Iranian Journal of

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The incidence and prevalence of type2 diabetes mellitus is increasing worldwide. Many believe that type 2 diabetes mellitus is a disease that can be prevented by appropriate interventions in individuals at high risk for the disease. A number of studies have therefore looked at primary prevention during the past decade. Iran’s diabetic population of approximately 2 million people and the warning by the World Health Organisation that diabetes is on the rise in developing countries make the primary prevention of diabetes mellitus in Iran doubly important. Researchers have been increasingly focusing on identifying the risk factors for type 2 diabetes and, through these, appropriate strategies to prevent the rapidly growing incidence of this disease in the population at risk. Genetic predisposition (a positive family history), insulin resistance, obesity, impaired glucose tolerance, a history of gestational diabetes mellitus, physical inactivity and an unsuitable diet are among the most important recognised risk factors for type 2 diabetes other factors have also been found to contribute. Most of the available research has evaluated the effect of behavioural or lifestyle modification, in the form usually of dietary education and increased physical activity, in the primary prevention of type 2 diabetes. The second most common approach has been pharmacological manipulation. The information available indicates that type 2 diabetes will come to be considered as a preventable disease within the next decade. The weight of research behind this problem will undoubtedly discover even more effective methods of preventing type 2 diabetes in the near future than behavioural/lifestyle modification.

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Introduction: In patients with type 2 diabetes, triglyceride (TG) is usually increased, HDL decreased, and LDL normal. This pattern is associated with an increased risk of coronary heart disease. More recently, dense-particle LDL has been identified as an important risk factor for coronary heart disease.
Methods: 298 patients with type 2 diabetes attending the diabetes clinic at Doctor Shariati University Hospital underwent anthropometric and biochemical assessment. Anthropometric measurements followed WHO criteria. Biochemical indices (apoB100, TG, cholesterol, LDL, LDL particle size, HDL, and apoA1) were measured using standard laboratory methods. One-way ANOVA was used to analyse data with SPSSv6 software.
Results: Mean patient age was 55±13.2 years. Mean duration of diabetes was 9.5±6.1 years. The majority of patients were moderate to severely overweight. 73.2% of patients had some form of hyperlipidaemia. 20.7% had isolated hypertriglyceridaemia, 21% isolated hypercholesterolaemia, and 31.5% mixed hyperlipidaemia. Mean apoA1 concentration was higher than normal in this group, and mean apoB100 concentration lower. LDL particle size generally followed a small and dense pattern.
Conclusion: This study shows that LDL particles in both men and women with type 2 diabetes undergo both qualitative and quantitative changes. 35.5% of patients had smaller, denser LDL particles than normal. It appears that dyslipidaemia and B-pattern LDL particles are important risk factors for atherosclerosis in this group.

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Background: Atherosclerotic complications are one the most common causes of death in patients with type 2 diabetes mellitus. Epidemiological data indicate that the consumption of omega-3 unsaturated fatty acids (O3FA) leads to a reduction in cardiovascular disorders. The metabolic effect of this substance in patients with type 2 diabetes is still a matter of debate, however. The aim of this study was to assess the metabolic effect of O3FA in Iranian diabetic patients.
Methods: 50 diabetic patients (20 men and 30 women mean age 49±7.3 years) were randomly allocated to either the intervention (diet + fish oil containing O3FA) or the control group (diet alone). The lipid and glucose levels, blood pressure, and weight of each patient were measured at the beginning of the study. The duration of the study was 3 months. The aforementioned parameters were re-assessed at the end of the study.
Results: O3FA consumption was associated with a significant reduction in serum triglyceride levels (p<0.001). Reductions in weight, fasting blood sugar, and glycosylated haemoglobin were noted in the intervention group but were not statistically significant. No changes occurred in total cholesterol, HDL, and LDL levels. The dosage of oral hypoglycaemic agents was unchanged in both groups throughout the study.
Conclusion: O3FA may be recommended for the management of hypertriglyceridaemia.

