Iranian Journal of

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Background: Diabetes mellitus, the most common metabolic disorder of childhood, has important physical and emotional complications this urges the role of patient education and self-monitoring. Diabetes is costly since patients have to do several lab tests and spend a lot on treatment.
Methods: 150 patients with IDDM entered this cross-sectional study. The metabolic control and degree to which these patients were utilizing available facilities were determined and compared with same surveys from Germany, France, USA, Australia, and Saudi Arabia.
Results: 91.3% of patients had no glucometer thus were unable to do self-monitoring. HbA1C had been regularly determined in only 8.66%. Insulin therapy was improper or inadequate in 59.1%. The quality of metabolic control was significantly poorer than the other mentioned nations (P< 0.001).
Conclusion: The study advocates educational programs for diabetics. Complete insurance coverage and free weekly lab tests are also suggested.

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Background: Early detection of carbohydrate intolerance is important to prevent maternal and perinatal complications. This study aims to determine association of symptoms and clinical feature with different degree of carbohydrate intolerance in comparison with healthy pregnant women.
Methods: Two thousand four hundred sixteen pregnant women referred to five university hospital clinics were followed up until delivery. Previously known diabetic patients were excluded from the study. The universal screening was performed with a 50-g 1-hour glucose challenge test (GCT). Those with plasma glucose 130mg/dl underwent a 100-g 3-hour glucose tolerance test (GTT) to diagnose gestational diabetes mellitus (GDM) according to Carpenter and Coustan criteria. Also based on result of GCT and GTT all pregnancy divided to four groups GDM, impaired GCT (IGCT), impaired GTT (IGT) and normal pregnancy. Family and obstetric histories were taken followed by a complete physical examination included: BMI and blood pressure measurements, excess weight gain during pregnancy, proteinuria, glycosuria, polyhydramnios, and edema. Symptoms were considered were as followed: polyuria, polydipsia.
Results: Among the 2416 pregnant women, 114(4.7) were diagnosed with GDM. Of the 114, 42(36.8%) were obese, 39 (34.2%) had glycosuria, 5 (4.3%) had pre-eclampsia, , 22 (19.2%) had abnormal excess weight gain during pregnancy. The most important symptoms were polyuria (14.9%), polydipsia (12.6%). In comparison with healthy group, GDM patients had a significantly higher BMI, glycosuria, polyhydramnios, proteinuria, and excess weight gain. Association of these symptoms in GDM patients was significantly different from that in healthy pregnant women. Out of 114 GDM patients 59 (51.7%) did not have any symptoms or any abnormal clinical features.
Conclusion: The rate of asymptomatic patients in different level of carbohydrat intolerance indicates that symptom – based screening would miss many subjects. Despite clinical feature is not a reliable basis for screening GDM patients, it maybe used to improve maternal surveillance.

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Celiac disease and typel diabetes mellirus have been linked to the same HLA markers and chromosomal loci, which may account for the concurrence of the two disorders in a significant number of patients. This study was designed to investigate the frequency of anti-gliadin antibodies, a marker for celiac disease, in diabetic patients.
Methods: In this study, 182 diabetic patients (52 with typel and 130 with type2 diabetes) were screened for anti-gliadin IgG by indirect immunofluorescence. Age range was 3-29.5 and 42-65 years for type 1 and type 2 diabetes groups.
Results: Anti-gliadin IgG was found in 1.9% and 1.5% of patients with type land type 2 diabetes. In Tehran, 0.02% of healthy blood donors have been reported to be seropositivitive for anti-gliadin IgG.
Conclusion: The prevalence of anti-gliadin seropositivity in type 1 and type 2 diabetics, was respectively 30 and 24 times higher than the general population of Tehran. This concurs with other reports indicating higher occurrence of celiac disease in diabetic populations. The rather low sensitivity and specificity (both around 80%) of the antigliadin antibody test has made it a suboptimal diagnostic test. However, it is quick and inexpensive and can be suitable for screening programs. We recommend the test in all at-risk populations including diabetics.

