We aimed to determine the relationship between the neutrophil to lymphocyte ratio and mean platelet volume with diabetic nephropathy.
Methods: This cross-sectional study was performed from 2021 to 2022 in diabetes clinic of Ghaem hospital, Mashhad.  Patients with type II diabetes were categorized into two groups: without and with nephropathy (urinary albumin excretion greater than 30 mg/24h or GFR less than 60). Patients’ data, including demographic data, past medical and drug history and lab data were gathered and analyzed.
Results: In total, 100 diabetic patients including 50 with (mean age=64.04±7.40 years) and 50 without nephropathy (mean age=56.06±6.36 years), were studied. Patients with nephropathy were older, had a longer history of diabetes and a higher blood pressure (P < 0.05). However, the distribution of gender, weight, height, and BMI was not significantly different the two groups (P>0.05). The absolute neutrophil count was not significantly different between the two groups (P>0.05), while the mean platelet volume, neutrophil% and neutrophil/lymphocyte ratio were significantly higher in patients with nephropathy (P<0.05).
Conclusion: According to our findings, patients with diabetic nephropathy had higher mean platelet volume, neutrophil%, and neutrophil/lymphocyte ratios compared to diabetic patients without nephropathy.

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Background: Sirtuin-1 is known as a key metabolic sensor in various tissues, including skeletal muscle and tissue, which can play a pivotal role in regulating glucose and lipid metabolism through diacetylase activity. The aim of the present study was to investigate the role of licorice extract and swimming exercise on SIRT1 signaling pathways in the soleus muscle of diabetes male rats.
Methods: The research is of an experimental and fundamental type, and the working method is an experimental work with a descriptive-solution nature. Fifty mice were bought and divided into 5 groups of 10. The main training program consisted of swimming in the rodent tank of the special swimming water tank for 6 weeks and 5 sessions per week. In order to induce diabetes in the mice, streptozotocin was injected. Seven days after the injection, the blood sugar of the mice was measured, and the mice with blood sugar more than 250 ml/dL were selected as diabetes samples. Licorice root extract was given to two groups of rats. In order to analyze, two-way analysis of variance was used using SPSS26 software.
Results: The results showed that the interaction effect of swimming training and consumption of licorice extract on SIRT1 signaling pathways is statistically significant (P= 0.002).
Conclusion: SIRT1 plays an important role in the control of glucose homeostasis. In fact, under certain conditions, the activity and expression level of SIRT1 gene decreases in different SI tissues due to its important metabolic role. Swimming training along with licorice supplement may be used for prevention and treatment of diabetes by positive regulation of SIRT1 gene expression.

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Background: Mitophagy is a type of cell death that regulates the quality of mitochondria and can lead to disorders in diseases such as diabetes. Therefore, the purpose of this study was to investigate the effect of high-intensity interval training (HIIT) on the content of proteins related to the mitophagy pathway (LC3 and BNIP3L) in muscle tissue soleus of rats with type 2 diabetes.
Methods: In this experimental study, 18 three-month-old male Sprague Dawley rats with an average weight of 270±30 g were selected. Rats were infected with type 2 diabetes by intraperitoneal injection of a streptozotocin and nicotinamide solution. Rats were randomly divided into two groups: diabetic and diabetic. A healthy control group was also included. The training group performed HIIT for eight weeks at an intensity of 85-95% of the maximum speed. Data analysis was performed using a one-way ANOVA test in GraphPad Prism version 9.5 software. A significance level of P≤ 0.05 was considered statistically significant.
Results: The levels of LC3 and BNIP3L proteins significantly increase after eight weeks of HIIT compared to both the diabetic and healthy control groups (P= 0.0001).
Conclusion: It can be concluded that HIIT by increasing the factors related to mitophagy can cause the cleaning of dysfunctional mitochondria in the muscle of diabetic subjects; However, excessive mitophagy can also cause functional defects in regulating the quality of mitochondria.

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Background: Type 1 diabetes is characterized by persistent hyperglycemia and leads to impaired protein synthesis and ultimately muscle breakdown and reduction in muscle function. Therefore, this research was conducted with the aim of investigating the effect of moderate intensity continuous training (MICT) on the amount of 4EBP1 in the biceps muscle of type 1 diabetic rats.
Methods: The present study is of experimental-fundamental type in which 12 2-month-old male Sprague Dawley rats with an average weight of 280±30 grams participated. To induce type 1 diabetes, streptozotocin (STZ) solution was injected intraperitoneally at a dose of 65 mg/kg. 3 days after the injection, blood sugar above 300 mg/dl was considered as an indicator of type 1 diabetes. After the induction of diabetes, the rats were randomly divided into 2 diabetic training groups (6 heads) and diabetic control groups (6 heads). The continuous training program (32 minutes with an intensity of 50-70% of maximum speed) was 8 weeks and 3 sessions every week. Data analysis was done through independent t-tests. Data analysis was done using GraphPad Prism software version 10.2.2. The significance level of the present study was considered P≤0.05.
Results: In the training group after 8 weeks of MICT, the intracellular content of phosphorylated (P=0.0001), total (P=0.0001) and the ratio of phosphorylated to total (P=0.002) protein 4EBP1 showed a significant change compared to the control group in the twin muscle tissue.
Conclusion: 4EBP1 protein seems to increase through 8 weeks of MICT and this mechanism can increase muscle synthesis in muscle tissue.