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Background: The non-enzymatic glycosylation (NEG) of proteins in diabetes damages both the structure and function of these proteins. In vivo and in vitro studies have shown that NEG of proteins and advanced glycosylation end-products (AGE) contribute to the pathogenesis of both macrovascular, such as atherosclerosis, and microvascular complications, such as retinopathy and nephropathy, in diabetes.
Methods: We studied the electrophoretic mobility, fluorescence at isoelectric pH, and time-dependent AGE formation of glycosylated albumin. For the first time, we have used isoelectric focusing to study serum glycosylated albumin in diabetic patients and healthy controls. Results: After 10 weeks incubation with glucose, the electrophoretic mobility of glycosylated albumin increased 21.3% compared with normal albumin. The isoelectric pH of albumin decreased from 4.6 on day 1 to 4.1 on day 7. The increase in electrophoretic mobility was accompanied by the drop in pH during the first week of incubation. These changes correlated well with those observed by fluorescence. The glucose content of the albumin samples decreased during the first week of incubation, but gradually increased thereafter. Fluorescence readings agreed with these observations. Using isoelectric focusing, there was a significant difference between the serum albumin of diabetic and normal individuals (p<0.001).
Conclusion: Increased electrophoretic mobility during the first week with a simultaneous decline in isoelectric pH shows that AGE formation begins after the first week. The reduction in glucose concentration during the first week and its subsequent increase during the second week may be attributed to the formation and hydrolysis of AGE. This method may be used to determine the stability or progress of diabetes.

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Patients with type 2 diabetes have a higher risk of coronary heart disease and a worse prognosis compared with patients without diabetes. In this study, the prevalence of cardiovascular risk factors have been investigated in type 2 diabetic patients.
Methods: A Cross Sectional study with a target population of known type 2 diabetic subjects was conducted in 2002 in Isfahan. From registered patients, 1150 were selected and evaluated for age. sex.duration of diabetes, BMI, hypertension, lipid profile, proteinuria, fasting blood glucose. HbAlc and smoking using convenience sampling methods.
Results: Mean fasting blood glucose and HbAl were 165.16 x 53.4 mg/dl and 9.2+ 3.5 percent respectively. The number of women with 3 cardiovascular risk factors was significantly greater than men (50.7% VS 33.5% PO.001). 19.5% of men and 50.2% of wjomen had high serum cholesterol level (>230 mg/dl). The prevalence of obesity (BMI >30Kg/m2) was 13.6% for men and 30.8% for women. 56.6% were hypertensive and 29.3% had proteinuria (P<0.001).
Conclusion: Cardiovascular risk factors are present in a considerable proportion of studied type 2 diabetic patients. Control of risk factors and life style modifications should be tightly considered in order to decrease the prevalence ofTHD in the up -coming years of their life.

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Background: Previous in vitro and animal studies have supported a role for growth hormone in development of diabetic nephropathy. The purpose of this study was to investigate the relation between basal and stimulated growth hormone and proteinuria in type 2 diabetic patients.
Methods: 21 type 2 diabetic patients with macroalbuminuria were selected. Fasting insulin, basal and levodopa stimulated growth hormone levels were measured. The control group consisted of 21 type 2 diabetic patients with 24 hr urine protein of less than 50 mg. The two groups were matched according to sex, age, duration of diabetes, body mass index, creatinine clearance, fasting blood sugar, glycosylated hemoglobin, and blood pressure.
Results: The patients with macroalbuminuria had higher basal growth hormone (3.1  2.6 vs 1.25  0.7 ng/ml, P = 0.024). Stimulated growth hormone and fasting insulin levels were not significantly different.
Conclusion: There is direct relation between basal growth hormone and development of diabetic nephropathy and this relation suggests a role for growth hormone in human diabetic nephropathy.

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Background: Recurrent GDM are more common in women with previous GDM. Also GDM is an important risk factor for abnormal glucose tolerance and type 2 diabetes during postpartum. This study aims to determine the prevalence of postpartum IGT and T2DM in women with previous GDM.
Methods: A cohort study was conducted on 2416 pregnant women referred to five Tehran university hospital clinics. The universal screening was performed with a GCT-50g and those with plasma glucose level130mg/dl, were diagnosed as having GDM if they had an impaired GTT-100g based on Carpenter and Coustan criteria. All pregnancies were followed up until delivery. Available GDM patients underwent an OGTT-75gr within 6 to 12 weeks after delivery. Postpartum diabetes mellitus was diagnosed according to ADA criteria. Student T test and ANOVA used for comparing means of variables and Chi Square used for comparing of frequency of variables. Value of P less than 0.5 determine as significant different.
Results: the prevalence of GDM was 4.7%. In fallow up 85.9% of women with GDM were screen in postpartum. 16.3% of women required insulin treatment and other patients were managed with diet. Prevalence of postpartum diabetes mellitus and IGT were 8.1% (CI 95%: 3.5-15.4) and 21.4% (CI 95%: 13.7-30.8) respectively, and 70.5% returned to normoglycemy.
Conclusion: Abnormal glucose tolerance is a common disorder in the early postpartum in GDM patients. Because of the high incidence of glucose tolerance disorders in women with previous GDM, screening, diagnosis and management during pregnancy was important for prevention of these disorders. Following up these mothers after delivery is highly recommended.