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There are controversies on the effects of diabetes and lifestyle of affected patients on their bone mineral densities (BMDs). This study has investigated the effects of lifestyle of type 2 diabetics on BMD at the lumbar spine and proximal femur in pre and postmenopausal women.
Methods: In a historical cohort study, 20 pre-menopausal type 2 diabetics and 57 non-diabetics and 126 type 2 Diabetics and 315 non-diabetics postmenopausal women, were recruited. BMD measurements were also made to the spine and proximal femur (Neck, Wards, and Shaft) by dual energy X-ray absorptiometry (DXA) technique. Exclusion criteria were endocrine, rheumatologic or chronic diseases. Type 2 diabetic cases and non-diabetics were matched for age and body mass index (BMI) in both pre menopausal or postmenopausal groups.
Results: A total of 146 type 2 Diabetic patients without any other endocrine disorder and 372 non-diabetic women, aged 40-81 years were enrolled. No significant differences were found between diabetics and healthy controls in terms of BMD values of spine and femur regions in the pre‌menopausal women. Postmenopausal diabetics, however, had higher BMD at the lumbar spine compared with the healthy postmenopausal controls. An age-related decrease in BMD values (lumbar and femur) was observable in all groups and a significant correlation between BMI and BMD was found. Adjusting for age and BMI, the effect of lifestyle on BMD at all sites was investigated. Occupation was associated with BMD in postmenopausal, but not in premenopausal women. Among the investigated dietary items, milk, yogurt and cheese were all associated with increased BMD in at least one region in diabetic patients. Smoking was not associated with BMD.
Conclusion: Type 2 Diabetes does not seem to be complicated by bone loss and osteoporosis. Physical activity and milk consumption in postmenopausal diabetic women can be a protective factor against bone loss.

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Diabetes mellitus (DM) is the commonest cause of renal failure, blindness and non traumatic amputation. According to ADA, prevention of DM complications is possible through monitoring and control of blood glucose levels.
Methods: The Betachek strip, produced in Australia, is able to determine biood glucose level with no need for electronic glucometer devices.
Results: In this study, we compared venous and capillary blood glucose levels as determined by lest strips with measurements of enzymatic method (the standard laboratory kit). The mean capillary and venous blood glucose measured by the strip test was 21.85 mg/dl (P< 0.0001) and 17.9 mg/dl (P< 0.002) respectively that was 11.13% more than the standard method.
Conclusion: In this study, standard method had higher correlation with venous samples glucose level, than capillary samples (as measured by Betachek) (0.84 vs. 0.824). This difference was statistically significant (P< 0.0001).
Good correlation between the Betachek strip and the standard enzymatic method of blood glucose measurements, advocate its usage in home setting.

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At least 2 million people are affected by type II diabetes mellitus in Iran. Neuropathy is one of the commonest complications of diabetes affecting the quality of life of patients and can result in foot ulcer and amputation. The current study aimed to examine possible factors that could alter development of diabetic neuropathy.
Methods: In this case-control study, 110 diabetic patients were selected from Shariati hospital diabetes clinic. Michigan Neuropathic Diabetic Scoring (MNDS) was used to distinguish cases from controls. The neuropathic status of patients was confirmed with EMG-NCV. Multiple factors were compared between the two groups including ACE-I consumption, blood pressure, serum lipid level, sex, smoking, method of diabetes control and its quality.
Results: Statistically significant relations were found between neuropathy and age, gender, quality of glycemic control and duration of diabetes (P values: 0.04, 0.04, 0.000 and 0.005, respectively). No correlation existed between atherosclerotic risk factors (high BP, hyperlipidemia, cigarette smoking) and diabetic neuropathy.
Conclusion: In this study, hyperglycemia was the only modifiable risk factor for diabetic neuropathy. Glycemic control can decrease the incidence of neuropathy and delay its progression leading to improvement in the quality of life in diabetics. Aged and male diabetic patients and those with poor diabetes control are groups in most need of regular foot exam and more practical educations.

