Tehran University Medical Journal

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A cross-sectional study was conducted on type II diabetic patients during 1991-1996 in Isfahan. By systemic sampling, 715 patients were enrolled. Variables studied, include: age, gender, duration of diabetes, body mass index (BMI), literacy, smoking habits, hypertension, lipid profiles, fasting blood glucose (FBS), retinopathy, ischaemic heart disease (IHD), proteinuria and type of treatment of diabetes. Prevalence of IHD in males (37.4%) was more than females (32.6%). Logistic regression analysis revealed a direct association between IHD prevalence with age, BMI, hypertension, proteinuria, diabetic retinopathy and type of treatment. Conclusions: 1) The factors mentiond are good predictors of IHD, but genetic influences may also contribute to the risk of IHD. 2) As obesity and BMI are prone to medical manipulation, control of these risk factors may decrease prevalence of IHD.

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Some factors such as: aging, obesity, hypoactivity, stress, urbanization, hyperlipidemia, hypertension, multiple pregnancies, smoking and so forth, are important factors that are always argued whether in disease production or in increasing morbidity and mortality in diabetic patients. In a descriptive, cross-sectional and correlational study, we looked for some important risk factors in 780 diabetic patients in Yazd city. The main objective in this study was to identifying the at risk cases. In this study, 54% of understudied patients were obese, 52.3% hypoactive, 80.7% urbanized, 21.5% smokers and approximately 11% were continiously or occasional alcohol users. 85% of all patients had no habit to sport, and the mean of their last fast blood sugar was significantly upper than those who had continiously physical exercises (P=0.01). Majority of understudied women (65.3%) had experienced 6 or more pregnancies during their life, and the last mean blood sugar in these patients was significantly upper than those with <6 pregnancies (P=0.0004). The age of majority of patients in either males or females was 50-70 years, and duration of disease in majority of them was <10 years. Increasing of the last mean blood sugar was significantly compatible with increasing of disease duration (P=0.00003). Regardless the type of diabetes, the disease in every generation was more frequent in female gender and totally, the mean of last fast blood sugar in the patients was 216 mg/dl which is not a controlled sugar. We have suggested the mean of last fast blood sugar in all of the referal cases as a performance indicator during evaluation of center of diabetic patients control

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To examine the relation between oral contraceptive (OCPs) use, body mass index, parity, familial history of gallstone disease, history of diabetes, history of hyperlipidemia and gallstone disease in women, we have undertaken a case-control study. The study population comparison 80 hospital patients with diagnosed acute gallstone disease as case group and 200 controls who were patients in hospital with no history of gallstone disease. The data were analyzed by Chi-square and T-student test. The results revealed that: The use of OCPs in case group is higher than that of control group. But there is no significant difference between them. No relation was found between gallstone disease and body mass index, parity, history of diabetes, familial history of gallstone disease, use of OCPs of different types and duration of use. While there was a significant difference between the 2 groups regarding history of hyperlipidemia (P<0.05). Finally we found no correlation between the history of use, types and duration of use of OCPs and symptomatic gallstone disease. There was no indication of any interaction between oral contraceptive use and other risk factors and duration of OCP use and other risk factors in the production of disease.

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Estimating fetal weight in utero, for better management of pregnancy and appropriate timing of delivery especially in high-risk pregnancies is necessary. Our purpose to evaluate a simple method in estimating fetal weight in Iranian pregnant patients and also to compare was with a previous western study. This study was carried out in Arash hospital, Tehran university of medical sciences in 1996-99. In a descriptive-analytic study that was done prospectively on 464 pregnant patients, ultrasonic measurement of biparietal diameter (BPD), mean abdominal diameter (MAD), and femur length (FL) performed close to delivery was conducted. Birth weight also was identified. Statistical analysis was done using multiple linear regression on the data and also student's T-test for comparison. Mean birth weight was 2320 gr. The outcome of linear regression analysis was the following model: Weight (gr)=95.8×FL (cm)+25×MAD (cm)-15.6×BPD (cm)-4632.1. The effect of all parameters were statistically significant (P<0.02). A fetal weight estimating table was also developed. T-test analysis showed a significant difference (P<0.05) in some final ranks of table (Weight estimations>4000 gr) in comparison with the Rose and Mc callum study. Our study showed that ultrasound using the sum of BPD, MAD and FL is a precise method in fetal weight estimation. Application of other biometric measurements may be needed for better elucidation especially in small and large for gestational age fetuses.