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Background: Diabetes type 2 is one of the most prevalent reasons of Hyperglycemia. Different areas experience varying degrees of epidemic intensity. Diabetes is one of the most important causes of death and disability in most countries and imposes heavy financial burdens on people and governments. Although much research has been conducted on its prevention and treatment. It has been recognized as a hereditary disease, the genes causing it or its mode of inheritance are not yet known. Because of the significant role they play in metabolism of glucose, several genes have suggested, but the main cause of the disease has not yet been identified. Our objective is to investigate the epidemic aspects of the hereditary diabetes in people aged 20 years and over.
Methods: A cross sectional study was conducted on 14687 subjects, in the urban setting of east Tehran between 1379 and 1380. Of 407 families, 180 agreed to and completed related questionnaires and underwent the necessary tests 180 diabetic families, with at least one member suffering from diabetes type 2, were studied closely in order to clarify the degree of spread and family background. Analysis was performed using Chi Square and t-test.
Results: Of 1612 subjects, 497 had diabetes, including 802 women and 792 men (p<0. 001). Most of the diabetics (approx. 79%) were between the ages of 41-70 years old with the highest (55.3%) and lowest (6.2%) rates in the age groups of 51-60 and 20-30 years respectively. Diabetes was more prevalent among siblings with 53% in comparison to the prevalence among offsprings-44%. The prevalence of Diabetes type 2 in first-degree relatives was more frequent between sister and brother (52.7%), followed by that between father and daughter (36%). Conclusion: It is recommended that the related authorities implement strategies, including screening of families, with a view to identify those at risk and reduce related complications.

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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: Constipation is the most common gastrointestinal complication in diabetic patients. Erythromycin mimics the effects of the gastrointestinal hormone Motilin in gastric contractile activity and insulin secretion. In this study, we compared the effects of Erythromycin and Metoclopramide on glycemic control and constipation in type 2 diabetic patients. Methods: As a clinical trial, thirty-nine type 2 diabetic patients with constipation were divided into two groups. Patients in group 1 (n=24) were treated with erythromycin (400 mg/day before sleep) and participants in the second group (n=15) received metoclopramide (10mg 3 times / day before each meal) for 3 months. FBS, 2hPP BS, HbA1c and the frequency of defecations during a week were measured and compared before and after the intervention. Results: In Erythromycin treated group, 2hPP BS decreased from 199.7 ± 47.0 before treatment to 174.0±46.3 after intervention (P=0.01) and a significant improvement in constipational symptoms was observed in both groups. Conclusion: It seems that Erythromycin not only can improve symptoms of constipation but may have a role in glycemic control in type 2 diabetic patients.

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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: Hyperhomocysteinemia may increase blood pressure by inducing endothelial cells dysfunction . The aim of this study was determining the relationship between plasma Homocysteine (Hcy) levels and blood pressure in new cases of type 2 diabetes mellitus.
Methods: As a cross sectional study, 46 new cases of type 2 diabetes mellitus referred to Isfahan Endocrine and Metabolism Research Center were selected by convenient sampling. Basal characteristics of patients were recorded. Systolic and diastolic blood pressure was measured two times with 30 minutes interval on two consequent days. After ten hours of overnight fasting, blood samples were taken to measure fasting plasma glucose, HbA1c, triglyceride, Total cholesterol, HDL-C and creatinine. All data were expressed as mean (SD). Relationship between plasma Homocysteine levels and both systolic and diastolic blood pressure was assessed by Pearson's correlation coefficient. Patients were divided into three groups according to their plasma Homocysteine levels, (Hcy<10mol/L, 10Hcy<15 mol/L and Hcy15mol/L).. Then mean of systolic and diastolic blood pressure between groups were compared by one – way ANOVA and Tuckey-HSD tests.
Results: Mean (SD) of plasma Homocysteine levels was 12.2 (6.8) mol/L and of systolic and diastolic blood pressure was 128.8 (18.1) and 82.3(9) mm/Hg, respectively. There was a significant correlation between plasma Homocysteine levels, and both systolic (r=0.39, P<0.01) and diastolic (r=0.46, P<0.01) blood pressures. Mean (SD) of systolic and diastolic blood pressure in patients with plasma Homocysteine level of 15mol/L was 152.5 (17.7) and 91.8 (7.3) mm/Hg, respectively, so blood pressure in those group with hyperhomocysteinemia was higher than other two groups (P<0.001). There was no correlation between Homocysteine levels and FPG, HbA1c and lipid profile.
Conclusion: There is a significant correlation between plasma Homocysteine levels and both systolic and diastolic blood pressure in newly diagnosed type 2 diabetics. Patients with hyperhomocyteinemia have higher blood pressure.

