Iranian Journal of

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Background: Lipid metabolism disorder in muscle plays an important role in creating insulin resistance in skeletal muscle. Perilipin 3 (PLIN3) is one of PLIN proteins in regulation of muscle lipolysis. The purpose of this study was compared two different endurance training intensities on perilipin 3 protein expression in skeletal muscle, serum insulin levels and glucose in streptozotocin-induced diabetic rats.
Method: 24 male Wistar rats were randomly divided into three groups. Low and high and high-intensity and control group. Endurance training was applied three times a week for eight weeks. The low-intensity exercise group was trained to the treadmill by running at a speed of 60 percent of vo2max and high-intensity training 85%Vo2max. The expression of the plin2 protein was analyzed by Western blot technique. To determine the significance of differences between the groups, the results were analyzed using one-way ANOVA and Tukey post-hoc test (α= 0.05).
Results: Direct comparison between the groups by ANOVA showed significant differences in perilipin 3 (p=0.0006). Tukey's post hoc test showed that there was a statistical difference between the mean values of the diabetic control group and high-intensity endurance group (P = 0.01). Perilipin 3 not significantly increased in low-intensity exercise compared to the control group (P=0. 67). Also, the comparison between groups showed, there was significant difference between the three groups. The serum levels of glucose and insulin (respectively p=0.001 and p=.001).
Conclusion: The results of the present study showed that the Effects of with high-intensity endurance training increase the expression perilipin 3 in diabetes rats.

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Background: For nearly 100 years, amniotic membranes have been used to treat various types of skin wounds. Amniotic extract is one of the derivatives of amniotic membrane that contains all the properties of amniotic membrane. The aim of this study was to evaluate the safety of the amniotic membrane extract in the treatment of diabetic ulcers.
Methods: This study was an Open labeled clinical trial without control group. A total of 10 patients with Wagner Grade 2 diabetic foot ulcers were selected in both sexes. The extract was used every 48 hours in the first week and every 72 hours from the second week until the end of the wound treatment. Patients were followed up weekly until wound healing.
Results: In this study 80% of patients were men and 20% were women with mean age (56.7 ± 8.7) years. The ulcer duration was 8.9 ± 2.12 weeks. The mean area of ulcers at the time of entry into the wound group ≥ 500 mm², 977.5 ± 201.9 and in the wound group ≤500 mm² was 145.6 ± 36.4. At 4 weeks post treatment, the wound healing rate in the wound group was ≤500mm² ,98.9 ± 2.40 % and in the wound group ≥mm² 500 was 92.1 ± 7.23%. in sixth week of treatment, ulcers were complete closure  in both groups.
Conclusion: The results of this study suggest that the use of amniotic extract can be effective in the healing of diabetes foot ulcer without any side effects.

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Background: Identifying the risk factors for the health of the elderly and designing interventions to improve the health of the elderly is one of the priorities of the health care system in the world today. This first requires the promotion of scientific knowledge in the field of health problems of the elderly.
Methods: In this review conducted in 1399, all studies with the keyword of aging or age-related diseases such as atherosclerosis, osteoporosis, diabetes, dementia, frailty, cognitive impairment, daily life function, nutritional status with organizational affiliation of the Endocrinology and Metabolism Research center or the Elderly Health Research Center of Tehran University of Medical Sciences were reviewed without time limit in databases, PubMed, Web of Science, Scopus and Google Scalar search engines.
Results: A total of 115 studies were found with these keywords. By examining the sampling, method, data analysis and also the removal of similar data, 63 articles were reviewed.
Conclusion: In this regard, the Elderly Health Research center has conducted several studies to localize tools for assessing the health of the elderly, identifying common diseases of the elderly, the prevalence of diseases and syndromes of the elderly and designing several interventional studies in the form of three large studies Kahrizak elderly study, Bushehr elderly health study and Birjand elderly longitudinal study has been discussed in this review.