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Diabetes Mellitus is the most common endocrine disorders in children. There is a close association between diabetes and other autoimmune disease especially thyroid disorders. As many as 20 percent of Insulin dependent diabetic patients may have thyroid antibodies in their serum. The prevalence is 2-20 times greater than observed in normal populations. In this study, 122 patients with Diabetes Mellitus type I who referred to Institute of Endocrine & Metabolism and private office during a 3 years period were studied. A complete history was taken and physical examination was done in al patients by Endocrinologist. The diabetic patients due to major thalassemia excluded from this study. The grading of the goiter was determined by WHO classification and T4 and TSH were measured by RIA method in all patients. All patients were on Insulin treatment. There were 64 girls (52.4 percent) and 58 boys (47.6 percent) in 2-16 years age group (mean age 11.2 years). The mean duration of diabetes was 4.2 years. Prevalence of goiter was 53.2 percent and 7.3 percent of patients with goiter had hypothyroidism and 1.6 percent, had hypothyroidism. Most of the patients with goiter were euthyroid (91.9 percent). The patients with hypothyroidism had marked growth retardation and frequent episodes of hypoglycemia. The findings of this study indicate that the risk of development of goiter and thyroid disorders is higher in our diabetic patients and decelebration of growth and brittle diabetes may be due to thyroid disorders. It is suggested that all of the diabetic children should be screened yearly for thyroid disorders.

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Diabetes Mellitus is the most common endocrine disorders in children. There is a close association between diabetes and other autoimmune disease especially thyroid disorders. As many as 20 percent of Insulin dependent diabetic patients may have thyroid antibodies in their serum. The prevalence is 2-20 times greater than observed in normal populations. In this study, 122 patients with Diabetes Mellitus type I who referred to Institute of Endocrine & Metabolism and private office during a 3 years period were studied. A complete history was taken and physical examination was done in al patients by Endocrinologist. The diabetic patients due to major thalassemia excluded from this study. The grading of the goiter was determined by WHO classification and T4 and TSH were measured by RIA method in all patients. All patients were on Insulin treatment. There were 64 girls (52.4 percent) and 58 boys (47.6 percent) in 2-16 years age group (mean age 11.2 years). The mean duration of diabetes was 4.2 years. Prevalence of goiter was 53.2 percent and 7.3 percent of patients with goiter had hypothyroidism and 1.6 percent, had hypothyroidism. Most of the patients with goiter were euthyroid (91.9 percent). The patients with hypothyroidism had marked growth retardation and frequent episodes of hypoglycemia. The findings of this study indicate that the risk of development of goiter and thyroid disorders is higher in our diabetic patients and decelebration of growth and brittle diabetes may be due to thyroid disorders. It is suggested that all of the diabetic children should be screened yearly for thyroid disorders.

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Background: Hypertention and diabetes are important risk factors for cardiovascular disease. studies have shown that microalbuminuria is a strong predictor of cardiov-ascular disease in different population.In this study the relation of microalbuminuria with diabetes and hypertention as risk factors of atherosclerosis disease were investi-gated.

Methods: Two hundered twenty eight patients with angiographically confirmed coronary atherosclerotic lesions, (mean age 60 ± 0.5 SD) referred to Madani Hospital, Tabriz, Iran were studied .This patients according to the number of diseased vessels were classified in two groups. The levels of glucose and creatinine and that of post parandial glucose were determined in venous blood samples by standard methods. Immunoturbidimetric method was employed in the measurement of microalbuminuria. The results were analysed by statistical tests.

Results: The increased albumin/creatinine ratio was markedly correlated with fasting blood sugar, systolic and diastolic blood pressure (P < 0.05 in all cases). Significant correlation was noticed between microalbuminuria, diabetes according to the extension of the disease lesions (P < 0.05). No relationship was observed between microalbumin-uria, high levels of blood pressure according to the number of diseased vessels (P > 0.05).  Conclusion: The relationship between diabetes and microalbuminuria was meaningful. According to atherosclerotic lesions a marked correlation was also noticed between microalbuminuria and diabetes. These facts may contribute to the higher cardiovascular risk in diabetic patients. An associated between hypertension and microalbuminuria was noticed. The result suggests that although risk factors such as hypertension and diabetes are known to cause cardiovascular disease, microalbuminuria may in fact be a better indicator of established microvascular damage and better predictor of cardiov-ascular events.

