Iranian Journal of

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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.