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Background: Diabetes disorders can lead to muscular burnout. The aim of this study was to determine the simultaneous effect of resistance training and endothelial stem cell injection on the factor of degeneration in the muscles of diabetic rats.
Methods: 36 male wistar rats (age 6 weeks with weight of 20±200g) were randomly divided into five groups of basic healthy, diabetic control (D), diabetic and resistance training (DR), untrained diabetic by injection of endothelial stem cells (DI), diabetic training by simultaneous injection of endothelial stem questions (DRI). Western blotting and insulin resistance index were measured by ELISA method to evaluate the changes in MURF1 expression. The data were analyzed by two-factor analysis of variance by SPSS software version 19 at a significant level of α≥%5.
Results: In this study, 6 weeks of resistance training significantly reduced MURF1 and insulin resistance index. The interactive effect of resistance training and stem cell injection also resulted in a significant decrease in murf1 levels, but insulin resistance index was not significantly superior to only training or injection.
Conclusion: Based on the findings of this study, it can be stated that resistance training or injection of endothelial ancestral cells can improve muscular degeneration, but simultaneous use of these two strategies was not superior in reducing atrophy complications in diabetic rats.
 

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Background: Empagliflozin, selective glucose-sodium inhibitor of the latest drugs in the treatment of type 2 diabetes. Diabetes induced hypogonadism disrupts sexual function. There is a direct relationship between reducing blood glucose and reduced libido. In this project, the anti-diabetic drug Empagliflozin in addition to treatment has been studied, in terms of effect on sexual function.
Methods: Type 2 diabetes with injection of 60 mg/kg streptozotocin per body weight was create intraperitoneally. The primary diabetes was treated with two doses of 10 and 25 mg/kg Empagliflozin per body weight. Sexual hormones, biochemical parameters and lipid profile were measured. Evaluation of Sperm parameters and morphological studies were performed on testicular tissue, pancreas and epididymis. Data were analyzed by one-way ANOVA in SPSS software version 22 and P˂0.05 was considered as a significant level.
Results: Empagliflozin significantly increases the quality, survival and natural state of sperm head and tail. Empagliflozin reduces weight in diabetic rats. Empagliflozin Without increasing hyperglycemia by reducing blood glucose affects steroidogenesis, maintains fertility strength in testicles, and increases the level of sex hormones. Empagliflozin significantly increases insulin secretion. Empagliflozin maintains and integrity of pancreatic beta cells. Empagliflozin has no effect on lipid profile.
Conclusion: Empagliflozin in addition positive effects on the treatment of diabetes in the early stage improves sexual function in adult rats.

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Background: Because insulin therapy cannot properly control the progression of diabetes and its complications, other alternative therapies may be desirable. The aim of this study was to investigate the effect of resistance training and endothelial stem cell injection on skeletal muscle oxidant and antioxidant status in STZ-induced diabetic male rats.
Method: In this experimental study, 36 male Wistar rats (age 6 weeks) were divided into six groups of control (healthy), basal diabetic control, diabetic control, diabetes + stem cell injection, diabetes + resistance training and diabetes + stem cell injection + resistance training. In this study, rats became diabetic intraperitoneally using streptozotocin as a single dose of 40 mg/kg. Resistance exercises including climbing a one-meter ladder with weights hanging from the tail were performed for 17 sessions. 500,000 bone-derived stem cells were injected by a cell counter. The levels of superoxide dismutase (SOD) and malondialdehyde (MDA) in skeletal muscle tissue of rat were measured by using the kit and ELISA method.
Results: The results showed that the SOD level of rats in the resistance training and endothelial stem cell injection group was significantly higher than the diabetic control group (P<0.001). Also, the level of MDA rats in the resistance training and endothelial stem cell injection group was significantly lower than the control group (P<0.001).
Conclusion: Resistance training and endothelial stem cell injections can be considered as a non-pharmacological treatment to reduce skeletal muscle complications in type 1 diabetes.
 

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Background: Cardiovascular disease is a major cause of death in patients with type 1 diabetes, and cardiovascular risk remains high even in patients with type 1 diabetes with good metabolic control. The aim of this study was to evaluate the effect of six weeks of aerobic exercise on inflammation and damage indicators of heart tissue in type 1 diabetic male rats.
Methods: In this experimental study, 19 male Wistar rats (mean weight 200-250 g) were randomly divided into four groups: aerobic training, sham, control and healthy. In this study, induction of type 1 diabetes was performed by injecting a single dose of streptozotocin dissolved in sodium citrate buffer intraperitoneally. Aerobic exercise program was performed with intensity of 50-60% VO2max, 5 days a week for 6 weeks. After anesthesia, an autopsy was performed and left ventricle of the heart was removed. Levels of Tumour necrosis factor α (TNF-α), Peroxisome proliferator-activated receptor-γ coactivator (PGC-1α) and Creatine kinase (CK) in rat heart tissue were measured by Western blotting. Data were analyzed by One-way ANOVA and Tukey post hoc test at the P<0.05.
Results:  The results showed that six weeks of aerobic training led to significant decrease in TNF-α and CK and significant increase in PGC-1α of the heart tissue in type 1 diabetic rats (P<0.001).
Conclusion:  According to the results, it seems that aerobic training can help improve the inflammation and damage indicators of heart in type 1 diabetes.

