Iranian Journal of

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Background: The current study aimed to ascertain the impact of pulsed magnetic therapy, multicomponent exercise, and a combination of both modalities on bone markers type 2 diabetic patients with osteoporotic.
Methods: In a randomized controlled clinical trial study, 56 older patients with type 2 diabetic osteoporosis (age: 68.18±3.67 yr; weight: 78.13±7.65 kg, body mass index: 28.40±1.76 kg/m2) were randomly assigned to either the multicomponent exercise + Full-body pulsed electromagnetic field (MCEx+PEMF, n= 18) multicomponent exercise + placebo full-body PEMF (MCEx+PPEMF, n=17) and a full-body PEMF alone (PEMF, n= 21). PEMF was applied for the whole body using a full-body mat three times per week, 60 minutes for 12 weeks, with a multicomponent exercise protocol that includes flexibility, aerobic exercise, strengthening, weight-bearing, and balance exercises followed by whole-body vibration (WBV) training. The body composition, bone mineral density (BMD), bone metabolism markers (phosphorus, calcium, sclerostin, osteocalcin, Bone-specific alkaline phosphatase (BALP)) before and after the intervention. The data were analyzed using the dependent t test and the two-way repeated measures ANOVA at the level of less than 0.05.
Results: After 12 weeks of intervention, there is a significant difference in the serum levels of bone mineral density and bone metabolism markers (phosphorus, calcium, sclerostin, BALP) between the groups (P< 0.05). However, the bonferoni post-test showed an increase in serum levels of BMD, phosphorus, sclerostin, BALP with a significant decrease in calcium in the MCEx+PEMF group in compared to alone PEMF group.
Conclusion: The findings showed that the PEMF rehabilitation method combined with multicomponent exercise is more effective and safer than exercise or PEMF only for improving BMD and bone metabolism markers in the type 2 diabetic population with osteoporosis. Therefore, exercise rehabilitation clinics should be encouraged to consider exercise rehabilitation as a treatment method for type 2 diabetic patients with osteoporosis. More studies with long-term follow-up should be considered to confirm these findings.
 

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Background: Type 2 Diabetes Mellitus (T2DM) is a chronic metabolic disease characterized by insulin resistance and inadequate insulin secretion by pancreatic beta cells. Insulin resistance is the most important characteristic of T2DM, in which the peripheral tissues, including the liver, skeletal muscles, and adipose tissue, shows a lower response to the presence of insulin and insulin function is impaired. Adipose tissue, in addition to storing fat, synthesizes and secretes several bioactive peptides called adipokine and cytokine, which play an important role in regulating metabolism, inflammation, obesity and diabetes.
Methods: In the present study, searches were conducted in the Persian and Latin databases PubMed, Science Direct, Google Scholar, SID, and Magiran using keywords such as Diabetes, Insulin Resistance, Adipokine, Adiponectin, Leptin, Resistin, TNF-α, IL-6, RBP-4, Chemerin, Vaspin, Visfatin, Omentin, and Aplin to retrieve articles published from 2011 to 2024.
Results: The results indicated that adiponectin levels are reduced in patients with T2DM and insulin resistance. Elevated levels of leptin and retinol-binding protein-4 play a crucial role in the development of insulin resistance and T2DM. According to the evidence, adiponectin, resistin, TNF-α, interleukin-6, vaspin, and visfatin are associated with insulin resistance and T2DM. Contradictory results were found regarding the associations of omentin, apelin, and chemerin with insulin resistance and T2DM.
Conclusion: Adipocytokines may serve as biomarkers for predicting and early diagnosis of insulin resistance and T2DM. 

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Background: Diabetes is one of the most common disorders of the endocrine glands, the main characteristic of which is an increase in the concentration of glucose in the serum of patients. Herbal medicines are widely accepted by people due to less side effects. The purpose of this study is to investigate the protective effect of the silybum marianum, melissa officinalis, vaccinium arctostaphylos, trigonella foenum, urtica dioica and citrullus colocynthis extracts mixtures in the PC12 cell model in a high glucose environment.
Methods: After 24, 48, and 72 hours of adding different concentrations of plant extracts (silybum marianum, melissa officinalis, vaccinium arctostaphylos, trigonella foenum, urtica dioica and citrullus colocynthis) in the normal culture medium of PC12 cells and the medium with high glucose (25 mg/ml, 13/5), cell viability was measured by MTT method.
Results: The results showed that the viability of PC12 cells did not change in 24, 48 and 72 hours after treatment with a mixture of plant extracts. The survival rate of cells in the high dose glucose group was significantly reduced compared to the control group, and the mixture of plant extracts in high doses significantly reduced cell death in these conditions.
Conclusion: Based on the available findings, glucose with a concentration of 25, 13.5 mg/ml caused the death of PC12 cells and the mixture of plant extracts was able to reduce the cell death caused by high glucose after exposure with nerve cells.
 

