Iranian Journal of

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Diabetes is one of the most common metabolic diseases. The prevalence of diabetes, which is around 4.5 - 6% in Iran, reaches as high as 14.2% in population of age 30 years and over in Yazd. Microalbuminuria is diagnosable before development of nephropathy and could be detected at an early stage when effective therapy can still be carried out. In this stage near normalization of blood glucose, strict blood pressure control and administration of ACE inhibitors can prevent nephropathic complications.
This study was aimed to determine the correlation among microalbuminuria, age, duration of diabetes, body mass Index, serum triglyceride, serum cholesterol and blood pressure in type 2 diabetic inhabitants of Yazd diabetes research center.
Methods: This cross-sectional study was carried out during November 2002-July 2003 to investigate the correlation between microalbuminuria and assumed risk factors. Two hundred and eighty eight type 2 diabetic patients (141 males and 147 females) were selected through consecutive sampling. Results: Overall prevalence of microalbuminuria was 14.2%. Chi-square analysis revealed the association between microalbuminuria and high diastolic blood pressure (P-value=0.003) and duration of diabetes (P-value = 0.001). No statistically significant correlation was found between microalbuminuria and body mass index, serum triglyceride, serum cholesterol and systolic blood pressure.
Conclusion: Determination of urine albumin/creatinin ratio is an easy method for screening microalbuminuria which is recommended for all diabetics especially those with hypertension and a long term history of diabetes.

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Background: The precise mechanisms of vascular diseases in insulin dependent diabetes mellitus (IDDM) are not clearly understood. There are evidences of alteration in mechanisms involved in regulating vascular tone including increased ACE activity in some tissues. To investigate the effect of insulin treatment on these changes this study was performed.
Methods: Three groups of 8 male Sprauge Dawely rats including control (C) and two diabetic groups (D, IT) were used in this study. Diabetes was induced by injection of 60 mg/kg STZ ip. After induction of diabetes IT group were treated with insulin (10 units/kg/day s.c.) for four weeks. The control group and the untreated diabetic group were treated with the same amount of Saline and for the same time. ACE activity was determined by HPLC method.
Results: 4 weeks after induction of diabetes, SBP and ACE activity in serum, lung, heart and aorta increased in D group compared to control rats. Insulin treatment reversed these changes to normal values in IT group.
Conclusion: It is concluded that increased ACE activity could contribute to the development of diabetic vasculopathy and ACE reducing activity of insulin may be partially involved in decrease of cardiovascular complications in diabetes.

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Background: Due to homeostatic and regulatory potentials of nitric oxide (NO) in vascular physiology, regulatory systems that determine NO bio-synthesis and bioavailability have been the subject of extensive research in molecular medicine. In the field of vascular system pathophysiology, endothelial nitric oxide synthase (eNOS) which is the major producer and regulator of NO in vascular tissues has received the most attention. Impairment of NO bioavailability (NO quenching) is a common feature in poorly controlled diabetics due to increased catabolism and decreased production of NO. Such impairment in severe forms could end to vasodilation breakdown in peripheral tissues (mainly in skeletal muscles) and defective regional blood flow, that in turn disturb insulin-dependent glucose uptake ensuing insulin resistance state.
Methods: The phenotypic impact of an eNOS gene polymorphism at position 786*C/T (that its functionality has been revealed already) on genetic propensity to diabetic retinopathy is evaluated in a British-Caucasian population with type 1 diabetes (T1DM).
Results: In contrast to genotypes, there was a significant difference in distribution of allele frequencies between T1DM patients (n= 249) and healthy controls (n= 104) (p= 0/036), that may imply eNOS and/or NO involvement in development of T1DM. Most notably a significant difference also was evident in allele frequency between retinopaths (n= 134) and healthy controls (p= 0/02). No significant difference was detected when the genotype/allele frequencies were compared between retinopaths (n= 134) and non-retinopaths diabetics (n= 115) (p=NS).
Conclusion: Our data is compatible with previous studies which demonstrated that allele C of eNOS 786*C/T polymorphism is associated with increased HbA1c levels. By emphasizing the phenotypic and prognostic value of the abovementioned polymorphism, our data calls for further investigations to find out whether this polymorphism can be employed as a genetic marker in clinical medicine to recognize high-risk diabetics at the time of diabetes onset/diagnosis.