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Neuropathy is a common complication of diabetes mellitus. Meticulous neurological examination and electrodiagnosis are valuable tools in early diagnosis of neuropathy and prevention of its sequels.
Methods: A hundred and three randomly selected diabetic patients were recruited from the endocrine clinic. Mean age of patients was 52.6 ±14 years. 29.4% had type 1 and 70.6% had type 2 diabetes.
Medical history was taken from patients and neurological examination was done. Electroneurographic examination included nerve conduction velocity, action potential amplitude, distal latency and H reflex measurements.
Results: Neuropathy was found in 79.4% of patients. The prevalence of neuropathy had a direct relation with duration of the disease. The most common complaints were tingling and numbness of extremities (72%) and burning sensation of the feet (36%). The most common physical findings were abnormal ankle jerk (92%), and decreased vibration perception (76%) in feet. Abnormal H reflex
(92.5%) and decreased amplitude of action potentials (79%) were the most common electroneurographic findings. There was a strong correlation between clinical and electroneurographic findings.
Conclusion: Neuropathy was quite common in diabetic patients. Neurologic examination is, therefore, recommended to prevent unnecessary workups and prevent complications.

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Depression is one of the most prevalent mental disorders in diabetics, which affects treatment course and disease prognosis. This study focuses on the association between diabetes and depression as well as depression and glycemic control.
Methods: 375 diabetic patients (type I and II) of diabetes clinic of Doctor Shariati Hospital and diabetes association of Iran participated in this cross-sectional study.Patients were screened for depression with Beck Depression Inventory. Then depressed subjects were
evaluated with DSM IV criteria for determination of the depressive disorders category.
Results: Depression was diagnosed with Beck Depression Inventory in 41.9% of patients. Of these patients major depressive disorder was defined in 23.7%, dysthymic disorder in 9.3% and association of two disorders in 0.8% of patients. Major depressive disorder was more prevalent in 31-59 year old group and dysthymic disorder in more than 60 year age group. Also depression was more prevalent in
women, diabetics with uncontrolled blood glucose and patients with diabetes complications.
Conclusion: Depression is a prevalent psychiatric disorder in diabetics, which is associated with female gender, poor glycemic control and diabetes complications. Therefore, glycemic control and prevention and treatment of diabetes complications can prevent depressive disorders in diabetics.

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Background: Type 1A Diabetes Mellitus (T1DM) is a chronic and progressive auto- immune disorder resulting from immune mediated destruction of Langerhans islet beta cells. The etiology of T1DM like the other autoimmune diseases is unknown and many factors are involved, Both humoral and cell-mediated immunity have a critical role in T1DM pathogenesis. The cytokines, the immunomodulatory peptides, are responsible for the immune cell recruitment and producing auto-antibodies by the immune effector cells. To evaluate the role of cytokines in sensitivity or resistance to T1DM, we have employed IFN gamma to determine their gene polymorphisms and their association with T1DM.
Methods: 30 patient suffering from T1DM and 40 normal control were studied simultaneously .PCR technique was used to characterize the polymorphisms of cytokine. Salting out method was performed for DNA isolation .The polymorphosime of IFN gamma gene was determined on position UTR+5664`5.The PCR products were evaluated by Gel Electerophoresis Technique.
Results: There was a significant difference between patient and control group in TT allele IFN gamma gene: p<0.05, RR: 0.39(0.22