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Diabetes mellitus (DM) is a chronic and multi-organ disease that affects a large population worldwide, and its incidence is increasing despite the preventive measures taken globally. Despite effective guidelines for managing DM, healthcare professionals and patients/caregivers often struggle to understand and follow these recommendations. Therefore, this study presents a comprehensive approach to diabetes management based on the American Diabetes Association's latest guidelines, aiming to facilitate the process of adherence to these guidelines within the Iranian population. The study's focus encompassed recommendations pertaining to patient communication, structured patient education and support, psychosocial factors, social determinants of health, avoidance of therapeutic inertia, individualized patient pathophysiology, continuous and effective management and care organization, mitigation of hypoglycemia risk, continuous monitoring and surveillance, modification of health-affecting behaviors, screening, ongoing management and care for diabetes-related complications, shared decision-making, and the components of the disease care. The most recent updates to the American Diabetes Association guidelines for diabetes management were also briefly explained.

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Background: Today, obesity is closely related to metabolic syndrome and especially type 2 diabetes, which changes the secretion and release of adipocytokines, and different training programs have different results on these indicators. Therefore, the aim of the present study is to investigate the durability of changes caused by exercise programs on adipocytokine indices of obese type 2 diabetic patients.
Methods: In this semi-experimental study, 45 obese men with type 2 diabetes were randomly divided into a control group (no exercise) and 4 exercise groups (aerobic, combined, resistance and high-intensity interval). The exercise program of the groups was considered based on the calories consumed in each session. The participants performed 12 weeks of training programs and 12 weeks of non-training. Physiological, anthropometric indicators and inflammatory and pro-inflammatory indicators (IL-6, TNF-α, resistin and leptin) and anti-inflammatory indicators (adiponectin and SFRP5) were measured before the program and at weeks 6, 12, 18 and 24. became.
Results: After 12 weeks of combined, aerobic, high intensity and resistance training, anti-inflammatory indices (adiponectin and SFRP5) showed a significant increase compared to the baseline (before starting the training program) (P< 0.05). Regarding pro-inflammatory and anti-inflammatory indicators (IL-6, TNF-α, resistin and leptin), a significant decrease was observed in all groups after 12 weeks of training program (P< 0.05). In this study, a significant improvement in weight loss and blood glucose was observed after 12 weeks of exercise program in all 4 exercise groups (P< 0.05). In the second part of the findings (non-training or durability of training effect), it was resistance training that showed a lower percentage decrease (P< 0.05) in anti-inflammatory indices and an increase in pro-inflammatory and inflammatory indices after 12 weeks of non-training, which showed the durability It shows more recovery in obese type 2 diabetic patients (P< 0.05).
Conclusion: The findings of the research showed that high-intensity interval training after 12 weeks can cause a greater effect on inflammatory, pro-inflammatory and anti-inflammatory indicators compared to aerobic, combined and resistance training. But this is the resistance exercise that caused the reduction in inflammatory, pro-inflammatory indicators and increase in anti-inflammatory indicators in obese type 2 diabetic patients to be more permanent. Therefore, the effectiveness of resistance training in non-training conditions from three methods of high-intensity interval training, aerobic and combined (aerobic + resistance) has a greater effect on low-grade inflammation and results in a longer recovery in obese type 2 diabetic patients.
 

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Background: Metabolic syndrome is characterized by a cluster of conditions such as abdominal obesity, high triglycerides, high blood pressure, high blood sugar, and low levels of healthy fat. Therefore, this study aimed to investigate the effect of endurance training on PGC1α protein content, glycosylated hemoglobin and metabolic syndrome indices in obese rats with type 2 diabetes.
Methods: Eighteen male Wistar rats with an average weight of 200±20 g were selected and placed on a high-fat diet for four weeks. Then 12 rats were randomly selected and induced type 2 diabetes by injecting nicotinamide (110 mg/kg) and streptozotocin (50 mg/kg) solutions. Diabetic rats were randomly divided into two groups of training and control patients. The samples of the training group performed endurance training on the treadmill for 8 weeks and 5 sessions every week with an intensity of about 50 to 70% of the maximum speed. 48 hours after the last training session, mice were sacrificed and variables were measured. To analyze the data, one-way ANOVA and Tukey's post hoc tests were performed in SPSS software version 29.
Results: Endurance training led to a significant decrease in fasting blood sugar levels, HbA1c and triglyceride levels (P= 0.0001). On the other hand, it did not show any effect on HDL levels (P= 0.087). On the contrary, it led to an increase in the intracellular amount of PGC-1α (P= 0.0001).
Conclusion: The results show that endurance training can be considered as an adjuvant drug by regulating the factors related to metabolic syndrome.