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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: The risk of cardiovascular diseases increase in diabetic patients. So, it is important for patients to achieve the optimal lipid levels. Nutrition including consumption of anthocyanins plays a primary role in reducing the risk of heart disease and hypertension. In this study, we assessed the effect of concentrated sour cherry juice (SCJ) consumption as a rich source of anthocyanins on lipid profile and blood pressure of type II diabetic patients.
Methods: In this quasi-experimental study 16 type II diabetic women with fasting blood sugar ≥110 mg/dl and LDL-C ≥100 mg/dl were recruited and consumed 40 g/day of SCJ for 6 weeks. Measurements of weight, lipid profile and blood pressure were done in baseline and after completion of the study. A 2-day food records was completed by patients so. The Wilcoxon test was used for statistical analysis. Results: Mean (± SD) age, weight, total cholesterol, LDL-C, systolic and diastolic blood pressure were 53.6±8.8 years, 72.8±14.9 kg, 213.9±27/0 mg/dl, 118.4±14.7 mg/dl, 129.1±15.7 mmHg and 81.7±8.1 mmHg respectively in the beginning of the study. After consumption of SCJ, a significant decrease (P<0.05) in weight, total cholesterol, LDL-C, systolic and diastolic blood pressure was seen. Changes in serum triglyceride and HDL-C concentrations were not significant statistically.
Conclusion: It is concluded that SCJ consumption may modify cardiovascular disease risk factors in diabetic type 2 patients.

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Background: Overweight is one of the most worldwide health problems particularly in industrial and developed communities. Obese subjects are at high risk for developing various disorders such as diabetes and especially cardiovascular diseases. It has been well established that life style modification plays an important role in reducing these complications, particularly weight reduction and caloric restriction (CR) as a non- pharmacological approach. In the present study the possible effects of caloric restriction on Nitric Oxide production and blood pressures in rat were investigated.
Methods: Four groups of rats were selected as control(C), caloric restriction (CR), diabetic (D), and caloric restriction diabetic (CRD). Control animals fed freely with standard pellet but caloric restricted animals fed an every other day diet for 4 weeks. The systolic blood pressure (SBP) was measured in all groups using the tail-cuff method under the light general anesthesia induced by ether. Nitric oxide (NO x) concentrations were determined in serum using a colorimetric non- enzymatic NO assay kit .
Results: In CR experimental groups (CR&CRD) SBP was significantly decreased as compared to control: (P<0.001) and diabetic (P<0.01) rats , while the serum NO x was significantly increased (P<0.01) in both groups as compared to control and diabetic rats.
Conclusion: On the basis of obtained results, it could be concluded that caloric restriction may reduce blood pressure and increase nitric oxide in diabetic and non-diabetic rats. Increase nitric oxide is the likely mechanism for decreasing blood pressure .

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Background: CoQ10 is a lipid-soluble and a powerful antioxidant. Decreased level of this antioxidant was reported in many conditions like vascular, diabetes, high blood pressure and coronary artery diseases. With regards to increased oxidative stress in diabetes and its role in the development of high blood pressure, this study aimed to examine the effect of Q10 supplementation on blood pressure level and its relation to nitric oxide metabolites (NOx) level in type 2 diabetic patients. Methods: In this 12-week randomized controlled trial, T2D subjects received either placebo or coenzyme Q10 (100 mg twice a day). Anthropometric measures, blood pressure, biochemical analysis including NOx level, fasting blood glucose, glycosylated hemoglobin (HbA1c) and lipid profile were evaluated at the beginning and after the intervention. Results: The intervention resulted in a significant improvement in systolic blood pressure (115.3±27.61 versus 118.2±12.6 mmHg), diastolic blood pressure (77.1±8.22 versus 80.3±12.11mmHg), NOx (Pvalue=0.014) and HbA1c. Moreover Q10 supplementation resulted a significant decrease in elevated levels of cholesterol. Conclusions: In conclusion, CoQ10 supplementation (200 mg/day) for 12 weeks, significantly decreased systolic and diastolic blood pressure, NOx, HbA1c, total cholesterol and LDL-C in type 2 diabetic patients.

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Background: The higher dietary acid load may affect blood pressure, blood sugar levels, and insulin levels. The purpose of this systematic review study is to examine the relation of dietary acid load with blood pressure and blood glucose.
Methods: We searched in PubMed, Google Scholar, Scopus and Medline up to July 2016, using the keywords "dietary acid load", "serum glucose", "insulin resistance" and "hypertension ". 12 studies (6 cross-sections, 5 cohorts and 1 intervention) were included in this systematic review.
Results: Out of eleven articles related to blood pressure, three studies showed a significant relationship between dietary acid load scale and hypertension. Three studies found only a significant association between dietary acid load and systolic blood pressure, while other studies did not show any significant correlation between dietary acid load and systolic or diastolic blood pressure. Moreover, in relation to blood glucose control, among eight studies, one study demonstrated a significant relationship between increasing dietary acid load and the incidence of diabetes. One study reported a significant relation of dietary acid load with fasting blood glucose and glycosylated hemoglobin concentration. In addition, two studies indicated a significant correlation between increased dietary acid load and insulin resistance, but other studies not revealed a meaningful relationship.
Conclusion: Since most studies suggest a significant association between increased dietary acid load and higher blood pressure, therefore it seems which dietary acid load can effect on blood pressure. The results of the investigation of the relationship between dietary acid load with glucose, insulin levels or diabetes have many contradictions. According to limited studies in this field, there is a need to further trial or prospective studies regarding the dietary acid load and the incidence of diabetes, insulin levels, and other blood glucose markers.