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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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In the field of health care and medical practice, gain sharing plans should be carefully examined to be sure they reflect the codes of ethics. Ethical principles involved in gain sharing include informed consent and conflict of interest. Physicians must discharge their responsibilities to patients with loyalty, honesty and good faith, all the while avoiding conflict of interest. Conflict of interest rules usually focus on financial gain. This may raise some important issues, including kickbacks, fee-splitting and self-referral. These practices can potentially distort professional judgment. Some countries have rules of professional conduct governing these issues. In this article, we intend to describe importance of the issues of kickbacks, fee-splitting and self-referral in the field of clinical medicine and discuss some ethical issues that should be considered by physicians.

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Background: Patient education as an integral aspect of communication between health care providers and patients plays an important role in patient health management Teach Back (TB) is a method of interactive education. Using the teach-back technique not only improves patient’s knowledge and understanding, but also increases patient’s adherence to disease management. Furthermore, self-care education to diabetic patients has always been a key strategy for successful control of diabetes. The aim of this study is assessment the effect of self care education based on Teach Back method on promotion of self care behaviors in type II diabetic patients of Hamadan city, 2012. Methods: This interventional quasi-experimental study was performed by choosing 70 type II diabetic patients Random permutation divided into two experimental (n=35) and control (n=35) groups. Educational programs base on TB designed for patients in the intervention group included four sessions. Before and one month after the educational intervention, the results were evaluated. Participants responded to the knowledge and SDSCA questionnaires. Information was collected through interviews and self report, and then data were analyzed by SPSS-20. Results: The results indicated a positive impact of TB on knowledge (p< 0.001) and self-care behaviores (p<0.001) among patients of the intervention group. Conclusion: The results showed the positive effect of education program based on Teach Back method to increase self management among diabetic patients, while implementing such programs seem to be effective in the treatment and prevention of diabetes complications.

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Background: Non-alcoholic fatty liver disease (NAFLD) is a chronic liver disease is increasing in adults and children worldwide. Obesity, insulin resistance or diabetes type II, hyperlipidemia and hypertriglyceridemia plays a major role in the epidemiology of this disease. Cytokeratin 18 (CK-18) the major intermediate filament protein in the liver is a marker of increased hepatocyte apoptosis. The aim of this study was to determinate CK-18 level as a marker of hepatocyte apoptosis and paraoxonase as a biochemical marker for lipid peroxidation.

Methods: This case–control study was done on 51 subjects with confirmed NAFLD by ultrasound and 30 healthy individuals. CK-18 is proposed as a biomarker alternative cell death. The serum was used for measurement of the apoptosis-associated neo-epitope in the C-terminal domain of CK-18 by the M30-Apoptosense ELISA kit. The M30 detection antibody recognizes a neo-epitope mapped to positions 387 to 396 of CK18, so called CK18-Asp396 that is only revealed after caspase cleavage of the protein and is postulated as a selective biomarker of apoptosis. Serum PON1 activity was assayed using a synthetic substrate. Paraoxon substrate (diethyl-p nitrophenylphosphate), was deliberated using the increase of absorbance at 412 nm at 37 ◦C. 

Results: There were significant differences regarding serum cytokeratin 18 (p=0.005), paraoxonase activity (p=0.03), triglycerides (p=0.04) and low-density lipoprotein (p=0.04) between NAFLD and healthy subjects. Between CK-18 and paraoxonase with the early stages of fatty liver disease are associated.

Conclusion: This study suggests that serum levels of cytokeratin 18 can be useful in predicting non-alcoholic fatty liver disease. Paraoxonase activity (PON1) should be considered a biochemical marker of lipid peroxidation and the need for follow-up in patients with NAFLD

Keywords: Non-alcoholic fatty liver disease (NAFLD), non-alcoholic steatohepatitis (NASH), Cytokeratin 18 (CK-18), Paraoxonases

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Background: Inhibitors of α-glucosidase by interfering with digestion of carbohydrates play a role in controlling diabetes. Thymus vulgaris is an herb belonging to the mint family (lamiaceae). The essence of this plant contain the phenols such as thymol and carvacrol, cymene, linalool, pinene. The aim of this study was to investigate the inhibitory effect of the constituents of the thymus vulgaris extract on the activity of α-glucosidase enzyme by molecular docking.
Methods: In this study, to investigate how the compounds are attached to the active site of the enzyme, mapping of chemical structure of the compounds, energy optimization, docking studies and final analysis were carried out by ChemDraw, HyperChem, AutoDock 4.2, DS Visualizer and Lig Pluto software, respectively.
Results: All of the studied compounds were able to occupy the active site of the enzyme, among all of them, the best results of docking was  related to the combination of Caryophlla-4- (12), 8 (13) -dien-5-β-ol. In fact, this compound has the most negative energy level of connection, the highest affinity for binding to the active site of the enzyme and the interaction site is similar to that of the co-crystal molecule.
Conclusion: considering the high efficacy of plant extract compounds in the bioinformatics study, and for complementary studies, the effect of the extract of this plant can be analyzed in order to control the increase of glucose in vitro and in vivo conditions. 