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Background: Type 1 diabetes mellitus or juvenile/adolescent diabetes has a significant impact on the quality of life among children and parents. Thus, the development of a deep understanding of the disease of diabetes in childhood and the ways to prevent and treat patients allows health care providers to respond to their specific needs. One of the solutions to improve the knowledge of the patients is online education. Therefore, this study designed and evaluated a childhood diabetes education website with the goal of improving the quality of care for children and reducing mortality.
Methods: This study involved three phases of content collection, website design, and evaluation. The website content information was collected from reliable library sources and created using the WordPress website design tool. Subsequently, the website content, performance, display capabilities, terminology and information retrieval, and ease of learning were evaluated by physicians and nurses.
Results: Comprehensive clinical information about pediatric diabetes was provided on the website. In the evaluation of the website content, the highest average was related to the type 1 diabetes section at a glance and the lowest average was related to the pathology section. In evaluating the website performance, the highest average was related to the overall design and the lowest average was related to the ease of use. Overall, the website performance was of good quality.
Conclusion: To increase the effectiveness of care services and reduce the complications of diseases, providing accurate and reliable information in the form of educational websites should be considered.

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Background: Moderate and intense aerobic exercise increases the production of free radicals, and on the other hand, the use of antioxidant supplements such as grape seed extract (GSE) has been suggested as one of the ways to deal with oxidative stress. Based on this, the aim of this study was to determine the interventions effect of combined exercise and consumption of GSE on some factors of oxidative and antioxidant stress in postmenopausal women with type 2 diabetes.
Methods: The current study was conducted as a clinical trial on the 80 women with type 2 diabetes, who were randomly divided into four groups (20 people): control, exercise, GSE supplement, exercise + GSE supplement. The combined exercise protocol consisted of aerobic (20 minutes of treadmill running at an intensity of 60–70% of reserve heart rate) and strength training (at an intensity of 70% of one repetition maximum), which was performed for eight weeks (five days/week). GSE supplement was taken in the form of 200 mg capsules daily (morning and noon). Samples (five cc) were taken before and after eight weeks of interventions. In order to determine the acceptance or rejection of the null hypothesis of intragroup and intergroup changes, was used the two-way AVOVA, and then Tukey's post hoc test to determine different groups by SPSS version 25 (P≤ 0.05).
Results: The values of total antioxidant capacity (TAC) and serum glutathione reduction (GSH) in the GSE and exercise + GSE groups increased significantly compared to the control and exercise groups (P= 0.001). Serum malondialdehyde (MDA) levels in the GSE group showed a significant decrease compared to the control and exercise groups (P= 0.001).
Conclusion: It seems that the intervention of grape seed extract is more effective in reducing oxidative stress than combined exercise. The consumption of this extract alone, as well as with combined exercise, has a significant effect on increasing the total antioxidant capacity and reducing GSH (glutathione).

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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.

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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.

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Background: Type 2 diabetes is a prevalent metabolic disorder characterized by insulin resistance and impaired glucose absorption. The COVID-19 pandemic and associated quarantines led to significant lifestyle changes, including reduced physical activity among diabetic individuals. This study investigates the patterns of physical activity and perceptions among diabetic individuals in post-COVID Iran.
Methods: An online questionnaire was created using the "Pors Online" platform and shared via social media. Among 435 participants from 35 Iranian cities, 400 responses (200 diabetics and 200 healthy individuals) were deemed complete and valid for analysis. The data were analyzed using an independent t-test, with a significance level set at P< 0.05.
Results: The results showed that the physical activity level of diabetic individuals was significantly lower than that of non-diabetic individuals P< 0.05. Additionally, their preferred types of physical activities differed; both groups showed the most interest in walking and the least interest in traditional games. The primary motivation for exercise among diabetic individuals was disease prevention, but financial barriers had the greatest impact on reducing their physical activity P< 0.05. Their main sources of information about physical activity were magazines and books.
Conclusion: Improving access to sports facilities and tailored equipment for diabetics, coupled with awareness campaigns on the benefits of exercise, is essential. Developing customized sports programs suited to the health conditions of diabetics can enhance their participation and overall well-being.