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Background: Type 2 diabetic patients have 2 or 4 fold risk of coronary heart diseases. According to researches, all types of dyslipidemia independently have atherogenic properties so it seems small dense LDL has the most effects in this case. To investigate whether glycemic control, which is assessed by concurrent HbAlc, has any favorable impact on LDL size we determined the relation between LDL size and HbAlc in diabetics.
Methods: In this study, LDL size was determined by non-denaturing polyacrylamide gel electrophoresis in 81 type 2 diabetics 50 to 70 aged. BMI was calculated in all participants as weight (Kg) divided by height (m2). TG and HDL-C were measured using enzymatic kits. HbAlc was determined using immunoturbidometric method.
Results: Based on results obtained LDL size in diabetics was significantly correlated with TG (r=-0.281, P<0.05), sex (r=-0.276, P<0.05), HbAlc (r=-0.232, P<0.05) and HDL-C (r=0.215, P<0.01). In linear regression analysis TG (standardized =-0.192 p<0.054), HDL-C (standardized =0.214 p<0.05) and female sex (standardized =0.196 p<0.056) were the independent determinants of LDL size (although they showed borderline significance). HbAlc showed high co linearity with HDL-C and was excluded from the model.
Conclusion: HbAlc is inversely correlated with LDL size in diabetics. However it is not an independent predictor of LDL size. It is likely that decrease in HDL-C levels due to poor glycemic control results in decrease in LDL size.

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Background: Metformin is usually using for glycemic control in type 2 diabetes mellitus. The drug is the first line for obese patients without renal or liver failure. Different pharmaceutical types of Metformin are available. As a clinical trial, we compared effects of Aria Metformin (product of Aria pharmaceutical company, Iran) with Merck Metformin or Glucophage (product of Merck pharmaceutical company, France), in diabetic patients.
Methods: This double blind randomized clinical trial study performed with 60 non- pregnant diabetic patients, in order to comparison of therapeutic effects of combination therapy (Glibenclamide + Metformin "Aria or Merck") in a 12 weeks period. We evaluated FBS, BS 2hpp, HbA1c, lipid profile, liver function tests, weight, BMI and common or uncommon side effects.
Results: Not only each of two pharmaceutical types of Metformin had the same therapeutic effects for controlling of glycemia, lipid profile and weight, but also there were not difference between them in side effects. Distention was the most common side effects of two types products (33%). There is not significant difference between them in common side effects. 70% of patients were satisfied with each two kinds of Metformin.
Conclusion: It seems, in view of beneficial therapeutic effects of Aria Metformin, low rate of side effects, and finally low cost, Aria Metformin is a good choice.

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Background: To determine the importance of type 2 Diabetes mellitus as a risk factor for osteoporosis in postmenopausal women, this study was designed in endocrine clinic of zanjan in 2003.
Methods: As a case-control study, 40 diabetic and 40 healthy menopause women have been recruited. These two groups were matched in terms of their age, length of their menopausal period and body mass index. Serum Calcium, Phosphorus, Alkaline phosphatase and Estradiol were measured in all the cases and bone densities in three sites (Femoral neck, lumbar spine and forearm) were evaluated with DXA. All data were analyzed using T-test, analysis of variance, chi-square and multiple regression tests.
Results: The frequency of osteoporosis and osteopenia in diabetic women were not significantly different from non diabetics. The mean bone density in femoral neck was higher in diabetic group (P= 0.013). In both groups there was a significant relationship between bone density and length of menopause (P<0.01) .The relationship between BMI and Bone density was significant only in femoral neck (P<0.01) in both groups. In diabetic women, the higher HbA1c accompanied with the lower bone density in lumbar spine.
Conclusion: Although the level of HbA1c as a marker of blood glucose control, has a relationship with lumbar spine density in diabetics, Diabetes type 2 is not a risk factor for osteoporosis, So screening, diagnosis and management of osteoporosis in diabetes type 2, Should be done independently and according to other risk factors.