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Background: The aim of the present study was to investigate the effect of 8 weeks of HIIT training and supplementation of black grape seed extract on Wnt and Β-catenin gene expression in pancreatic tissue in male rats with type 2 diabetes.
Methods: In this experimental study, 40 male Wistar rats, with average weight of 250 ± 20 gr, after induction of diabetes by STZ, were randomly divided into 5 groups: training- supplement, training-placebo, supplement and diabetic-control and base control. After becoming diabetic, rats were familiarized with protocol for one week and then trained for eight weeks, five days a week. They ran on treadmill with 90% of VO2 max. Intragastric injection of GSPE extracted from black grape seed (Cabernet sauvignon) once a day for 8 weeks (250 mg/kg, proanthocyanidin content >96%). 24 hours after the last session of training, pancreas tissue was extracted, and the level of gene expression was measured by Real Time-PCR. In all statistical analyzes, the statistical significance level was considered to be 0.05.
Results: Eight weeks and supplement significantly increased the mean expression of Wnt and Β-catenin genes in pancreatic tissue of type 2 diabetic rats but the effect of exercise with black grape seed extract on the expression of Wnt genes in the pancreas of diabetic rats was not significant.
Conclusion: It seems that regulating the expression of Wnt and Β-catenin genes through exercise and consumption of black grape seed extract is likely to improve and maintain the function of pancreatic beta cells, especially in diabetic samples.

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Backgrond: Although some studies have studied the mechanism of action of beta cells in animal models and more or less in human populations, but so far the role of exercise therapy or exercise exercise HIIT along with black grape supplementation on the expression of involved genes Less has been studied in pancreatic beta cells, so the aim of the present study was to investigate the effect of eight weeks of intense intermittent exercise with black grape supplementation on the expression of PPARα and PPARγ gene in pancreatic tissue of male rats with type 2 diabetes.
Methods: The study was conducted in the form of an experimental design. The subjects of this project were 40 8-month-old male rats with an average weight of 250 grams. After familiarizing the subjects with exercise and induction of diabetes by STZ, the subjects were randomly divided into 5 groups including exercise, supplement, exercise and supplement, diabetic control and basic control. After 8 weeks of training, 5 sessions per week for 8 weeks with 90% Vo2max activity and supplementation of black grape seed extract, PPARα and PPARγ genes were measured after RNA extraction from pancreas and cDNA synthesis. PPARα and PPARγ genes were measured by Time-Real PCR. Data were analyzed using independent t-test and two-factor analysis of variance at a significance level of 0.05 by SPSS software version 24.
Results: The effect of exercise with consumption of black grape seed extract on the expression of PPARγ and PPARα genes in the pancreas of diabetic rats was not significant, but exercise alone significantly increased the expression of PPARα gene in the pancreatic tissue of diabetic specimens. Consumption of black grape seed extract alone significantly increased the expression of PPARγ and PPARα genes.
Conclusion: It seems that regulating the expression of PPARα and PPARγ genes through exercise and consumption of black grape seed extract may lead to the improvement and maintenance of pancreatic beta cell function in diabetic rats.

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Background: Although some studies have studied the mechanism of action of beta cells in animal models and more or less in human populations, but so far the role of exercise therapy or exercise exercise HIIT with black grape supplementation on the expression of genes involved in pancreatic beta cells This study investigates the effect of black grape supplementation combined with intense intermittent exercise on Bcl-2 and Bax genes in pancreatic tissue of rats with type 2 diabetes.
Methods: The study was conducted in the form of an experimental design. The subjects of this project were 40 8-month-old male rats with an average weight of 250 grams. After familiarizing the subjects with exercise and induction of diabetes by STZ, the subjects were randomly divided into 5 groups including exercise, supplement, exercise and supplement, diabetic control and basic control. After 8 weeks of training, which was 5 sessions per week for 8 weeks, the activity was on a treadmill with an intensity of 90% Vo2max and supplementation with black grape seed extract. Bcl-2 and Bax genes were measured after RNA extraction from pancreas and cDNA synthesis. Bcl-2 and Bax genes were measured by Time-Real PCR. Data were analyzed using independent t-test and two-factor analysis of variance at the significance level of 0.05 by SPSS software version 24.
Results: The results showed that the main effect of exercise had no significant effect on Bcl-2 gene expression. The main effect of the extract on the expression of this gene was significant. Also, the interaction between exercise and Bcl-2 supplementation was not significant. Regarding Bax gene expression, it was shown that the main effect of exercise on the gene was significant. The main effect of extract and interaction of exercise and supplementation on Bax gene expression was not significant. No significant changes were observed in the effect of exercise and extract on the expression of Bcl-2 and Bax genes.
Conclusion: It seems that regulating the expression of Bcl-2 and Bax genes through exercise and consumption of black grape seed extract is likely to improve and maintain pancreatic beta cell function in diabetic rats.