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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: Exercise training represents an effective approach that contributes substantially to lowering chemerin and vaspin levels, enhancing body composition, and preventing complications related to overweight and obesity. In this context, the present study sought to examine the effects of exercise training on chemerin, vaspin, and body composition in individuals with type 2 diabetes.
Methods: A systematic review and meta-analysis was conducted to evaluate the effects of exercise interventions on various outcomes in patients with type 2 diabetes. A comprehensive search for English and Persian articles published up to )January 4, 2025( was performed across the following databases: PubMed, Web of Science, Scopus, Google Scholar, IranDoc, Magiran, Noormags, and SID (Scientific Information Database). Fifteen studies, including 19 exercise interventions and 440 participants with type 2 diabetes, were included. Data were analyzed using a random-effects model, and the mean differences with 95% confidence intervals (CI) were calculated. Heterogeneity was assessed using the I² statistic, and publication bias was evaluated through visual inspection of funnel plots and Egger’s test.
Results: A total of 15 studies (with 19 exercise interventions) involving 440 participants with type 2 diabetes were included in the meta-analysis. The results indicated that exercise interventions led to non-significant changes in c-Merlin [SMD= −0.967, 95% CI: −2.453 to 0.518, P= 0.202], body mass index (BMI) [SMD= −0.228, 95% CI: −0.470 to 0.013, P= 0.064], waist-to-hip ratio (WHR) [SMD= −0.038, 95% CI: −0.773 to 0.007, P= 0.054], and body fat percentage [SMD= 0.080, 95% CI: −0.524 to 0.685, P= 0.795] compared with the control group in individuals with type 2 diabetes.
Conclusion: The results of the present study demonstrated that exercise training significantly reduces vaspin levels in patients with type 2 diabetes, while it has no significant effect on chemerin, body composition, or body composition indices (including body mass index, body fat percentage, and waist-to-hip ratio). It appears that physical exercise may play an effective role in improving the metabolic status of patients with type 2 diabetes through the modulation of vaspin levels.

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Background: Diabetes is a serious global health problem, and effective methods for its prediction and management are essential. Conventional diagnostic approaches typically rely on tests such as oral glucose tolerance test (OGTT), fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c). Machine learning has the potential to enhance diagnostic accuracy; however, its performance and alignment with clinical guidelines require thorough evaluation.
Methods: This narrative review examines the effectiveness of machine learning in the early diagnosis of diabetes. Articles were selected based on predefined criteria and analyzed in terms of algorithm classification, output measures, involvement of clinical experts, and interpretability. Evaluation metrics such as accuracy, area under the curve (AUC), specificity and sensitivity were used to assess algorithmic performance. Relevant studies comparing prediabetes diagnosis using artificial intelligence and conventional methods were reviewed, and clinical guidelines from both domains were extracted and compared.
Results: Analysis of 41 articles showed that ANN, LR, and DNN were the most frequently used algorithms. Only 2% of the studies incorporated clinical rules and physician involvement, and 12% demonstrated model interpretability. While conventional methods rely on HbA1c and FPG tests, no clinical guidelines currently exist for AI-based diagnosis. Machine learning algorithms outperformed traditional methods, showing 29% higher sensitivity and 23% higher specificity.
Conclusion: Although artificial intelligence demonstrates superior performance in prediabetes diagnosis, limitations such as lack of interpretability and the absence of standardized clinical guidelines hinder its current clinical application. Addressing these challenges could enable AI to become a more efficient and reliable diagnostic tool.
 

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Background: Type 2 diabetes is a major public-health threat of the present century, imposing substantial clinical and economic burdens on health systems. Accurate forecasting of disease incidence can support resource allocation and the design of targeted interventions.
Methods: In this study, we developed a hybrid model that integrates Cellular Learning Automata (CLA) with a Susceptible–Infected–Recovered (SIR) framework to predict the 20-year spread of type 2 diabetes using real patient data from Kerman province. The dataset comprised demographic and laboratory features of patients with diabetes collected during the Persian calendar years 2005– 2013. After preprocessing and imputation of missing values, the proposed model was implemented in MATLAB.
Results: Results indicate that the CLA–SIR combination models the disease trajectory with high accuracy. Moreover, factors such as blood pressure, cholesterol, and body mass index were identified as key drivers influencing the activation states of model cells.
Conclusion: These findings suggest that intelligent hybrid approaches can be effective for health-data analysis and long-term prediction of chronic diseases.
 

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Background: In recent years, the prevalence of diabetes has increased significantly. Parents of children with diabetes suffer from many physical and psychological problems; Therefore, various interventions have been designed to improve their quality of life and well-being. These interventions have benefited from a wide range of approaches and methodologies. The present study was conducted with the aim of identifying and reviewing various psychological interventions for parents of children under 6 years old with diabetes and examining their strengths and weaknesses.
Methods: The search for interventional protocols was done through various databases such as Google Scholar, PubMed, Science Direct and Scopus. after checking the data entry criteria, 11 articles were selected and studied.
Results: The interventions used different approaches such as cognitive-behavioral, social learning, family therapy, and positive parenting. The intervention methods were mostly remote and had different consequences for the parent and the child, which has been highlighted. Also, the sample size in these studies was between 30 and 200 parents, and the satisfaction level of the main interventions was reported to be high.
Conclusion: In general, limited interventions have been conducted. Given that interventions focusing on the psychological state of parents can lead to increased social support and improved mental health in parents and children with diabetes, it is hoped that this article will pave the way for examining different approaches.
 

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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.