Iranian Journal of

---

Diabetes mellitus is a common disease and its incidence and prevalence are increasing in most populations. The trend is particularly worrying in developing countries. The number of diabetic patients in Iran is estimated at 1.5 million. The distribution of diabetes in Iran has been the subject of several surveys. Disease prevalence rates, for all forms of diabetes, of 7–17% have been variously reported in several adult urban populations. Geographical prevalence is not uniform, however, and the prevalence of type 2 diabetes mellitus has been reported at 3-5% in rural communities. A screening program conducted at different locations of Iran revealed that nearly 50% of people with type 2 diabetes were unaware of their condition. Not surprisingly, therefore, that the incidence of complications for diabetes is high in Iran. A battle is being waged on all fronts at present to control the socio-economic scourge that is diabetes mellitus. A national program has been designed for the primary, secondary, and tertiary prevention of diabetes. The major strategies that it puts forwards are screening, the identification of high-risk groups, public education, and the training of specialist care providers. This article reviews the epidemiological features of diabetes in Iran.

---

Background: The American Heart Association used the findings of the Framingham Heart Study to design an equation that quantifies the risk of coronary heart disease (CHD).
Methods: The variables in this equation are age, total cholesterol, HDL-cholesterol, systolic blood pressure, cigarette smoking, diabetes mellitus and evidence of left ventricular hypertrophy on electrocardiography. We calculated the CHD risk of 139 patients, with type 2 diabetes mellitus, who attended our diabetes clinic. We also assessed risk factors not taken into account by the Framingham equation, such as obesity (body mass index (BMI) or waist-hip ratio (WHR)), plasma triglyceride, LDL-cholesterol (LDL-C), and diastolic blood pressure (DBP). We used the linear regression and one-way ANOVA functions on the SPSS.v6 software to analyze our data.
Results: Ninety-one women and 48 men enrolled in the study. Men had a higher five- and ten-year CHD risk than women. 36.4% of our subjects had plasma HDL-C <35mg/dl. The TC:HDL-C ratio was 6.18±1.76 in men and 5.97±2.21 in women. We found no significant correlation between two- and five-year CHD risk and WHR, BMI or triglyceride levels. There was a significant correlation between two- and five-year CHD risk and DBP (p=0.0006 and p=0.0001) and LDL-C (p=0.005 and p=0.001).
Conclusion: Patients with diabetes mellitus have a higher, but smaller than expected, risk of CHD. The value of the Framingham equation in diabetic patients is equivocal, given the absence of correlation between obesity markers and CHD risk. Larger, prospective, studies are needed to clarify the matter.

---

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.

---

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.

---

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.

---

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.

---

Diabetes mellitus is characterized by several adverse consequences among which diabetic foot is a major complication. With a life long incidence of 15%, diabetic foot is accountable for more than 50% of non-traumatic lower limb amputations. Regular care, proper footwear and early treatment, but, have proved effective measures in preventing such outcome. The problem and features as infection, ulceration, or gangrene. Neuropathy, poor circulation, and decreased resistance to infection are the three major contributors to the development of diabetic foot which when present, foot deformities or minor trauma can readily lead to ulceration and infection. Not all diabetic foots are preventable, but appropriate preventive measures can dramatically reduce their occurrence.

---

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.

