Iranian Journal of

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

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Background: Detecting mothers with gestational diabetes mellitus (GDM) is not only important in prevention of prenatal morbidities but also has significant effect on neonatal and maternal long term outcomes. Today, there are screening tests for GDM but they are time-consuming and expensive, therefore it seems necessary to perform testes that are uses expensive but with higher sensitivity and specificity. The aim of this study was to determine a cut - off point of fasting plasma glucose (FPG) for screening of GDM.
Methods: 200 pregnant women referring to the perinatal clinic of Imam Khomeini hospital, (Sari – Iran) were studied. All cases with age ≥25 years old, history of recurrent abortion, GDM, preeclampsia, macrosomia, still birth, diabetes mellitus(DM) in first degree family or pre gestational body mass index ≥25kg/m2 were selected. Those with pre gestational diabetes mellitus were excluded. All of participants underwent a 50 g glucose challenge test (GCT) between the 24th and 28th gestational week. If 1- hour plasma glucose was more than 130 mg/dl, a 3- hour 100g oral glucose tolerance test (OGTT) was performed. The diagnosis of GDM was made by ADA 2006 recommendation (Carpenter and Coustan diagnostic criteria). Referring to the Receiver Operative Characteristic Curve, level of FPG having highest sensitivity and specificity in diagnosis of GDM was determined.
Results: From 200 participants, 65 women had positive GCT, of them 58 (response rate 89%) referred for 100g OGTT and 20(10%) were diagnosed GDM. Using ROC curve and under curve area of 0.853 the FBG level of 91.5 mg/dl, showed the highest sensitivity and specificity, 80% and 92% respectively in diagnosis of GDM.
Conclusion: FBG ≥ 91.5 mg/dl has good sensitivity and specificity in screening of GDM. Since this is simpler and cheaper than 50g GCT, is recommended as a screening method in diagnosis of GDM.

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Background: Alternate Day Fasting (ADF) is one of dietary regimens in which food is available only every other day. Available limited evidence shows that this regimen may result in beneficial effects similar to classic caloric restriction, including weight loss and other associated useful effects of weight loss. Methods: Twelve week-old Wistar rats were obtained from animal house of Jundi Shapur University and fed a standard diet. Food was provided ad-libittum (AL) until 13 week of age. At that time rats were assigned to one of two groups: AL fed ad libitum or ADF, provided access to food every other day. Body weight was measured each week on the same day and time. Food intake was measured daily. Fasting blood glucose levels were measured before and after the intervention. Statistical tests performed as two-tailed and P value of less than 0.05 was considered as statistically significance level. Results: At the end of the intervention period body weight and food intakes of the (ADF) group were significantly lower than AL group (p<0.05) but there were not significant changes in fasting blood glucose levels. Conclusion: According to findings of this experimental study, ADF regimen could be used as an individualized eating strategy for weight loss but it could not have beneficial effects on fasting blood glucose levels.

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Background: In recent years, dietary supplements play an important role in maintaining a healthy diet in most chronic diseases such as diabetes. Spirulina platensis as a food supplement has been raised and regulator effects on cholesterol and antioxidant and immune regulating effects of this supplement are also considered. It contains vitamin B, beta-carotene, vitamin E, high value proteins, minerals, gamma linolenic acid and antioxidants.
Methods: In this study 50 patients with type II diabetes were randomly selected and after taking patient's history they were divided into two equal groups including control. 8 grams of spirulina that was prepared in tablet (each 1 gram) form was administered daily to patient group for three months. Fasting blood sugar levels monthly and hemoglobin A1C levels at the beginning and end of the projects were measured in both groups and their results were compared with each other.
Results: Fasting plasma glucose in patient group after 3 months of treatment with spirulina powder gave a significant reduction from the 158.1± 44.2 mg/dl at the beginning of study to 127.8 ± 36.7 mg/dl but was not significant in the control group. Glycosylated hemoglobin in the both groups decreased but this decrease was not statistically significant.
Conclusion: Spirulina platensis as a supplement can be administered in type II diabetic patients that used oral anti-diabetic drugs. It is effective in reducing fasting blood glucose in the short term but its effect on hemoglobin A1C need to prescribe longer.

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Background: Patients with diabetes need to be educated efficiently and effectively in order to increase their quality of life. According to modern technological developments, multimedia message-based education is considered as one of the effective educational strategies. The purpose of this study was to investigate the effect of multimedia-based education in the Telegram application and in-person method on fasting blood glucose and glycosylated hemoglobin levels in patients with insulin-dependent diabetes.
Methods: In this clinical trial study, a sample of 66 patients with insulin-dependent diabetes who referred to the emergency department and the clinic of Sina hospital in Tabriz, were randomly assigned in double blocks into two groups: in-person education and multimedia-based education. Data gathering tools included a demographic form, glycosylated hemoglobin and fasting blood glucose were measured before and three months after the educational intervention. Data were analyzed with independent and paired samples t-tests.
Results: The results indicated that there were no significant differences in the mean values of glycosylated hemoglobin and fasting blood glucose between two groups before and after education(P >0.05). In within-group comparison, there was a statistically significant difference in the multimedia message group on the reduction of mean values of glycosylated hemoglobin (p= 0.02) but these values differences were not significant in in-person group (p= 0.33).
Conclusion: Multimedia-based education in the Telegram application compared to in-person education improves self-care and reduces the mean values of glycosylated hemoglobin in diabetic patients. This educational context can be used to facilitate the self-care education process to patients.