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Background: Diabetic neuropathy is an incapacitating disease that afflicts almost 50 percent of patients with diabetes. A late finding in type 1 diabetes, diabetic neuropathy can be an early finding in non insulin-dependent diabetes. Diabetic neuropathies are divided primarily into two groups, sensorimotor and autonomic. Patients may acquire only one type of diabetic neuropathy or may present with combinations of neuropathies, such as autonomic neuropathy or distal symmetric polyneuropathy, the latter of which the most common form. Motor deficits, orthostatic hypotension, silent cardiac ischemia, hyperhidrosis, vasomotor instability, gastroparesis, bladder dysfunction, and sexual dysfunction can also result from diabetic neuropathy. Strict control of blood sugar, combined with proper daily foot care, is essential to avoid the complications of this disorder. With the potential to afflict any part of the nervous system, diabetic neuropathy should be suspected in all patients with type 2 diabetes as well as patients who have had type 1 diabetes for over five years. Although some patients with diabetic neuropathy notice few symptoms, upon physical examination mild to moderately severe sensory loss may be noted by the physician. Idiopathic neuropathy has been known to precede the onset of type 2 diabetes.

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Background: The effects of population aging are becoming apparent throughout the world. Diseases, such as cardio-vascular disease (CVD) and diabetes, are among the most important factors affecting morbidity and mortality, especially in the elderly. These diseases not only result in huge economic costs for treatment and care, but also results in hardship and time lost for relatives of the afflicted individuals. The association between nutritional status and disease is well known. In the present study, the effects of both under-nutrition and over-nutrition on the prevalence of disease are monitored in an urban Iranian elderly population. Thus far, no similar study has been performed in the Iran.
Methods: This cross-sectional study was conducted in Isfahan, Iran, during late 2003 on 1694 elderly people (731 males, 963 females), aged 60 years and older. Subjects were randomly chosen from all urban elderly people during a door-to-door and weight and height survey. They were selected using a cluster sampling method, each containing 30 clusters. From each cluster, 58 elderly were selected at random. Using each subjects body mass index (BMI), the nutritional status was categorized as overweight (BMI greater than 25), underweight (BMI less than 19) and normal (having a BMI equal to or more than 19 and equal to or less than 25). Any illnesses known to each subject were also recorded.
Results: Results showed that 4.7% of the subjects were underweight and 61.2% overweight. Women were more likely to be overweight and long periods of watching television increased the risk of overweight in all subjects. Being overweight was associated with diabetes and coronary vascular diseases, and lean people were less likely to suffer from such diseases.
Conclusion: This study indicates a high prevalence of overweight among the Iranian elderly population, indicating the need for improvement in nutritional status in order to reduce the prevalence of diabetes and CVD.

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Background: The aim of this study was to estimate the prevalence, severity, and risk factors for diabetic retinopathy in diabetic cases admitted for non-ocular diabetic complications and to investigate the association between retinopathy and these complications.

Methods: In this cross-sectional study, 84 diabetic patients admitted to our university-affiliated hospital for non-ocular diabetic complications were fully evaluated for proliferative and nonproliferative diabetic retinopathy. Cases of nonproliferative retinopathy (NPDR) were graded as microaneurysm, mild, moderate or severe. To determine the association of retinopathy with the complications that caused hospitalization, statistical analysis was performed using SPSS ver. 11.5.