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Background: Diabetic Neuropathy is the most common and troublesome complication of Diabetes Mellitus, leading to the greatest morbidity and mortality and resulting in a huge economic burden for diabetes care. Early diagnosis of distal symmetric sensorimotor polyneuropathy, a common complication of diabetes, may decrease morbidity by allowing potential therapeutic interventions.
Methods: In 68 diabetic patients after neuropathy screening by U.K and Michigan scores, Bilateral sural nerve conduction parameters as nerve conduction velocity, latency and amplitude were determined and analysed.
Results: 54.4% of patients had Rt sural abnormal response, 50% had abnormality in left side and 39.7% had bilateral abnormality. There was significant statistical correlation between Michigan physical score and electrophysiologic finding (P-value < 0.003) but no correlation with U.K score (P-value > 0.3). The most prevalent abnormal electrophysiologic finding was amplitude decrement of sural response. Conclusion: Sural nerve response is one of the simplest and most sensitive peripheral sensory nerves for electrophysiologic study of diabetic neuropathy and its evaluation is recommended in all diabetic patients in spite of normal physical examination and history for detection of subclinical neuropathic cases. For increment of sensitivity, amplitude measurement of sensory response is highly recommended.

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Background: Diabetes Mellitus is a common chronic disease with severe of complications. Proper glycaemic control can prevent these complications considerably. Evaluation of effectiveness of community based and patient centered interventions on glycaemic control, quality of life, patient satisfaction, patient knowledge and reported symptoms were the main aims of this research.
Methods: In a clinical trial, patients referring to Iranian Diabetes Association, who were more than 18 years old, divided to intervention and control group randomly. After three months of general interventions in both groups, including diabetes education and specific interventions including telephone calls, continuous corresponding and sending educational issues in intervention group, changes in variables were studied. Results: Among 52 patients in each group, 17 were male and 42 had type 2 diabetes. The average age was 49 in intervention and 51 in control group. Two groups had no significant difference in age, sex, type of diabetes, treatment method and duration of diabetes, other diseases and education. Both groups showed significant improvement in glycaemic control. The mean reduction in HbA1c was 1.45 in intervention and 0.86 percent in control group the difference is statistically significant (P= 0.02). Patient satisfaction increased in both groups. The satisfaction is significantly higher in intervention group (P=0.000). Knowledge has increased significantly in both groups the difference in groups is not significant. The improvement in Quality of Life was just significant in intervention group. The reported sign and symptoms have not changed in both groups.
Conclusion: Community based and patient centered interventions with emphasis on continuous education and support can improve glycemic control, quality of life, patient satisfaction and patient knowledge in diabetes mellitus.

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Background: up to know many herbal medicines with different oral formulations have been recommended for diabetes. The aim of this study was to investigate the effect of 4 herbal hypoglycemic agents include garlic (Allium sativum) neem (Azadirachta indica), tulsi (Ocimum sanctum) and bitter gourd (Momordica charantia) on blood glucose, antioxidant enzymes and metal ions in diabetics
Methods: Crude extracts of herbal agents was prepared and each one was given to one group of diabetic rats. Two group of diabetic rats received insulin and glibenclamide. As controls, two groups of healthy and diabetic rats received saline. Body weight, fasting blood glucose, antioxidant enzymes and metal ions were measured before and after the study.
Results: All agents including herbal preparations, insulin and glibenclamide reduced the levels of blood sugar and lipid peroxide when compared with diabetic control. These agents also increased levels of antioxidant enzymes in diabetic rats. Antioxidant enzymes decreased significantly in diabetic controls. Metal ions increased in diabetic rats treated with herbal agents, insulin and glibenclamide but decreased in diabetic controls.
Conclusion: Above mentioned herbal plants may be useful in the treatment of diabetes as they not only have hypoglycemic effect but they also protect rats from free radical mediated cellular injury by improving the activity of antioxidant enzymes. They also improve the levels of metal ions which are associated with antioxidant enzymes.

