Iranian Journal of

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Background: Diabetes is a chronic disease where the body cannot use or store glucose properly. Diabetes occurs when the pancreas is unable to produce insulin, or the body cannot use the insulin produced. Nowadays, diabetes is a common disease worldwide, and providing automated methods for its diagnosis is critically important.
Methods: This paper introduces a novel method for diagnosing diabetes using artificial intelligence (AI) algorithms. The proposed method is based on metaheuristic and classification algorithms. The simulated annealing (SA) metaheuristic algorithm was used for feature selection. Diabetes diagnosis was performed using the improved K-nearest neighbor (KNN) classification algorithm. In addition to the proposed method, the performance of two other methods, named MVMCNN and WKNN, was studied for diabetes diagnosis.
Results: The proposed method has been compared practically with the two other methods for diagnosing diabetes. The comparisons are based on the accuracy rate of disease diagnosis. In the experiments, the proposed method (SAKNN) demonstrated 95% accuracy, the MVMCNN method showed 93% accuracy, and the WKNN method demonstrated 90% accuracy. Thus, the proposed method outperformed the others. The proposed method also had acceptable performance in terms of time and several other criteria.
Conclusion: The proposed method for diagnosing diabetes, using metaheuristic and classification algorithms, provides higher accuracy compared to other methods. These results indicate that the proper use of AI techniques can offer effective solutions for the automatic diagnosis of diabetes and can be used as an auxiliary tool for doctors and researchers.
 

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Background: Recurrent diabetic ketoacidosis is one of the serious and life-threatening complications of diabetes that can lead to repeated hospitalizations and significant complications. This study was conducted with the aim of investigating the prevalence, risk factors, and clinical outcomes of recurrent diabetic ketoacidosis in southeast Iran.
Methods: In this retrospective descriptive-cross-sectional study, the medical records of 560 patients with diabetic ketoacidosis during the years 2017-2020 at Afzalipour Hospital in Kerman were reviewed. Patients with at least two admissions due to diabetic ketoacidosis were included in the study. Demographic, clinical, and laboratory data were collected and analyzed using a checklist. The collected data were analyzed using SPSS software version 25 with chi-square and independent t-tests at a significance level of 0.05.
Results: Of 560 patients, 40 patients (7.16%) had recurrent diabetic ketoacidosis. The mean age of patients was 28.36 ± 15.04 years, and 60% were women. 70% of patients had type 1 diabetes. The most common underlying causes included irregular consumption or discontinuation of insulin (72.5%) and presence of infection (55%). Substance abuse was reported in 25% of patients. The mean serum levels of urea, creatinine, and potassium were 55.23 ± 37.73 mg/dL, 0.98 ± 0.67 mg/dL, and 4.38 ± 0.64 mEq/L, respectively.
Conclusion: This study showed that patients with type 1 diabetes are at higher risk of recurrent diabetic ketoacidosis. Non-adherence to insulin therapy and infections were the most important identified risk factors. These findings emphasize the importance of patient education regarding regular insulin consumption and prevention of infections.
 

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Background: Type 1 diabetes is the most common type of diabetes affecting children and adolescents. Nursing interventions for children with type 1 diabetes include recognizing the adolescent's problems and providing technical care and emotional support. Nurses play an important role in helping adolescents and their families manage emotions, adjust treatment regimens, and integrate new routines into daily life. The aim of this systematic review is to identify and analyze effective nursing interventions in the management of type 1 diabetes in children and support their families. This study, by reviewing the available evidence, attempts to explain the role of nurses in improving clinical, psychological, and behavioral outcomes in children and promoting awareness, self-care skills, and quality of life in families.
Methods: A systematic search was conducted in the scientific databases PubMed, Scopus, Web of Science, CINAHL, SID and Magiran between 2010 and 2025. The search strategy was created using the PubMed keywords (Nursing Interventions) [title/abstract], (Type 1 Diabetes), (Child) and (Family). Systematic search with English keywords: ((Nursing Interventions[title/abstract]) AND (Type 1 Diabetes [title/abstract])) AND (Child[title/abstract])) AND (Family[title/abstract]). Out of 500 studies on nursing interventions in pediatric type 1 diabetes with more detailed review, a total of 10 studies met the inclusion criteria and were included in the final analysis.
Results: The findings showed that nursing interventions can have a significant impact on diabetes management by children and families, leading to improved adherence to treatment regimens, better blood sugar control, and increased quality of life for children and families.
Conclusion: Nursing interventions play a significant role in improving blood sugar control, increasing awareness and self-care of children with type 1 diabetes, and supporting their families. Interventions such as patient and family education, psychological counseling, regular follow-up, use of educational and care-oriented technologies, and team collaboration have been able to provide favorable results in reducing disease complications, improving quality of life, and increasing psychosocial adjustment. Accordingly, the development and implementation of evidence-based intervention programs, taking into account the individual, cultural, and social characteristics of families, is recommended to improve nursing care in children with diabetes.
 