Results: The prevalence of diabetic retinopathy among our cases was 77.4% (65 patients), with proliferative diabetic retinopathy (PDR) present in 23 patients (35.4% of the retinopathy cases). Diabetic retinopathy was higher in patients who had been hospitalized for nephropathy than in patients with diabetic foot and diabetic ketoacidosis (DKA, p=0.001), and higher in those hospitalized for diabetic foot than for DKA (p=0.008). Among the 35 patients who had nephropathy and retinopathy, 16 subjects (45.7%) had PDR, and the other 19 subjects had NPDR. Twenty-seven patients had diabetic foot and retinopathy, six (22.7%) of whom had PDR, and 21 (77.8%) had NPDR. Factors significantly related to the occurrence of diabetic retinopathy were type 2 diabetes, presence of hypertension, elevated serum levels of creatinine, duration of diabetes and coexisting nephropathy or diabetic foot (all with p values <0.05). In the logistic regression model, diabetic duration had a slight association with PDR (p=0.06).

Conclusion: Our data suggest that diabetic retinopathy in our patients is common, especially in patients with nephropathy. In addition to glycemic control, lowering of serum cholesterol and triglycerides as well as blood pressure may be effective in lowering the prevalence of diabetic retinopathy.

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Background: Several randomized controlled trials have demonstrated the safety and efficacy of drug eluting stents (DES) in selected groups of patients with less complicated diabetes. We conducted this study to determine how an unselected group of diabetic patients in Iran fare following DES implantation.

Methods: Data were collected on 147 consecutive diabetic patients who underwent percutaneous coronary intervention (PCI) with the implantation of at least one DES at the Tehran Heart Center from June 2003 to September 2005. Clinical follow-up was performed by timely scheduled visits at one, four and nine months following DES implantation. Nine months of follow-up was completed for 94.5% of the patients. The primary endpoint was the occurrence of major adverse cardiac events (MACE), which include cardiac death, myocardial infarction and target vessel revascularization (TVR). In-hospital complications were the secondary endpoint.

Results: A total of 158 coronary artery lesions were treated with DES in 147 diabetic patients (mean age = 56.4±8.92 years, 57.1% were men). During the nine-month follow-up, MACE occurred in 3.4% of patients, with a myocardial infarction rate of 1.4% and TVR rate of 1.4%. Considering one patient who underwent TVR due to acute stent thrombosis following angioplasty (during hospitalization) the total number of TVR reached 3 (2%). Only one patient (0.7%) died of cardiac death, which occurred after the procedure and before discharge. In-hospital complications occurred in six patients (4.1%) five patients suffered from myocardial infarction.

Conclusions: PCI with DES seems to be safe and effective in diabetic patients. However, more studies with larger study populations and longer follow-up are required to confirm this issue.

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Background: Myeloperoxidase (MPO), an iron-containing protein, is found in the azurophilic granules of neutrophils (PMNs), and catalyzes the conversion of hydrogen peroxide and chloride ions (Cl) into hypochlorous acid, which plays an important role in oxygen-dependent bacterial killing. The enzyme was first isolated in 1941, and deficiency of MPO was first described in 1954. Fewer than 5% of patients with MPO deficiency contract severe infections, which are usually fungal infections in diabetes mellitus (DM) patients. Besides the disorder in antifungal activity, diminished rate of bacterial (S. aureus) killing, and carcinogenesis, it seems that MPO deficiency is also related to atherosclerosis, degenerative neurologic diseases, as well as other disorders. In this study, we compared the levels of the MPO enzyme in the peripheral neutrophils of infected and non-infected DM patients at Imam Khomeini Hospital during 2005-2006. We compared these two groups the prevalence of MPO deficiency in each group, in order to then determine any correlations this may have with infection.

Methods: In this case-control study, 50 patients were in the infected group (case group) and 50 were in the control group. Patients were chosen using simple sampling methods. Data was gathered from blood samples, using a qualitative test to determine MPO deficiency (Kaplow stain), laboratory results (BUN, Cr, PMN, HbA1c), interviews and completion of a questionnaires, as well as hospital records. Data were analyzed with SPSS software using T test and chi-square test, with a confidence index of 0.05.

Results: In spite of differences seen in stained slides, the MPO enzyme was positive in all of the patients, and no differences were seen between the two groups.

The average patient age and the duration of DM in the case group were more than those of the control group. No statistical differences in the type of DM and glycosylated hemoglobin (HbA1c) levels were found between the two groups. Body mass indexes (BMI) and PMN counts were higher in the case group. The most prevalent infections were in the skin and soft tissue, bones and joints, as well as chronic respiratory infections (TB), pneumonia, urinary infections, CNS infections, gastrointestinal and intra-abdominal infections, mucormycosis, and sepsis.