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Background: Diabetic disorders can lead to muscle atrophy. The aim of this study was to investigate the combination of resistance training and endothelial progenitor cell injection on the expression of horseshoe muscle atrophy factor in diabetic rats.
Methods: 30 rats (6 weeks old weighing 200 20 200 g) were randomly divided into five groups: healthy baseline, control diabetic, trained diabetic, non-trained diabetic by endothelial progenitor cell injection, diabetic trained by simultaneous injection Endothelial progenitor cells were divided. Heat 25 was measured by Western blotting to evaluate changes in protein expression. Data were analyzed by two-factor analysis of variance test by SPSS software version 19 at a significance level of α≥ 5%.
Results: In this study, 6 weeks of resistance training had no significant effect on the expression of heat shock protein 25. But injection of endothelial progenitor cells resulted in a significant increase in the expression of heat shock protein 25. The interactive effect of resistance training and progenitor cell injection on heat shock protein 25 was not significant, in other words, there was no significant superiority over training and injection at the same time as training or injection alone.
Conclusion: Based on the findings of this study, it can be stated that injection of endothelial progenitor cells can improve muscle wasting but resistance training alone was not effective. Also, the combination of these two strategies was not superior in reducing the complications of atrophy in diabetic rats.

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Background: Damage to the heart tissue in diabetics causes inflammation and destruction of heart cells, which in turn leads to apoptosis or cell death. The aim of this study was to investigate compare the effect of six weeks of aerobic and resistance training on apoptotic indice of caspase-8 and catalase in the heart tissue of male diabetic rats.
Method: In this experimental study, 24 male Wistar rats were divided into six groups: aerobic training, resistance training, aerobic sham, resistance sham, control and healthy. Diabetes was induced by intraperitoneal injection of a single dose of streptozotocin in the amount of 30 mg per kg. The aerobic and resistance training program was performed for six weeks. Western blotting was used to measure caspase-8 and catalase. Data were analyzed by one-way analysis of variance and Tukey post hoc test at the P<0.05.
Results: The results showed that the mean difference of caspase-8 between aerobic training group and healthy group (P=0.752), resistance training group with healthy group (P=0.723) and resistance training with aerobic training group (P=1.00) were significant. Caspase 8 was lower in the aerobic exercise group than in the resistance exercise group. The difference between the mean catalase between the aerobic training group with the healthy group (P=0.024) and the aerobic training group with the resistance training group (P=0.023) was significant and the amount of catalase in the resistance training group was higher than aerobic training.
Conclusion: Aerobic and resistance training can reduce the apoptotic index of caspase-8 and increase catalase in the heart tissue of diabetic rats.

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Diabetes is a serious public health problem in low- and middle-income countries. There is a strong association between hyperglycemia, oxidative stress and the development of diabetes. Therefore, screening and early diagnosis of this disease in people at high risk can be effective in preventing these complications. The main route of insulin signaling is to control lipid and glucose metabolism, and its imbalance leads to type 2 diabetes. P-Cymene is an aromatic monoterpene with a wide range of therapeutic properties including antioxidant activity. The aim of this study was to evaluate the effect of p-Cymene at a dose of 50 mg / kg in preventing the symptoms of diabetes and serum factors.
Materials and Methods: 30 male Wistar rats weighing approximately 250 g were randomly selected and divided into five groups: control, diabetic control (sham), metformin-treated diabetic (met), and non-diabetic treated. P-Cymene and diabetics treated with P-Cymene were divided.  One week after streptozotocin injection, treatment with P-Cymene at a dose of 50 mg / kg was performed by sunflower oil solvent for 28 days by gavage. At the end of the experiment, blood samples were taken from the hearts of rats and the parameters of glucose, insulin, and superoxide dismutase (SOD) were measured.
Results: The results showed that diabetes increased water and food intake as well as glucose levels and decreased insulin (P <0.001) and superoxide dismutase activity in rats and administration of P-Cymene extract improved the symptoms of diabetes and oxidative stress in Became diabetic rat.