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Background: The aim of this study was to determine the best Anthropometric indices for prediction of the risk of type 2 Diabetes in lower and higher 60 years old population in Tehran.
Methods: As a prospective study among 4479 non-diabetic men and women over 20 years from the participants of Tehran Lipid and Glucose Study (TLGS) who had complete data of blood pressure, plasma glucose in the fasting state and 2 hours after ingestion of 75 g glucose (2-hPG) as well as fasting serum lipids, anthropometric measurement including body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and demographic data at baseline and were followed for a mean duration of 3.6 years. Subjects reevaluated for measurement of fasting Glucose and 2-hPG at follow-up. Diabetes and its associated risk factors were defined according to the ADA criteria. Different measurements of general and central obesity were defined based on the WHO criteria. Logistic regression analysis with stepwise conditional method was used to estimate the Odds Ratio (OR) with 95% CI. Results: A total of 166 new cases of type 2 diabetes (3.7%) were diagnosed during 3.6 years of follow-up, with an approximately one percent per year incidence rate (men=3.7% and women =3.7%, P= 0.95). Diabetic subjects of follow-up were significantly more obese than nondiabetics considering their BMI, WC and WHR. In subjects aged< 60 years high WC was a predictor of diabetes only in model 1 and 2, while general obesity and high WHR predicted diabetes risk in all the 3 models. In these 3 models the OR of general obesity were 5.3(2.9-9.5), 3.4(1.8-6.3), 2.4(1.1-5.1) and the OR of high WHR were 3.5(2.1-5.8), 3.4(1.4-5.8) and 2.6(1.3-4.9), respectively. In subjects aged≥ 60 years general obesity predicted diabetes only in models 1 and 2, while high WHR was a predictor of diabetes risk only in model 1. In this age group, high WC predicted diabetes in all models 1, 2, 3 with the OR of 4.6 (2.3-4.1), 4.5 (2.3-8.9) and 3.8 (1.8-7.7), respectively.
Conclusion: General obesity and high WHR in young Iranian subjects (< 60years) and high WC in older ones (≥ 60 years) are the important anthropometric indices for prediction of type 2 diabetes. Age should be considered when using different anthropometric indices for predicting the risk of type 2 diabetes.

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Background: Glucokinase serves as a glucose sensor in pancreatic β-cells and plays a key role in glucose homeostasis and glucose-stimulated insulin secretion (GSIS). In the present study we examined the effect of glucosamine, a glucokinase inhibitor, on the pancreatic glucokinase and hexokinase activities and on insulin secretion from freshly rat pancreatic islets of Langerhans. Insulin concentration was measured by rat insulin ELISA kit. Methods: The pancreatic islets from normal and type 2 diabetic (nSTZ) rats were isolated by collagenase digestion method. Glucose phosphorylation was quantitated by measuring the rate of glucose-6-phosphate formation in the fluorometric assay. Insulin secretion from hand-picked islets was evaluated in static incubation system. Insulin concentration was measured by rat insulin ELISA kit. Results: Our findings demonstrate that glucosamine in a dose dependent manner, reduced glucokinase activity in islet extract, but had no effect on hexokinase activity. The glucose-stimulated insulin secretion, was inhibited by glucosamine but it had no effect on the basal insulin secretion. In diabetic rats glucokinase was decreased while the basal insulin secretion and the activity of hexokinase were higher than normals. Conclusion: Based on results obtained from the present study, the assumption could be made that the decrease in the activity of glucokinase of pancreatic islets could be related to the impaired glucose stimulated insulin secretion. The increase in basal insulin secretion of diabetic rats may be due to an increase in pancreatic hexokinase activity.