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Background: The impact of psychological factors on physical diseases has highlighted the need to recognize these factors in the process of preventive and therapeutic interventions. In this regard, the aim of the present study was to compare personality traits, resilience, and coping strategies in diabetic patients and healthy individuals.
Methods: A causal-comparative method was used in a sample of 75 diabetic patients and 75 healthy individuals, who were selected by convenience sampling. Data collection was carried out using resilience, five-factor personality, and coping strategies questionnaires. Independent t-test and multivariate analysis of variance in SPSS 62 software were used to examine the hypotheses.
Results: The mean scores of resilience and the personality traits of extraversion and conscientiousness were higher in healthy individuals, and the mean score of neuroticism was higher in diabetic individuals. No significant difference was observed in the personality traits of agreeableness and openness between these two groups. The findings showed that the average scores of healthy individuals in using problem-oriented strategies and the average scores of diabetic individuals in using emotion-oriented strategies were higher than the other group.
Conclusion: The findings indicate that psychological factors play a significant role in the emergence and intensification of problems in diabetic patients. Addressing these factors and incorporating appropriate psychological strategies may therefore contribute to more effective prevention and treatment of diabetes.
 

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Background: Diabetes is a chronic condition that can significantly impairs quality of life and requires long-term care due to its complications. Effective self-care education plays a key role in blood glucose control and in the prevention of diabetes-related complications. Telenursing is considered a promising approach to enhance self-care education in patients with type 2 diabetes.
Methods: This study was a systematic review conducted using a three-stage search strategy. Using Persian and English keywords including "telenursing," "self-care," and "diabetes," as well as their MeSH equivalents, relevant literature was searched in Persian databases (Magiran, SID) and international databases (PubMed, Scopus, Google Scholar) within the time frame of 2000 to 2023. After applying inclusion criteria, 17 out of 1,092 retrieved articles were selected for final review and analysis.
Results: A total of 1,092 articles were initially retrieved. After removing duplicates and applying the inclusion criteria, 17 relevant articles were included in the review. These studies evaluated the use of telenursing—either via telephone or in combination with other technologies—for effectively improving self-care behaviors in diabetic patients. 
Conclusion: The findings indicated that telephone calls can serve as a potential method of remote nursing care for educating patients on diabetes self-management. Nurses can utilize telenursing as an effective and efficient educational tool to enhance blood glucose control in diabetic patients. This approach not only improves the quality of healthcare services but also empowers patients to manage their disease more consciously and prevent its complications.
 

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Blood glucose variability, defined as variations in blood glucose levels over time, is increasingly recognized as a significant factor in the pathology of diabetes complications. While chronic hyperglycemia has been linked to microvascular complications (retinopathy, nephropathy, and neuropathy) and macrovascular complications (coronary artery disease, stroke, and peripheral artery disease), emerging evidence suggests that glucose variability is an independent risk factor for these conditions. This review examined the relationship between blood glucose variability and the development of microvascular and macrovascular complications in diabetes, highlighting the underlying mechanisms, clinical implications, and therapeutic approaches.