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Background: Currently different criteria are used to diagnose Gestational Diabetes. ACOG (American college of obstetric and Gynecology) accepted NDDG's (criteria National Diabetes Data Group) Criteria and ADA (American Diabetes Association) accepted Carpenter Caustan’s. Although both of these criteria have been achieved by O Salivan and Mahan’s reaserches, the number of patients has been diagnosed are different .The aim of this study was to compare Gestational Diabetes prevalence according to Carpenter Caustan’s and NDDG’s Criteria.
Methods: 1200 pregnant women were screened in a prenatal care clinic. Patients with definite diabetes were excluded. According to universal GDM screening method, for all of the patients GCT and GTT (if GCT > 130) were preformed. The results evaluated according to Carpenter Caustan’s and NDDG’s criteria. Results: In this screening, 377 participants had positive GCT, according to Carpenter and Caustan’s criteria 83 women (6.9%), and according to NDDG criteria 50 women (3.6%) had Gestational Diabetes Mellitus. If the cut of point of GCT was 140 mg/dl instead of 130 mg/dl, according to Carpenter and Caustan’s criteria 16 women (18.1%), and according to NDDG 4 patients (9%) were missed.
Conclusion: Regarding the significant difference between two methods in diagnosis of gestational diabetes mellitus, assessment of each method value in improving prognosis and outcomes is necessary. According to the results the cut of point of 130mg/dl, as recommended in previous studies, has more accuracy for screening.

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Background: Type 2 diabetes is a hereditary disease but the inheritance and responsible genes have not been clearly clarified yet. According to the most studies, diabetes is one of the most common causes of mortality and morbidity in populations. Diabetes occurs in 30% of first degree family members of diabetic patients, But most people are not aware of their disease.
Methods: We studied first degree relatives of type 2 diabetes and screened them for diabetes, IFG and IGT.174 families(1556 people) of Tabriz residents were studied, among them 1232 persons grater than 30 years were alive and FBS and OGTT were done in this group .
Results: According to this study, 1232 persons were alive and 324 persons had died and DM was found in 343 (27.9%) and 82 (25.3%) of them respectively. We found 179 (14.5%) persons with IFG and 89 (7.2%) with IGT.The percent of diabetes in offspring and siblings were 32.9% and 22.1% respectively. The majority of patients had 41 – 50 years old. Risk of diabetes among offspring who had diabetes in both parents was more than the ones who had diabetic father or mother. In this study, women with diabetes were more than men (32.4% vs. 22.2% respectively). The prevalence of Diabetes type 2 in first-degree relatives was more frequent between sister and brother (41.95%), followed by that between father and son (10.9%).
Conclusion: Prevalence of diabetes in most populations is 8 – 10 %. If diabetes occurs in someone, risk of development of diabetes will increase to 30% in their family members. Therefore, screening must be done in all family members of diabetic patients to recognize the problem and to prevent from diabetes complication.

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Background: Hypertension and dyslipidemia are common in patients with type 2 diabetes mellitus. The high prevalence of cardiovascular disease in diabetic patients is, in part, related to these two risk factors. This study was performed to determine the prevalence of hypertension and dyslipidemia in newly diagnosed patients with type 2 diabetes mellitus in Isfahan.
Methods : In this cross – sectional study during 2001 – 2003, 310 newly diagnosed type 2 diabetic patients, in Isfahan endocrine and metabolism research center, were studied. Height, weight, blood pressure, Plasma lipid and lipoproteins, and HbA1c were determined for all subjects.
Results: Mean age at presentation was 489.83 years, and mean BMI was 28.44.62 Kg/m2. Hypertension was present in 32.9%, hypercholesterolaemia in 61.3%, hypertriglyceridaemia in 61.6%, high LDL in 77.3%, and low HDL in 67.8% of these patietns. The mean systolic and diastolic blood pressure were 119.0816.59 and 70.0214.02mmHg, respectively. The mean for total cholestrol was 216.1043.65, for triglyceride 207.46105.67, for LDL 124.7331.45, and for HDL 43.119.29 mg/dl.
Conclusion: Hypertension and dyslipidemia are common in newly diagnosed type 2 diabetic patients. This fact demonstrates the importance of early interventions for proper diagnosis and treatment of these two risk factors in diabetic patients.