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Background: Retinopathy is one of the microvascular complications of diabetes which is strongly related to the glycemic control and duration of the disease. According to results of other studies, the prevalence of retinopathy has been reported 5-30% in newly diagnosed patients whit type 2 diabetes (T2DM). The aim of this study was to determine the prevalence of idabeteic retinopathy among newly diagnosed T2DM patients in Isfahan, Iran.
Methods: From july 2001 to March 2004, 710 newly diagnosed patients with T2DM were recruited in this study. Patients with duration of diabetes less than 1 year were considered as newly diagnosed ones. Along with physical examination and laboratory measurment for FBS, HbA1c, lipid profile, urea, Creatinin, and 24 houre urin examniation for albumin, retinoscopy was performed by an experienced ophttalmologist.
Results: In this study, 286 men and 424 women were investigated. The mean age of patients at presentation and the mean duration time of diabetes were 48.8 ±9.8 years (range 31-72years) and 8.6±5.4 months respectively. The prevalence of retinopathy was 9 % (9/8% in males and 8.5% in females). Logistic regression analysis revealed that BMI, diastolic blood pressure and 24 hour urine albumin, were independent risk factors for developing retinopathy.
Conclusion: Nevertheless of relatively moderate prevalence of diabetic retinopathy in our study as compared with other studies, it is necessary to perform retinal examination in newly diagnosed T2DM patients in order to prevent the sight-threatening outcomes of diabetic retinopathy.

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Background : Women with polycystic overy syndrome (PCOS) are sussceptible for developing type 2 diabetes (T2DM) and cardiovascular diseases. In view increased prevalence of T2DM in patients with PCOS and priority of prescription agents capable to decrease insulin resistances for them, It is important to diagnose PCOS in T2DM patients. The aim of this study was to evaluate the prevalence of PCOS in T2DM women.
Methods : Using ‘1990 National Institute of Child Health and Human Development Conference of PCOS’ criteria, 157 premenopausal women with T2DM were assigned into PCOS and non – PCOS groups after they were examined for the evidences of clinical PCOS. A questionnaire on reproductive history was completed and the waist circumference, weight, height and BP were measured for each participant. Biochemical tests were performed in both groups, but hormonal measurements were requested only for PCOS group.
Results : The prevalence of PCOS was high (about 8%) among subjects. Patients with PCOS had significantly lower age at the onset of diabetes, higher BMI and waist circumference. The differences in BP, serum TG, HDL, LDL, cholesterol and HbA1c were non – significant between 2 groups and insulin resistance is more.
Conclusion : PCOS is prevalent in diabetic women and Insulin resistance is more likely in those with both PCOS and T2DM resistant than whom with diabetes alone. Emphasis on reducing insulin resistance may be of benefit to achieve a better diabetes control in these patients.

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Background: Diabetes is one of the chronic diseases need continual medical care and self care education, and nutritional therapy account as an integral part of dietary management. This study carried out to investigate the effect of diabetes dietary counseling on quality of life in type II diabetic patients.
Methods: As a Randomized Clinical Trial, 144 patients with type II diabetes aged 35-65 years were recruited from patients referred to Imam Hossein Hospital dietary clinic and randomly assigned in case and control groups. A dietary schedule consisting 50-60% carbohydrate, 10-20% protein and less than 30% fat was prescribed at the first orally in a 30-minute counseling session then in written form for case group, while the control group was left without any intervention. The quality of life score was estimated in both groups via using the Short-form 36-Item (SF-36), before dietary counseling and one mouth after the dietary counseling, and the quality of life score between both groups were compared. The data were analyzed using SPSS software. Results: Average age was 52.1±10 years. Before dietary counseling, the quality of life among 46% of subjects was assessed to be poor and 52% claimed their health status poorer than the last year. Independent-Samples T-Test with P<0.05 revealed significant difference in weight, systolic blood pressure, diastolic blood pressure, blood sugar before and after breakfast, blood cholesterol and triglyceride, after dietary counseling in both groups. Also, this test with P<0.05 revealed significant difference in the quality of life score in general and in each dimensions, after dietary counseling in both groups. Paired-Samples T-Test revealed significant increase in the quality of life score in general and in each dimensions on pre and post dietary counseling in case group, but didn’t observe in control group. Conclusion: According to the results, it was revealed that dietary counseling can promote the quality of life in patients with type II diabetes in all dimensions. So, it seems dietary counseling program is essential in prevention and decrease of type II diabetes complications.