---

Background: Polycystic ovary syndrome (PCOS) which is characterized by menstrual irregularities (due to chronic anovulation) and hyperandrogenism is one of the most common endocrine disorders of women at reproductive age. The precise cause of PCOS is unknown, but it seems that several factors may have role in its pathogenesis. Insulin resistance and impaired insulin secretion are common findings in PCOS patients. Approximately 30 – 40 % of women with PCOS have impaired glucose tolerance or type 2 DM. According to my knowledge, there is no published study about prevalence of IGT and type 2 Diabetes Mellitus (type 2 DM) in Iranian women with PCOS. The aim of this prospective, controlled study was to determine the prevalence of abnormal glucose metabolism in women from north west part of the country.
Methods: 302 PCOS women and 116 normal women as a control group were prospectively studied. The diagnosis of PCOS was made based upon the presence of chronic anovulation and hyperandrogenemia. Other causes of hyperandrogenism were excluded by appropriate clinical and laboratory evaluations. None of the patients were known diabetics prior to study. In all patients with PCOS and control women appropriate medical history was taken and physical examination was done. Blood pressure, body weight, height, BMI, waist / hip ratio, score of hirsutism and other signs of androgen excess were determined. Serum concentrations of total testosterone and DHEA–S were measured by RIA methods in both patients and control group. Standard Oral Glucose Tolerance Test (OGTT) with 75 grams oral glucose was performed between 8 -9 AM after an overnight fast of 10 – 12 hours. Fasting and 2 – hour post - glucose plasma sugars were measured by glucose oxidase method. Results: Results of OGTT were interpreted according to WHO criteria. Mean age and mean BMI were similar in both patients and controls. Serum levels of total testosterone and DHEA – S were significantly higher in PCOS women in comparison with controls. 65% of patients and 68% of controls had BMI of ≥ 25 kg / m2. 55% of PCOS women and 51.6% of control women were obese (BMI ≥ 27kg/m2). 96 (31.7%) of PCOS women had impaired glucose tolerance (IGT) and 27 (8.9%) were diabetics. The prevalence of IGT and diabetes in controls were 14.6% and 5.1% respectively. In non-obese PCOS women the prevalence of IGT and DM were 17.2% and 3.6% respectively, while only 8.9% of control women had IGT and 1.7% were diabetics. Finally, 44.1% of obese PCOS women were glucose intolerant and 13.5% had diabetes mellitus in comparison with 20% and 10% of controls. Conclusion: It is concluded that the prevalence of IGT and DM in both obese and non–obese PCOS women were significantly higher than in control women. Screening of all PCOS women for IGT and DM is highly recommended.

---

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.

---

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.

---

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.

---

Background: Gliclazide is a second generation sulfonylurea which its efficacy and safety in the treatment of diabetes has been established. Diamicron MR (30 mg) is a new formulation of gliclazide with modified release which offer once daily dosage administration. This study was designed to assess the effect of combination therapy with diamicron and metformin in the treatment of type 2 diabetes. Methods: 16 patients with type 2 diabetes (2 males, 14 females) more than 35 years old who despite treatment with glibenclamide and metformin had poor diabetes control participated in this clinical trial.HbA1c, lipid profile, liver and renal function tests at the end of study were compared with before. Results: No significant changes was found in FBS, BS2hpp, lipid profile and renal and liver function tests at the end of study. Patients' weight was stable during the study.
Conclusion: Regardless of well efficacy of diamicron in the treatment of new diabetics cases, it is not recommended for patients with poor diabetes control despite of combination therapy with metformin and glibenclamide.

---

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.

---

Background: Diabetes mellitus is the most common cause of renal failure, blindness, non- traumatic amputation and neuropathy. Homocysteine, a sulfurated amino acid, has a close correlation with Methionine and Cysteine. The conversion of Methionine to Homocysteine and Cysteine is required coenzymes like vitamin B6, B12 and Folate. The effect of Metformin on serum Homocysteine level by decreasing vitamin B12 level in patients with type 2 diabetes mellitus was described previously. Methods: This is a prospective clinical trail study among patients with type 2 diabetes mellitus in Shiraz. 76 patients were divided into two groups (38 patients in each group). First group treated with Metformin 500-2000 mg/day and the second group treated with Glibenclamide 5-20 mg/day with follow up period of at least 6 months. Hb and MCV were used in follow up to detect megaloblastic anemia, indicator of B12 and folate deficiency. Fasting plasma Homocysteine level Hb A1C and blood sugar were measured in baseline and at 3 and 6 months follow up periods. Results: There was no significant difference between age, sex, weight, height and BMI and baseline serum profile between the two groups. Homocysteine level increased significantly in Metformin group at 3 and 6 months(P=0.003 and 0.001 respectively). Mean plasma homocysteine level after 6 months were 10.98±0.58 μmol/l in Metformin and 10.0± 0.88 μmol/l in Glibenclamide group, with significant difference between the two groups (P=0.001). Conclusion: Metformin increases the plasma Homocysteine level. Metformin will accumulate highly in gastrointestinal wall and cause malabsorption of vitamin B12, therefore we can conclude that the use of Metformin for 6 months can cause vitamin B12 malabsorption and increase in plasma homocysteine level. Increase in plasma homocysteine level was 7.54% in our study that is higher in comparing to the other studies. It can be explained by longer duration of Metformin therapy in our study. Rising in Homocysteine levels may have detrimental effect on vessels that need further study.