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Background: Diabetes mellitus is the most common cause of renal failure, blindness, non- traumatic amputation and neuropathy. Homocysteine, a sulfurated amino acid, has a close correlation with Methionine and Cysteine. The conversion of Methionine to Homocysteine and Cysteine is required coenzymes like vitamin B6, B12 and Folate. The effect of Metformin on serum Homocysteine level by decreasing vitamin B12 level in patients with type 2 diabetes mellitus was described previously. Methods: This is a prospective clinical trail study among patients with type 2 diabetes mellitus in Shiraz. 76 patients were divided into two groups (38 patients in each group). First group treated with Metformin 500-2000 mg/day and the second group treated with Glibenclamide 5-20 mg/day with follow up period of at least 6 months. Hb and MCV were used in follow up to detect megaloblastic anemia, indicator of B12 and folate deficiency. Fasting plasma Homocysteine level Hb A1C and blood sugar were measured in baseline and at 3 and 6 months follow up periods. Results: There was no significant difference between age, sex, weight, height and BMI and baseline serum profile between the two groups. Homocysteine level increased significantly in Metformin group at 3 and 6 months(P=0.003 and 0.001 respectively). Mean plasma homocysteine level after 6 months were 10.98±0.58 μmol/l in Metformin and 10.0± 0.88 μmol/l in Glibenclamide group, with significant difference between the two groups (P=0.001). Conclusion: Metformin increases the plasma Homocysteine level. Metformin will accumulate highly in gastrointestinal wall and cause malabsorption of vitamin B12, therefore we can conclude that the use of Metformin for 6 months can cause vitamin B12 malabsorption and increase in plasma homocysteine level. Increase in plasma homocysteine level was 7.54% in our study that is higher in comparing to the other studies. It can be explained by longer duration of Metformin therapy in our study. Rising in Homocysteine levels may have detrimental effect on vessels that need further study.

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Background: The goal of dietary recommendations in children with type 1 diabetes mellitus is to achieve moderate to good control of blood glucose regarding to decrease in diabetic long-term complications. Although educational programs on appropriate dietary habits are offered in Isfahan Endocrine and Metabolism Research Center for diabetic patients, there is no information about their dietary habits . This study has been performed to investigate dietary intake in children with diabetes mellitus type1 and to compare the results with that of non-diabetic ones.
Methods: A cross-sectional study was performed in two groups of healthy and diabetic children. Data were collected by questionnaire and interview. The validity and reliability of the questionnaire were determined by content validity and pilot study. Data were described and analyzed by t-student and Pearson correlation tests in four age groups, using SPSS software.
Results: Findings showed that in “A” age group the intake of total calorie and fiber, in “B” age group the intake of fiber, fat, protein, carbohydrate, sugar and SFA, also fat, protein, carbohydrate, sugar and SFA-derived calorie consumption, in “C” age group the intake of sugar and fiber, also PUFA and sugar-derived calorie consumption and in “D” age group the intake of fiber, total calorie, protein, carbohydrate and sugar were higher in diabetic children as compared with the control group.
Conclusion: In all subjects, the intake of carbohydrate and total fat was the same as standard recommendations, while protein intake was a little higher which increases the risk of diabetic nephropathy. In all study groups, fiber intake has been decreased with increasing the age, so it is suggested to have dietary educational programs for general population with the goal of changing the life style of people, which itself can result in less social isolation in school-aged diabetic children.

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Background: Family satisfaction in subpopulations referred to the endocrine clinic including diabetic and non diabetic patients and their spouses are compared in the present study. This study also assesses the correlation between family satisfaction and variables such as age, sex, educational level, economic status, type of diabetes, duration of the disease, type of therapy and dosage of drugs. A comparison of the frequency of sexual dysfunction between diabetics and non-diabetic pairs was also done.
Methods: In this case- control study, 400 subjects were selected as simplified non-randomized method from outpatients referred to the Shahre Kord endocrine clinic in 2002. We assigned samples to group I (diabetic patients, n=100), group II (diabetic patients spouses, n=100), group III (non-diabetic patients, n=100) and group IV (non-diabetic patients spouses, n=100). Groups I and II were similar in sex, socioeconomic status and educational level. GRIMS family relationship questionnaire was used to evaluate family satisfaction.
Results: Family satisfaction for diabetics in comparison with non-diabetics (P=0.05), diabetics in comparison with their spouses (P=0.003), and non-diabetics in comparison with their spouses (p=0.002) were significantly less. There was no significant difference between family satisfaction in diabetic and non-diabetic patients spouses (p>0.05). Relative frequency of sexual dysfunction was 76% and 29% and relative frequency of decreased libido was 32% an 12%, in diabetic and non- diabetic couples, respectively. Family satisfaction was less in patients with diabetes type I and whom using higher dosage of drugs.
Conclusion: This study emphasized on the attention to the family as a part of approach to the diabetic patients. According to our results, it is recommended to focus the most attention in this field to the patients with type I diabetes and who consume more amounts of drugs.