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Background: Type 2 diabetes is rapidly increasing, particularly in the Middle East where central obesity is a major contributor to disease burden. Identifying high-risk individuals requires indices that assess visceral adiposity more effectively than body mass index (BMI). This study compared nine anthropometric indices in relation to diabetes and determined their predictive capacity and optimal cut-off values.
Methods: This cross-sectional analysis included 10,103 adults aged 35–70 years from the FASA cohort. Diabetes was defined as fasting glucose ≥126 mg/dL or antidiabetic medication use. Measurements included BMI, waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), body roundness index (BRI), body adiposity index (BAI), a body shape index (ABSI), abdominal volume index (AVI), and weight-adjusted waist index (WWI). Associations were examined using logistic regression (crude and adjusted models). Discriminatory accuracy was assessed using receiver operating characteristic (ROC) curves, area under the curve (AUC), and Youden's index. 
Results: Individuals with diabetes exhibited higher values across anthropometric indices (p< 0.05). In adjusted models, WC, WHR, WHtR, AVI, and WWI remained significant predictors (p< 0.05). WHR demonstrated the highest AUC (0.651, p< 0.001). Optimal cut-off values with high sensitivity and specificity included WHR= 0.91, WHtR= 0.53, and BRI= 4.1. 
Conclusion: Central obesity indices—particularly WHR, WHtR, and BRI—demonstrated superior discriminatory capacity for diabetes and support the use of simple waist-based indices for early screening.

 

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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: 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.

 

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Background: Obesity is one of the causes of diabetes. On the other hand, exercise along with cinnamon supplementation has been recommended as an important approach for controlling and preventing obesity and its related complications, such as diabetes and insulin resistance. Therefore, the aim of the present study is to investigate the combined effect of exercise training and cinnamon supplementation on glycemic indices in individuals with obesity and type 2 diabetes.
Methods: A systematic search of English and Persian articles published in PubMed, Web of Science, Scopus, Magiran, Google Scholar, NorMags, Irandoc, and SID databases was conducted up to January 2025. In data analysis, a random-effects model was used to calculate the weighted mean difference (WMD), standardized mean difference (SMD) and 95% confidence interval (CI). Also, heterogeneity of studies was assessed with the I² test.
Results: In total, 11 studies involving 230 participants with obesity and type 2 diabetes were meta-analyzed. The results indicated that the combination of exercise training and cinnamon supplementation significantly reduced glucose (WMD = -13.317 [95% CI: -19.599 to -7.034]; P = 0.001) and insulin resistance (WMD = -1.098 [95% CI: -1.577 to -0.618]; P = 0.001) compared to the control group in individuals with obesity and type 2 diabetes. However, insulin levels did not show a significant change (WMD = -2.123 [95% CI: -4.333 to 0.088]; P = 0.060).
Conclusion: The results of the present meta-analysis demonstrated that the combination of exercise training and cinnamon supplementation improves glucose and insulin resistance in individuals with obesity and type 2 diabetes. These beneficial effects are not accompanied by changes in insulin levels.

 

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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.
 

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Background: The aim of the present study was to investigate the effect of high-intensity interval training on lipid profile, fasting blood glucose, body composition, and Vo2max in patients with type 2 diabetes or obesity.
Methods: The type of research conducted is a systematic meta-analysis review. A systematic search of published articles was conducted from PubMed, Web of Science, Scopus, Sid, and Magiran databases up to January 2024. The mean difference and 95% confidence interval (CI) were calculated using a random-effects model. Heterogeneity was assessed using the (I2) test and publication bias was assessed using visual analysis of funnel plots and Egger's test.
Results: The results showed that high-intensity interval training significantly reduced body fat percentage [standard mean difference (SMD)=-0.796, P=0/001], BMI (SMD=-0.378, P=0/001), WHR (SMD=-0.424, P=0/001), LDL (SMD=-0.694, P=0/001), TC (SMD=-0.495, P=0/001), TG (SMD=-0.317, P=0/001) and fasting blood glucose (SMD=-0.557, P=0/001) in patients group compared to the control group had a significantly higher VO2max. However, high-intensity interval training significantly increased Vo2max (WMD=-0.997, P=0/001), and HDL (WMD=-0.558, P=0/001) in patients group compared to the control group.
Conclusion: Based on the results obtained, high-intensity interval training can have a positive effect on metabolic indices, body composition, and aerobic capacity in patients with type 2 diabetes or obesity and improve the condition of these individuals. Therefore, it is suggested that in medical centers for diabetic and obese patients, under the supervision of sports and medical specialists, the beneficial effects of high-intensity interval training should be utilized and used as an auxiliary strategy for the treatment and improvement of these individuals.