 

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Introduction: The purpose of this research was to explain the protective effect of quercetin on cardiac fatigue caused by exercise in skyrunning runners.
Methods: 26 professional sky running athletes voluntarily and purposefully participated in this race. Random people were placed in 2 groups: quercetin (13 people) and placebo (13 people). The race was held in the central Alborz mountains, the total distance traveled was 21 km and 200 meters, the altitude of the starting point was 1650 meters above sea level, the maximum altitude was 3150 meters above sea level. Before and immediately and 1 hour after the end of the race, blood was taken from the subjects. In order to check the changes of the studied variables, the independent T-test was used at the significance level of alpha 0.05.
Results: The amount of cardiac troponin T decreased significantly immediately and 1 hour after the end of the race in the quercetin group compared to the placebo group (P < 0.05). No significant difference was observed between the two groups of quercetin and placebo in the pre-test, immediately after the test and 1 hour after the test (P>0.05).
Conclusion: It seems that the increase of free fatty acids after the competition and long-term sports play an important role in reducing cardiac inotropic during the same period. Skyrunning competitions cause an increase in heart damage indices in professional athletes, despite this, quercetin supplementation reduces the increase in cardiac troponin T and can have a protective effect on the athlete's heart

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Background: A high-fat diet causes hyperinsulinemia and increases insulin resistance in the body. On the other hand, the oxidative stress caused by hyperglycemia can lead to the exacerbation of hyperglycemia and increase the complications of diabetes, and cardiovascular diseases are one of the most important complications of diabetes mellitus. Therefore, the aim of this study was to investigate the effect of 4 weeks of aerobic training on catalase enzyme activity in the left ventricle and insulin resistance index in male rats treated with streptozotocin and exposed to a high-fat diet.
Methods: In this experimental study, 19 male wistar rats, with an average age of 8-12 weeks and a weight of 200-250 grams, were divided into 3 groups: diabetic control (CD 8), training diabetes (TD 8) and healthy control (C 3). The exercise program included 4 weeks of aerobic exercise with an average of 60 to 75 Vo2max in an increasing manner. Before and 48 hours after the last training session, blood was taken and left ventricular tissue samples were extracted to check the HOMA-IR index and catalase activity by ELISA method. To compare the study groups, one-way analysis of variance and Scheffe's post hoc test were used in SPSS software (p≥0.05).
Results: The results showed that the induction of diabetes with STZ along with a high-fat diet causes a significant decrease in catalase enzyme (P=0.001) and a significant increase in HOMA-IR index, fasting glucose and Li index (P=0.001) in rats. However, doing 4 weeks of aerobic training caused a significant increase in catalase enzyme activity (P=0.001) and a decrease in HOMA-IR index, glucose and Li index (P=0.001).
Conclusion: Aerobic exercise with moderate intensity can be used as an effective non-pharmacological method in the treatment of diabetic cardiomyopathy by increasing catalase activity and reducing resistance to insulitis in diabetes.

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Background: During recent decades, physical activity has become a key auxiliary tool in controlling many diseases, including diabetes. The aim of this study was to investigate the effect of 8 weeks of resistance training on the plasma levels of preptin and endothelin 1 in men with type 2 diabetes.
Methods: The current research is semi-experimental. The statistical sample of this study consisted of 38 men with type 2 diabetes, who were randomly divided into two groups of 19 experimental and control. Subjects in the experimental group performed 8 weeks of resistance training three sessions a week with moderate intensity. 24 hours before and after 8 weeks of training, plasma levels of preptin, endothelin 1, and indicators related to type 2 diabetes were measured by the ELISA method. Correlated t-tests and independent t-tests were used to examine intra-group changes. SPSS software was used to analyze the data (P≥ 0.05).
Results: Correlated t results showed that plasma levels of preptin and insulin resistance index (P= 0.001) as well as plasma endothelin 1 (P= 0.001) decreased significantly in the post-test compared to the pre-test of the experimental group. has been found Also, the independent t-test results showed that the plasma levels of preptin, insulin resistance index (P= 0.001) and endothelin 1 (P= 0.002) were significantly lower in the post-test of the experimental group compared to the control.
Conclusion: According to the obtained results, it seems that doing resistance exercises improves glucose sensitivity by reducing preptin and reducing the possibility of blood pressure by reducing endothelin 1 in preople with type 2 diabetes.