Conclusions: We found no correlation between MPO enzyme deficiency and age, sex, type or duration of DM, HbA1c levels and BMI.

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Background: Diabetes mellitus is a common metabolic disorder accompanied with structural and functional changes in central and peripheral nervous system. Researches showed, memory disturbance were occurred in the course of diabetes. On the other hand, magnesium deficit has been described in diabetic patients. Some researches were showed that, appropriate magnesium supplementation can play a positive role in diabetic control.
Methods: Locally produced male rats were used. Diabetes was induced with intravenous injection of 40 mg/kg streptozotosin. In treatment groups, the animals were received magnesium sulfate via drinking water (10 g/l). Eight weeks after diabetes confirmation, the animals were assessed on Morris Water Maze.
Results: A significant decrease in time of platform finding (latency) and distance of swimming in all four experimental days were seen in all groups. Mean latency in diabetic group was significantly higher than the other. This weak response was almost completely prevented by magnesium sulfate administration.
Conclusion: It seems that after eight weeks magnesium sulfate administration (10g/l), spatial memory of the animals was improved in comparison to diabetic group that can suggest role of magnesium in recovery of diabetic animal memory.

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Background: Diabetes mellitus is a common endocrine disorder with increasing prevalence. Diabetic foot is a costly and serious chronic complication of diabetes mellitus that if it does not controlled will cause severe morbidities in patients with diabetes mellitus. Based on the study of center of management and prevention of diseases about 230 milliard Rials were expended for direct costs of diabetes annually and instruction of patients about protection of foots in some countries, decrease rate of amputation between 44 to 85% and infact instruction of diabetic patients is the base of treatment and prevention of complications of diabetes mellitus.
Methods: In a cross sectional study with attention to one of important causes of refer of diabetic patients to hospitals diabetic ulcers of foots, we discuss about risk factors and ways of treatment and prevention of them. The study done on patients admitted in endocrinology unit of Imam Khomeini hospital. For analysis we used SPSS 11.5 program. Although the costs for patients are calculated.
Results: In this study from 245 patients that admitted because of diabetic foot (63.26% male and 36.73% female), 74 patients have done amputation. From these 74 patients (30.2%), 65.67% were male and 24.32% were female. Age average was 58.24+12.29 years And the mean duration of DM was 10.56+8.32 years and the past history of diabetic foot was present in 45.95% of them. Past history of smoking was present in 66.21% of patients.
Conclusion: From 245 patients from 1996 to 2001 that admitted because of diabetic foot, 155 patients (63.26%) were male and 90 patients (36.73%) were female. From this numbers the most of them were in 60-70 years old and the least were 20-30 years old. Gender of most of them was male. For treatment of this complication a lot of costs were necessary and instruction of patients decrease this complications.

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Background: Among patients who have sensorineural hearing loss of unknown etiology, diabetes is one of the diseases to be routinely investigated. The relationship between diabetes mellitus and hearing loss is still controversial. The purpose of this study was to examine the prevalence of sensorineural hearing loss in patients with insulin-dependent diabetes mellitus (IDDM) compared to control group.
Methods: In a cross-sectional study pure tone audiometry (PTA) and speech audiometry was performed in 62 patients with insulin-dependent diabetes mellitus (IDDM), aged under 40 years, and in 62 randomly selected age-matched non-diabetic control subjects. Subjects with otological and other metabolic diseases were excluded from the study. We applied the SPSS.10 statistical analysis software Chi-square and student’s test.
Results: Statistical analysis showed that the hearing of the diabetic patients were significantly worsen than the control subjects. The hearing level tended to be worsen in the diabetic patients than that in control subjects, but the differences were statistically significant only at frequencies of 250,500, 4000 and 8000 Hz (p<0.05). There wasn’t statistical significant difference between sex in two study groups (p>0.05). The mean duration of diabetes was no statistically significant with hearing loss (p>0.05). The frequency of complications such as retinopathy, nephropathy, and neuropathy in the diabetic groups had no correlation with speech threshold (p>0.05). There were no significant differences between speech reception threshold, speech discrimination score and acoustic reflex in two groups.
Conclusions: We conclude that type I diabetes mellitus can cause sensorineural hearing loss.