 

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Background: Dietary acid load is thought to contribute to the development of metabolic syndrome through effects on acid–base balance with evidence being inconsistent. This study aimed to examine the associations between dietary acid load indices, Dietary Acid Load (DAL), Potential Renal Acid Load (PRAL), and Net Endogenous Acid Production (NEAP) and risk of metabolic syndrome and its components in an Iranian adult cohort.
Methods: 6,482 adults aged 35-65 years were enrolled from the Mashhad Stroke and Atherosclerosis Study. Dietary intake was assessed using a validated food frequency questionnaire, and dietary acid load indices were calculated. Participants were followed for nearly 10 years. Logistic regression models were used to evaluate associations of DAL, PRAL, and NEAP with the incidence of metabolic syndrome, diabetes, hypertension, and dyslipidemia, adjusting for major confounders.
Results: Following adjustment, no significant associations were found between DAL indices and the incidence of metabolic syndrome or its components. DAL odds ratio (OR) for the highest versus lowest tertile was 0.984 [95% confidence interval (CI): 0.815–1.188; p= 0.868]. For PRAL, the OR was 1.024 (95% CI: 0.865–1.212; p= 0.782), and for NEAP, the OR was 0.902 (95% CI: 0.763–1.066; p= 0.227). None of the indices were significantly related to new cases of diabetes, hypertension, or dyslipidemia (all p> 0.05).
Conclusion: In this Iranian adult cohort, DAL indices were not associated with the risk of metabolic syndrome or its components. Further studies in populations with different dietary habits are needed to clarify potential threshold effects or effect modifiers.

 

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Background: Since 1999, the International Working Group on the Diabetic Foot (IWGDF) has consistently provided evidence-based guidelines aimed at the prevention and management of diabetic foot (DF). The latest version of these guidelines was published in 2023. Despite similarities such as being compiled by a working group, based on systematic reviews, and using the GRADE methodology to grade recommendations, it has some differences from the 2019 version. Awareness of these similarities and differences facilitates the faster implementation of evidence into clinical practice. The aim was to compare the similarities and differences between the 2019 and 2023 versions of the IWGDF guidelines.
Methods: In this comparative review study, both guideline versions were reviewed as primary sources. Data were extracted in two domains: structural (methodology) and content (number of chapters and recommendations, and key points). A comparison was then conducted on the data both quantitatively and qualitatively, whereby the similarities and differences between the two versions were identified and analyzed by juxtaposing the extracted information.
Results: The 2019 version consists of six guidelines, while the 2023 version includes seven separate guidelines. Both versions contain individual guidelines for prevention of foot ulcers (14 recommendations in 2023 vs. 16 in 2019), classification of foot ulcers (5 recommendations in both versions), diagnosis and treatment of foot infections (26 recommendations in 2023 vs. 27 in 2019), diagnosis and treatment of peripheral artery disease (25 recommendations in 2023 vs. 17 in 2019), offloading interventions (12 recommendations in 2023 vs. 9 in 2019), and wound healing interventions (29 recommendations in 2023 vs. 9 in 2019). A significant difference in the 2023 version compared to 2019 is the addition of a guideline for the diagnosis and treatment of active Charcot neuro-osteoarthropathy, which includes 26 recommendations.
Conclusion: Despite content similarities, the 2023 version differs from the 2019 version in the number of recommendations, with the most notable difference being the inclusion of a guideline for the diagnosis and treatment of active Charcot neuro-osteoarthropathy.