---

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.

---

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.

---

Background: Diabetes mellitus is the most common human metabolic disease. Chronic hyperglycemia and carbohydrate metabolism disorder accompany with plasma lipid and lipoprotein disorder. Cardiovascular disease is one of the macro vascular complications of diabetes type 2 which leads to high morbidity and mortality. Dyslipidemia is one of the major risk factors of cardiovascular diseases in diabetic patients. High TG and low HDL-C levels are the most prevalent type of dyslipidemia. Low levels of HDL-c considered as a risk factor for cardiovascular diseases. Methods: In this study 40 type 2 diabetic patients (13 male - 27 female) were included. Lovastatin and Gemfibrozil were recommended separately for 2 months and HDL-C were measured at the baseline and after taking drugs. In all patients BS, TG and TC at the baseline before and after these drugs were normal and so were not any change in their diet. Laboratorial findings gathered and analyzed. The relationship between increase level of HDL and decrease of TC with taking Lovastatin and Gemfibrozil were studied. Results: The averages of TC and HDL-C before taking drug as linear were 36.5mg/dl and 174.56 mg/dl and after taking Lovastatin as linear were 43.3 mg/dl and 150.44 mg/dl. The average of TC and HDL-C after taking Gemfibrozil were 43.33mg/dl and 146.36mg/dl. 18.54 % increase in HDL-C and 13.82% decrease in TC were seen with Lovastatin and 18.54% increase in HDL-C and 16.05% decrease in TC were found with Gemfibrozil. Conclusion: In this study no difference was observed between the effect of Lovastatin and Gemfibrozil in increase of HDL-C (P=0.449). Also there was no difference between the effect of Lovastatin and Gemfibrozil in decrease of TC (P=0.992). The increase of HDL-C after taking Lovastatin had relation with sex and HDL-C increased in females (P=0.006) Also the increase of HDL-C after taking Gemfibrozil had relation with sex and females had more affected (P=0.035).

---

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.

---

Background: The determination of insulin receptors on RBC membrane is a suitable tool for the study of these receptors in diabetes and its related complications. The common methods for the study is the biopsy of fat or muscular tissues, cell culture or a preparation of certain amount of monocytes which is associated with some difficulties. Present study utilizes RBC's for this purpose.
Methods: Certain amount of RBCs were exposed to a known amount of labeled Insulin and varying concentration of unlabelled Insulin. The competitive effect of Insulin replacement was determined by the measurement of residual receptor radioactivity. This study was carried out in three groups of healthy, poor controlled and good controlled diabetics.
Results: There were significant differences between the normal and poor controlled diabetics (P=0.017). In addition differences in receptor binding was obtained between good controlled diabetics and normal which were not significant (P=0.09). All changes were inversely proportional to the HbA1C of specimen. Using Scat chard plots the number of receptors in each group, normal, poor controlled and good controlled were determined to be 1820 (± 72.8), 1026 (±40.4) and 1230 (± 49.2) respectively.
Conclusion: Considering the above results, it could be seen that the evaluation of the number of receptors in RBC could be a suitable tool for studying the state of insulin receptor in both physiological and pathological conditions.