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: The preferred modality of dialysis is a controversial issue in nephrology. In this study we compare some demographic and epidemiological characteristics of hemodialysis and peritoneal dialysis patients in an attempt to analyze this issue.
Methods: The results of the research protocol "A survey of the epidemiological characteristics of chronic dialyzed patients in Khorassan province", was used to compare some demographic and epidemiological aspects of chronic hemodialysis and peritoneal dialysis patients in search of any statistically significant difference.
Results: A total of 836 chronic dialysis patients entered this study, 802 (95.9%) of which were under chronic hemodialysis, and 34 (4.1%) patients were undergoing peritoneal dialysis, with 339 (42.3%) and 12 (35.3%) being female, respectively. The mean age for each group was 47.57 and 46.75 years, respectively. The causes of end-stage renal disease in hemodialzed patients were most commonly hypertension (32.2%), followed by diabetes mellitus (22.3%), unknown causes (19.6%) and chronic glomeru-lonephritis (10.2%). In the peritoneal dialysis group, chronic glomerulonephritis (32.4%) was the most common reason for dialysis, followed by diabetes mellitus (26.5%) and unknown causes (11.8%). The mean serum hemoglobin creatinine, calcium, and phosphorus levels for hemodialysis patients were 10.42, 8.5, 8.93, and 6.03 mg/dL, respectively, and those for peritoneal dialysis patients were 11.28, 8.52, 9.41 and 5.40 mg/dL. There were no statistical differences between the median age, sexual distribution and mean levels of Hgb, Ca, phosphorus, creatinine, HCV antibody and HbsAg of the hemodialysis patients and those of the peritoneal dialysis patients.
Conclusions: The results of our study show that hemodialysis and peritoneal dialysis are similarly effective treatments.

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 !mso]> ject classid="clsid:38481807-CA0E-42D2-BF39-B33AF135CC4D" id=ieooui> Background: Atherosclerosis and the side effects thereof are a major cause of mortality and morbidity in diabetic patients. Diabetic dyslipidemia is defined by a decrease in blood levels of HDL cholesterol and increases in triglycerides and LDL cholesterol. Diabetic dyslipidemia is atherogenic, inducing cardiovascular disease in diabetic patients at a frequency that is two to three times greater than that of nondiabetics.
Methods: This study analyzes the data from the first phase of the Yazd Healthy Heart Program, a community intervention project focused on the prevention of cardiovascular disease. Using the cluster sampling method, we analyzed data from 2000 subjects from Yazd, Iran, ranging in age from 20 to 74 years. Clinical and paraclinical data were recorded by trained health providers using a questionnaire with over 700 items.
Results: The most frequent lipid disturbance was TG>150 in 67.1% of the type-II diabetic patients (p<0.000), 54.6% of whom were unaware of their TG level. The mean lipid and TG levels are significantly higher (p<0.000). Furthermore, women as a group have higher mean cholesterol, LDL-C and HDL-C levels than men (p<0.000). Additionally, diabetic patients were more obese than the nondiabetic population. (p<0.000).
Conclusion: The high prevalence of diabetes mellitus in Yazd and hypertriglyceride-mia among diabetics in this city, in addition to the lack of awareness among more than half of these patients about their illness and diagnosis, indicate an urgent need to immediately control dyslipidemia in these high-risk patients.

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Background: It is well known that erectile dysfunction is most commonly associated with diabetes, affecting 35% to 75% of men with diabetes mellitus. Several studies have been carried out to find appropriate strategies for treatment of diabetes-induced erectile dysfunction. The aim of the present study was to investigate the ability of acute administration of the endogenous cannabinoid anandamide in vitro to alter the NANC-mediated relaxation of corpus cavernosum from diabetic rats and the possible role of nitric oxide in this manner.

Methods: Diabetes was induced by the administration of streptozotocin for eight weeks. Corpora cavernosa were isolated in organ baths for measurement of agonist-evoked or electrical field stimulation (EFS)-evoked smooth muscle tensions.