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Background: Clinical studies have demonstrated that diabetes, as a metabolic disorder, can significantly impact the quality of life of individuals affected by the condition. Physical activity has been identified as a potentially effective therapeutic intervention for managing diabetes in these individuals. This study examined the correlation between serum levels of GLP-1 and the hormones thyroxine, TSH, insulin, glucose, HbA1c, VO2max, as well as various anthropometric indicators after eight weeks of calisthenics exercises.
Methods: This semi-experimental study involved 14 sedentary children with type 1 diabetes, averaging 12.42±1.28 years, selected through non-random sampling. The participants performed calisthenics exercises for eight weeks (three sessions per week). Physiological assessments and blood samples were collected 48 hours before and after the training period. The relationship was analyzed using Pearson's correlation test, and intra-group changes were assessed using paired t-tests.
Results: The findings demonstrated a positive and significant correlation between GLP-1 and insulin both before (r= 0.703, P= 0.005) and after the exercise intervention (r= 0.668, P= 0.009). Additionally, an inverse and significant correlation was observed between GLP-1 and waist circumference (WC) levels before (r= 0.633, P= 0.019) and after exercise (r= 0.575, P= 0.043), as well as between GLP-1 and body fat percentage after exercise (r= 0.676, P= 0.007). In terms of intra-group changes, the results indicated a significant increase in GLP-1, insulin, and VO2max, along with a significant decrease in WC.

Conclusion: The findings of this study show that engaging in calisthenics exercises can be effective in reducing the negative effects of type 1 diabetes and increasing the health of diabetic children.

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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.

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Background: This study investigated the efficacy of the “Rehacom” cognitive rehabilitation software on five key cognitive domains—working memory, information processing speed, attention, inhibition, and executive functions—in patients diagnosed with Type 1 and Type 2 Diabetes Mellitus.
Methods: A pre-test/post-test experimental design with a control group was employed. A sample of 30 diabetic patients was recruited via convenience sampling and randomly allocated to either the experimental group (receiving Rehacom software intervention for 12 sessions) or the control group. Cognitive performance was assessed using the Rehacom software itself and the Barkley Deficits in Executive Functioning Scale (BDEFS). Each session lasted 45 minutes.
Results: Multivariate Analysis of Covariance (MANCOVA) revealed a significant overall effect of the intervention on the composite of dependent variables (Wilks’ Lambda= 0.184, F (5.24)= 7.978, P< 0.001). Subsequent Analysis of Covariance (ANCOVA) indicated that the intervention significantly enhanced “attention” (η²= 0.236, P= 0.016) and “executive functions” (η²= 0.621, P< 0.001). However, no significant impact was observed on working memory, information processing speed, or inhibition.
Conclusion: The findings suggest that the Rehacom software serves as an effective tool for improving attention and executive functions in diabetic patients. The notable effect sizes for these two domains underscore its clinical utility in cognitive rehabilitation programs for chronic patients. The absence of effects on other components may be attributable to factors such as the limited duration of the intervention, specific software exercises, or the underlying neurochemical and pathophysiological characteristics of diabetes, warranting further investigation with more robust designs.
 

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Background: Decision-making is a cognitive process with complex neural underpinnings, fundamental to all human behavior. This study reviewed existing research to present a comprehensive model of this process, integrating the functions of specific brain regions with cognitive and emotional factors to create a complete framework.
Methods: Using a qualitative approach, we conducted a literature review across reputable databases. Neurocognitive factors were extracted and validated through a series of expert panel sessions with eight specialists. The final conceptual model was designed, and its validity was confirmed through a multi-stage consensus process.
Results: The model provides a comprehensive framework for understanding the neurocognitive mechanisms of decision-making. It integrates cognitive, emotional, and motivational factors—such as intention, emotion, and cognitive reserve—to explain how choices are made and outcomes are evaluated. The model emphasizes the key roles of the prefrontal cortex and the limbic system, and demonstrates how external stimuli influence this process.
Conclusion: This validated model offers an integrated framework for the decision-making process, highlighting the interplay between key brain regions and cognitive and emotional factors. The model has important applications in education, psychotherapy, and designing interventions to improve decision-making skills.
 

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Background: National Document for the Prevention and Control of Non-Communicable Diseases (NCDs) and Related Risk Factors, developed in 2015, serves as Iran’s roadmap for guiding health policies to manage NCDs. After a decade, assessing its implementation and progress is essential. We aimed to review and synthesize existing evidence on the implementation status of the document’s interventions, and identify facilitators, barriers, and strategies to enhance its execution.
Methods: Following the PRISMA-ScR 2020 checklist, a systematic search was conducted in PubMed, Scopus, Web of Science, SID databases, Google Scholar, organizational repositories, and reference lists of related studies in Persian and English. Research or review studies that evaluated at least one objective or intervention of the national document—using health or health system indicators in Iran—were included. Three researchers independently performed screening and data extraction. Data were analyzed narratively and organized into thematic categories.
Results: Overall, 78 studies, reports, and national documents were included. Implemented actions encompassed establishing committees, developing action plans, integrating services into the health system, revising standards, producing educational materials, launching registries, and signing multisectoral cooperation agreements. Facilitators included legal support, intersectoral collaboration capacities, service delivery structures, and community capabilities. Major challenges were deficiencies in the national document, limited resources, weak coordination, and external disruptions such as COVID-19 and sanctions. Recommended strategies emphasized strengthening cost-effective interventions, continuous monitoring, securing sustainable resources, improving service delivery models, and enhancing multi-sectoral approaches.
Conclusion: Successful implementation of NCD prevention and control policies requires evidence-informed policymaking, prioritization of cost-effective interventions, ongoing evaluation, and sustained managerial support.