 

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Dear Editor-in-Chief of the Iranian Journal of Diabetes and Metabolism:

The aforementioned study aimed to investigate the concurrent effects of combined exercise training and grape seed extract (GSE) supplementation on oxidative and antioxidant indices in postmenopausal women with type 2 diabetes. The research, in terms of its design as a randomized clinical trial with independent group allocation, possesses a relatively appropriate structure, and its topic is noteworthy from the perspective of women's health and non-pharmacological interventions in diabetes. However, the following critiques concerning methodological, statistical, and interpretative dimensions are noteworthy

 

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Background: Diabetes is a prevalent chronic disease accompanied by numerous misconceptions among the general population. This qualitative study aimed to identify and categorize misconceptions about diabetes among individuals visiting healthcare centers.
Methods: The findings of this study are part of a research project to design a tool aimed at assessing awareness regarding diabetes. To identify misconceptions about diabetes, 12 semi-structured interviews were conducted with individuals of both genders. The data were analyzed using qualitative content analysis.
Results: Out of 420 identified codes, 64 were extracted as misconceptions about diabetes. These misconceptions were categorized into domains including general characteristics of diabetes, risk factors, symptoms, complications, prevention and management of diabetes, and other beliefs.
Conclusion: Findings revealed misunderstandings regarding diagnostic criteria, risk factors, unrealistic symptoms, and unscientific care practices. The results underscore the need for targeted educational programs to correct misconceptions and enhance public awareness.

 

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Background: Gestational diabetes is one of the most common pregnancy-related disorders and is associated with adverse outcomes for both mother and fetus. Enhancing health literacy and self-efficacy in these patients plays a key role in better disease management. This study aimed to compare the effects of face-to-face education and social media-based education on self-efficacy and health literacy among pregnant women with gestational diabetes.
Methods: This quasi-experimental study was conducted with the participation of 75 pregnant women diagnosed with gestational diabetes, who were randomly assigned to three groups: face-to-face education, virtual (social media-based) education, and control (25 participants in each group). The educational intervention lasted four weeks for the two intervention groups. Research instruments included self-efficacy and health literacy questionnaires, which were completed before and after the intervention.
Results: The mean scores of self-efficacy and health literacy significantly increased in both the face-to-face and social media-based education groups after the intervention (p < 0.05), whereas no significant change was observed in the control group. Post hoc analysis revealed that the mean changes in the intervention groups were significantly greater than those in the control group; however, no significant difference was found between the two intervention groups.
Conclusion: Both face-to-face and social media-based education are effective approaches to improving self-efficacy and health literacy in pregnant women with gestational diabetes. Given the widespread accessibility of technology, virtual education can be considered a complementary method to promote health indicators in this patient population.

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Background: Diabetic nephropathy is a major complication of diabetes, linked to cardiovascular disorders. QTc interval prolongation on electrocardiography increases the risk of cardiac arrhythmias and sudden death. This study evaluated the relationship between diabetic nephropathy severity and QTc prolongation.
Methods: In this prospective cohort study, 180 patients with type 1 or type 2 diabetes at teaching hospitals of Kerman University of Medical Sciences were enrolled. Based on albuminuria, patients were classified into microalbuminuria (30–300 mg/g) and macroalbuminuria (>300 mg/g) groups. QTc was measured using a standard 12-lead electrocardiogram and corrected with Bazett’s formula. Demographic, clinical, and laboratory data were analyzed with appropriate statistical tests.
Results: Among 180 patients, 14(7.8%) had microalbuminuria and 166(92.2%) had macroalbuminuria. Mean age was 59.65 ± 10.59 years. QTc was significantly longer in the macroalbuminuria group compared with the microalbuminuria group (436.07 ± 39.97 vs. 411.64 ± 23.63 ms, p= 0.002). Albumin excretion rate showed a weak positive correlation with QTc (r=0.182, p= 0.016). Logistic regression revealed macroalbuminuria was associated with a 10.5- fold higher odds of abnormal QTc (95% CI: 1.33–82.79, p=0.026).
Conclusion: Macroalbuminuria, indicating advanced diabetic nephropathy, is significantly associated with QTc prolongation. Regular electrocardiographic monitoring in diabetic patients with macroalbuminuria is recommended for early detection of cardiac electrophysiological abnormalities and prevention of cardiovascular complications.