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Background: This study was performed to evaluate the prevalence and risk factors of asymptomatic bacteriuria (ASB) in women with type 2 diabetes mellitus in Iranian population.
Methods: Between March 2003 and December 2003, 202 nonpregnant women with diabetes type 2 who were between 31 to 78 years old and had no abnormalities of the urinary tract system were included. We defined ASB as the presence of at least 105 colony-forming units/ml of 1 or 2 bacterial species, in two separated cultures of clean-voided midstream urine. All the participants were free from any symptoms of urinary tract infection (UTI). Risk factors for developing bacteriuria was assessed and compared in participants with and without bacteriuria.
Results: In this study, the prevalence of ASB was 10.9% among diabetic women. E.coli was the most prevalent microorganism responsible for positive urine culture. Most of the isolated microorganisms were resistant to Co-trimoxazole, Nalidixic acid and Ciprofloxacin. Pyuria (P<0.001) and glucosuria (P<0.05) had meaningful relation with bacteriuria but no association was evident between age (P<0.45), duration of diabetes (P<0.09), macroalbuminuria (P<0.10) and HbA1c level (P<0.75), and the presence of ASB.
Conclusion: The prevalence of ASB is more prevalent in women with type 2 diabetes, which pyuria and glucosuria can be considered as risk factors in this regard. Routine urine culture can be recommended for diabetic women even when there is not any urinary symptom.

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Background: Diabetes mellitus is the most common human metabolic disease. Chronic hyperglycemia and carbohydrate metabolism disorder accompany with plasma lipid and lipoprotein disorder. Cardiovascular disease is one of the macro vascular complications of diabetes type 2 which leads to high morbidity and mortality. Dyslipidemia is one of the major risk factors of cardiovascular diseases in diabetic patients. High TG and low HDL-C levels are the most prevalent type of dyslipidemia. Low levels of HDL-c considered as a risk factor for cardiovascular diseases. Methods: In this study 40 type 2 diabetic patients (13 male - 27 female) were included. Lovastatin and Gemfibrozil were recommended separately for 2 months and HDL-C were measured at the baseline and after taking drugs. In all patients BS, TG and TC at the baseline before and after these drugs were normal and so were not any change in their diet. Laboratorial findings gathered and analyzed. The relationship between increase level of HDL and decrease of TC with taking Lovastatin and Gemfibrozil were studied. Results: The averages of TC and HDL-C before taking drug as linear were 36.5mg/dl and 174.56 mg/dl and after taking Lovastatin as linear were 43.3 mg/dl and 150.44 mg/dl. The average of TC and HDL-C after taking Gemfibrozil were 43.33mg/dl and 146.36mg/dl. 18.54 % increase in HDL-C and 13.82% decrease in TC were seen with Lovastatin and 18.54% increase in HDL-C and 16.05% decrease in TC were found with Gemfibrozil. Conclusion: In this study no difference was observed between the effect of Lovastatin and Gemfibrozil in increase of HDL-C (P=0.449). Also there was no difference between the effect of Lovastatin and Gemfibrozil in decrease of TC (P=0.992). The increase of HDL-C after taking Lovastatin had relation with sex and HDL-C increased in females (P=0.006) Also the increase of HDL-C after taking Gemfibrozil had relation with sex and females had more affected (P=0.035).