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Background: The present study was conducted to investigate the effect of eight weeks of aerobic training and vitamin D3 supplementation on cardiac irisin protein levels, insulin resistance and lipid profile in rats induced with type 2 diabetes.
Methods: Forty male Wistar rats after induction of type 2 diabetes through the combination of high-fat diet +streptozotocin were randomly divided into five groups: 1) Normal control (NC) ,2) Diabetic Control (DC), 3) Diabetes+ Aerobic Training (DAT) ,4) Diabetes+ Vitamin D3 (DVD) and 5) Diabetes+ Aerobic Training+ Vitamin D3 (DVDAT). Aerobic training program (five times a week with 60% intensity of maximum running speed for one hour) and vitamin D3 supplementation (10000 IU/kg every week) were performed. After anesthetizing the rats, blood samples were taken to evaluate serum glucose, insulin, triglyceride, cholesterol, LDL and HDL levels. The heart tissue was isolated to evaluate the irisin.protein.
Results: The results of the one way analysis of variance showed that the irisin protein level of the heart tissue in DAT, DVD and DVDAT groups had a significant increase of 14.04, 12.28 and 24.56%, respectively compared to DC (P<0.001). Insulin resistance also showed a significant decrease in all intervention groups compared to the DC group (P<0.001); However, HDL, triglyceride and cholesterol levels were significantly decreased in DAT and DVDAT groups compared to DC group (P<0.001).
Conclusion: According to the results, it seems that eight weeks of aerobic training and vitamin D3 supplementation probably improves the insulin resistance index and lipid profile in rats induced to type 2 diabetes through increasing the cardiac irisin.

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Background: The aim of this study was to investigate the effect of eight weeks of circuit resistance training and saffron supplement on visfatin serum levels and insulin resistance in overweight men.
Methods: In this semi-experimental study, 40 obese and overweight students were randomly divided into 4 groups: exercise, exercise+supplement, supplement and control (10 people in each group). The exercise groups performed circular resistance exercises for eight weeks and three sessions each week for 90 minutes in the evening. The supplement and exercise+supplement groups used saffron tablets with a dose of 30 mg per day as a supplement. Blood samples were collected in two phases of the pre-test and 48 hours after the last training session. The data were analyzed using covariance and paired t test at a significant level of P≤0.05.
Results: Correlated t results showed a significant decrease in visfatin and insulin resistance in the post-test of the training, training+supplement and supplement groups compared to the pre-test (P<0.05). The results of the analysis of covariance showed that visfatin increased and the insulin resistance index decreased significantly in the exercise, exercise+supplement and supplement groups compared to the control group (P<0.05).
Conclusion: It seems that eight weeks of circuit resistance training and the addition of saffron help on visfatin serum levels and insulin resistance can lead to the reduction of these two variables in overweight men. The saffron plant can play a protective role due to the presence of flavonoids and by stimulating the secretion of Visfatin.

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Background: Glucose transporter4 (GLUT4) is the main glucose transporter in skeletal muscle. Impaired GLUT4 expression plays a role in the disorders of glycemic homeostasis. The aim of the present study was to investigate the combined effects of aerobic training and vitamin D3 supplementation on Glut4 protein levels and insulin resistance in the soleus muscle of diabetic rats with STZ and high-fat diet.
Methods: In 40 male Wistar rats type 2 diabetes was induced by 6 weeks high-fat diet followed by streptozotocin injection. Then rats were randomly divided into five groups: Healthy control (HC), Diabetic control (DC). Diabetes+Aerobic training (DAT), Diabetes+Vitamin D3 (DVD) and Diabetes+Aerobic training+ Vitamin D3 (DVDAT). The rats underwent eight weeks of aerobic training and vitamin D3 supplementation. 24h after last session of training and, the rats were anesthetized and soleus muscle was isolated for measurement of Glut4 protein concentrations and serum levels of insulin, glucose, vitamin D3 index were measured.
Results: One-way ANOVA showed that GLUT4 protein levels in DC group was significantly lower than HC group (P<0.001), but in DVDAT group was significantly higher than DC group (P<0.04) and DVD group (P<0.005). Also in DAT group was significantly higher than DVD (P<0.018). The HOMA-IR index also in DVDAT, DAT and DVD groups was significantly lower than DC group (P<0.001).
Conclusion: It seems that Eight weeks of aerobic training with vitamin D3 supplementation improves glucose metabolism in diabetic rats via increasing Glut4 protein levels and improving insulin resistance index.

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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: 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: 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: 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.