Results: The neurogenic relaxation of phenylephrine (7.5 µM) precontracted isolated corporal strips was impaired in diabetic animals. Anandamide (0.3, 1 and 3 µM) enhanced the relaxant responses to EFS in diabetic strips in a dose-dependent manner. This effect was antagonized by either the selective cannabinoid CB1 receptor antagonist AM251 (1 µM) or the selective vanilloid receptor antagonist capsazepine (3 µM). Concurrent administration of partially effective doses of L-arginine (10 µM) and anandamide (0.3 µM) exerted a synergistic improvement in EFS-induced relaxation of diabetic strips (p<0.001). The relaxant responses to the nitric oxide donor sodium nitroprusside of the subjects in the diabetic and control groups were similar.

Conclusion: For the first time, we demonstrated that acute administration of an endogenous cannabinoid, alone or in combination with L-arginine could improve the NO-mediated relaxation of cavernosal smooth muscle in diabetic rats and this effect was mediated by cannabinoid CB1 and vanilloid VR1 receptors within the tissue.
 

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Background: Maternal zinc deficiency during pregnancy has been related to adverse pregnancy outcomes. Most studies in which pregnant women have been supplemented with zinc to examine its effects on the outcome of the pregnancy have been carried out in industrialized countries and the results have been inconclusive. It has been shown that women with gestational diabetes (GDM) have lower serum zinc levels than healthy pregnant women, and higher rates of macrosomia. Zinc is required for normal glucose metabolism, and strengthens the insulin-induced transportation of glucose into cells by its effect on the insulin signaling pathway. The purpose of this study was to assess the serum zinc levels of GDM patients and evaluate the effect of zinc supplementation.
Methods: In the first stage of this prospective controlled study, we enrolled 70 women who were 24-28 weeks pregnant at the Prenatal Care Center of Mirza Kochak Khan Hospital, Tehran, Iran. The serum zinc level of each subject was determined. In the second stage, among these 70 subjects, the diabetics receiving insulin were divided into two groups, only one of which received a zinc supplement and the other group was the control group. Birth weight of neonates and insulin dosages were recorded.
Results: The mean serum zinc level in the GDM group was lower than that of the control group (94.83 vs. 103.49mg/dl, respectively) and the mean birth weight of neonates from the GDM women who received the zinc supplement was lower than that of the control group (3849g vs. 4136g). The rate of macrosomia was lower in the zinc supplemented group (20% vs. 53%). The mean of increase of insulin after receiving the zinc supplement was lower (8.4u vs. 13.53).
Conclusion: Maternal insulin resistance is associated with the accumulation of maternal fat tissue during early stages of pregnancy and greater fetoplacental nutrient availability in later stages, when 70% of fetal growth occurs, resulting in macrosomia. In our study, zinc supplementation is associated with a reduction in the rate of fetal macrosomia among pregnant women with GDM.

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Background: Type I diabetes is an autoimmune disease characterized by T-cell Mediated destruction of pancreatic β-cells. A variety of environmental, genetic and Immunologic factors are involved in the development of the disease. IL₁₈ is a cytokine secreted by macrophage and monocytes and play an important role in the pathogenesis of diabetes Type I through inducing IFN-γ production. It is shown to be strongly associated with the development of diabetes in NOD mice. It is also shown to have increased level in the subclinical stage of diabetes mellitus (type 1). Genetic polymorphisms in the IL-18 gene influence production and secretion of cytokine and are considered as a risk factor in auto-Immune diseases.

Methods: In this case control study, 75 type I diabetic patients and 88 healthy controls studied for polymorphism at positions -137 and -607. DNA extraction from the whole blood was performed according to the standardized method and polymorphism was determines by SSP-PCR. Data were analyzed by SPSS-12 using Chi-Square Test with 95% Confidence interval.

Results: A statistical significant difference in GG genotype (53%) and CC genotype (16%) at the -137 position of IL₁₈ gene was found, as compared to the control subjects (p=0.000) whereas we have not shown any statistical significance at the position -607.

Conclusion: IL₁₈ is a key cytokine secreted by macrophages and monocytes and stimulate the Th₁ lymphocyte. This cytokine can activate cytotoxic T lymphocytes (CTL) and destroy the pancreatic β cell. Our results show that the frequency of GG and CC genotypes at the position -137 may be associated with susceptibility to diabetes.