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Background: Diabetes mellitus is a metabolic syndrome characterized by elevated blood glucose. The α-glucosidase enzymes that are found in the small intestine are responsible for the hydrolysis of carbohydrates. The aim of this study was to Bioinformatics evaluation of T.foenum active compounds in suppression of α-glucosidase enzyme.
Methods: This study was a descriptive-analytical method. For this purpose, the compounds separation of Trigonella foenum were first downloaded from PubChem database and then the α-glucosidase enzyme file was obtained from PDB database. The toxicity class of compounds and the Lipinski rules were predicted by Toxtree & Protox II and the Swiss ADME server, respectively. Finally, molecular docking and enzyme interaction with the compounds in Trigonella foenumwere performed by AutoDock Tools 1.5.6 and Molegro Virtual Docker 6.0. Interaction results were also analyzed using Discovery Studio 3.5 & Ligplot 2.1 software.
Results: The results indicated that all selected of compounds in Trigonella foenumwere in follow with Lipinski's rules, proper binding energy, and lack of toxicity were appropriate options for α-glucosidase inhibition. But among these compounds, Vitexin had the lowest binding energy and the most inhibitory effect on the α-glucosidase enzyme, with -4.8 kcal/mol. These compounds also had lower binding energy than standard inhibitor (Voglibose).
Conclusion: From the results of this study, it can be concluded that among the most important compounds in Trigonella foenum, the Vitexin compound power inhibitor that due to more hydrogen and hydrophobic interactions with the α-glucosidase enzyme active site.
 

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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:  Diabetes mellitus is a group of metabolic disorders that are associated with elevated blood glucose levels due to impaired insulin secretion, insulin function, or both. alpha-glucosidase is a key enzyme in hydrolyzing carbohydrates and raising blood sugar levels. This study aimed to investigate the bioinformatics of inhibition of the alpha-glucosidase enzyme by the main constituents of Salvia officinalis.
Methods: This research was done by descriptive-analytical method. To study how the compounds interact and the amount of binding energy in the active site of the enzyme, the three-dimensional structure of the compounds and proteins were obtained from PubChem and PDB database, respectively. After energy optimization by Hyperchem software, docking studies were performed by AutoDock 4.2 software and the Swiss ADME server was used to obtain Lipinski parameters and physical and chemical properties of the compounds.
Results: The studied compounds were similar to the two positive control compounds, Voglibose and miglitol, in terms of binding energy and how they interact. The best docking results are related to the camphor . In fact, this compound with the most negative binding energy level (-3.95 Kcal / mol) has a greater tendency to bind to key amino acids in the active site of the alpha glucosidase enzyme.
Conclusion: Due to the appropriate interactions of Salvia officinalis.compounds with enzymes, after confirming the results in vitro and in vivo, this plant can be used as a suitable drug candidate in the treatment of diabetes.

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Background: In Iran, with the advancement of technology and the development of registration statistics, the need to use data mining methods has attracted more attention from researchers. Regression and classification tree is one of the important methods in Big data modeling, which has attracted the attention of many researchers for community control and prediction. The purpose of this study is to determine the influencing variables on the occurrence of complications caused by diabetes.
Methods: This paper is a cross sectional-analytical study. In this research, all diabetic patients covered by Mashhad University of Medical Sciences in 2017 were extracted from the SINA system. The number of diabetics with complications was 5016 and diabetics without complications were 53613. The method of fitting the regression tree model and classification and measurement criteria of the model is the coefficient of determination and the area of the Rock curve and the Lift diagram.
Results: The rock curve for the fitted tree model is 73.8%, which shows the relatively high power of the model. Based on the Lift chart, the decision-making power of diabetes complications increases 3.5 times for the person who comes to visit.
Conclusion: The results of the regression model and tree classification showed that, in descending order, age, risk assessment factor, FBS, HbA1C, total activity time, cholesterol, FBS and HDL, cardiovascular disease, history of stroke, blood pressure, cholesterol Statin prescription, job with hard physical activity, living area, consumed oil, walking, consumption of vegetables and gender are more effective than other factors in the occurrence of diabetes complications.

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Introduction:The purpose of the research was to compare the effect of two types of raeobic exercise with and without incline on the modulation of oxidative stress and kidney function in CKD mice.Methods:The number of 24 two-month-old C57bl6 female  mice weighing 25±26.1 grams were randomly divided into four groups:healthy control,CKD-affected mice,CKD and aerobic exercise without incline and CKD and aerobic exercise with incline were divided. In order to induce CKD,they received adenine powder of 0.2% mg/kg for 4 weeks.The training groups performed eight weeks of treadmill training(5 sessions perweek)one group performed with a 20-degree incline and the other group performed with a zero-degree incline.After the last training session, sampling of blood was done to measure blood  urea nitrogen and urea and glutathione concentration by ELISA method.The expression of SIRT1,NRF1 and TNF-α genes was measured by qPCR-Real Time technique. For statistical analysis,one way ANOVA test and Tukey's post hoc test and significance level P≤0.05 were used.Findings:The results showed that induction of CKD caused a significant increase in blood urea nitrogen and a significant decrease in glutathione concentration compared to the healthy control group (P<0.05).On the other hand, in the exercise group, there is a significant increase in glutathione concentration and a significant decrease in blood urea nitrogen (P<0.05).The expression level of SIRT1 and NRF1 in the slope training group increased significantly and the expression level of TNF-α decreased significantly (P<0.05).