 

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Background: Diabetes mellitus is recognized as a complex metabolic syndrome primarily characterized by elevated blood glucose levels (hyperglycemia). α-glucosidase, located in the microvilli of the small intestine, play a pivotal role in the hydrolysis of complex carbohydrates into absorbable monosaccharides. However, the use of common chemical inhibitors of this enzyme, such as metformin, is frequently associated with undesirable side effects. The present research aims to evaluate the inhibitory potential of compounds isolated from Fumaria officinalis on α-glucosidase activity, utilizing computational (in silico) approaches.
Methods: This study was designed and executed with a descriptive-analytical approach, based on computational methodologies. Initially, the 3D structures of key compounds identified from Fumaria officinalis were retrieved from the PubChem database. Simultaneously, the crystal structure of the α-glucosidase was downloaded from the Protein Data Bank (PDB). The toxicity profile of the compounds was predicted using Toxtree and Protox II tools, and drug-likeness properties, based on Lipinski’s rules, were assessed via the SwissADME server. Finally, molecular docking studies were conducted to investigate the interactions between the enzyme and the compounds of interest, employing AutoDock Tools 1.5.6 and Molegro Virtual Docker 6.0 software. Analysis of the molecular interactions resulting from docking was performed with Discovery Studio 3.5 software.
Results: The findings of this research indicate that all selected compounds from Fumaria officinalis, while adhering to Lipinski’s rules and showing no predicted toxicity, exhibited favorable binding energies, positioning them as potential candidates for α-glucosidase inhibition. Among the evaluated compounds, Fumaricine and Chlorogenic Acid demonstrated the lowest binding energies, -7.18 and -7.83 kcal/mol, respectively, thus exhibiting the highest inhibitory potential compared to other compounds. Notably, the binding energies of these two compounds were significantly more negative than that of the standard inhibitor, metformin, indicating their stronger binding affinity to the enzyme’s active site.
Conclusion: Based on the results obtained from this computational study, it can be inferred that Fumaricine and Chlorogenic Acid, as the most prominent compounds found in Fumaria officinalis, act as more effective inhibitors due to their ability to form stronger hydrogen and hydrophobic interactions with key amino acids in the α-glucosidase enzyme’s active site. Therefore, it is suggested that further in vitro and in vivo studies be conducted on these compounds to comprehensively validate their potential in the prevention and management of diabetes mellitus.
 

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Background: Type 2 Diabetes Mellitus (T2DM) Poses a Global Health Challenge, Requiring Effective Self-Care Management and Active Patient Engagement. Self-Care in Diabetes Management Is a Critical Determinant of Successful Outcomes. This Study Aimed to Predict Diabetes Management Self-Care Based on Intolerance of Uncertainty and Mindfulness, with Perceived Social Support as a Mediator, in Patients with T2DM.
Methods: This descriptive-correlational study utilized structural equation modeling (SEM). The statistical population consisted of patients referred to the Yazd Diabetes Association in the first half of 2024. A sample of 350 participants was selected using convenience sampling. Data were collected using the Intolerance of Uncertainty Scale (Carleton et al., 2007), the Mindful Attention Awareness Scale (Brown & Ryan, 2003), the Multidimensional Scale of Perceived Social Support (Zimet et al., 1988), and the Type 2 Diabetes Self-Care Questionnaire (Neamatizadeh et al., 2022). Data analysis was performed using SPSS-24 and AMOS software.
Results: The findings revealed that mindfulness had a significant direct (β= 0.343, p< 0.001) and indirect effect, mediated by perceived social support (β= 0.133, p< 0.001), on diabetes management Self-Care. Intolerance of uncertainty had a significant direct and negative effect on Self-Care (β= -0.191, p= 0.025); however, the mediating role of perceived social support in this relationship was not confirmed. The model fit indices (CFI= 0.97, RMSEA= 0.07) indicated a good fit of the proposed model.
Conclusion: The results suggest that mindfulness enhances Self-Care in diabetes management both directly and indirectly by boosting perceived social support. Conversely, intolerance of uncertainty acts as a direct barrier to Self-Care. Therefore, developing educational interventions focused on enhancing mindfulness and reducing intolerance of uncertainty could improve Self-Care management and lead to better glycemic control in patients with T2DM.