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Background: Peripheral neuropathy is a common complication associated with diabetes mellitus. It has been shown that oxidative stress is an important etiological factor in neuropathy which contributes to its development however, the exact pathophysiology underlying this complication is not fully understood. This study was designed to examine the effect of regular exercise and vitamin C administration on pain threshold in rats. Materials and Methods: In this experimental study, 36 male Wistar rats (220±10 g) were allocated to control and diabetic (control, vitamin C, exercise, and exercise+ vitamin C) groups. Diabetes was induced by the subcutaneous administration of streptozotocin (60 mg/kg). A week after the induction of diabetes, the rats were subjected to swimming training and vitamin C treatment for 8 weeks. At the end of weeks 3, 5, and 8, Tail-Flick test was done on the rats to assess pain threshold. Data were analyzed using SPSS software. Results: Diabetes significantly decreased pain threshold in the rats. Diabetes-induced hyperalgesia was significantly decreased by training and vitamin C. Concurrent effects of training and vitamin C on thermal pain threshold were significantly higher than each of them alone. Conclusion: Regular exercise together with vitamin C administration can be a proper method for preventing thermal hyperalgesia associated with diabetes. Therefore, they can be effective in the treatment and management of pain

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Background: Age-related macular degeneration is the most common cause of irreversible central visual loss in individuals over 50 years old. The aim of this study was to assess visual loss due to age-related macular degeneration and some of its associated risk factors. Materials and Methods: This case-control study was conducted on 150 patients with age-related macular degeneration and 150 controls, both aged over 50. A questionnaire on demographic and medical information was completed for each participant and an ophthalmological examination was performed. The results were recorded andthe data were analyzed using SPSS software version 16. Results: Mean age of the subjects in the case and control groups was 78.38 and 79.28 years, respectively.In a multivariable model, hypertension(p=0.003), diabetes(p=0.006), light iris color(p=0.05), hypercholesterolemia (p=0.036), lens opacity (p=0.029), and previous cataract surgery(p=0.029) were significantly associated with age-related macular degeneration. There was not a significant relationship between body mass index (p=0.11) and refractory errors (p=0.94) andage-related macular degeneration. Conclusion: Age-related macular degeneration is associated with hypertension, diabetes, hypercholesterolemia, light iris color, lens opacity, and previous cataract surgery.

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Background: Diabetes mellitus is one of the most important health problems in the world. B-cells are susceptible to damage by free radicals. Noticing the mechanism of cupping, this study was carried out to evaluate the effect of cupping together with drug therapy on biochemical factors and oxidative stress. Materials and Methods: In this clinical trial, 5ml of intravenous blood was obtained from diabetic patients in beginning and late stages of this disease who referred to a diabetes center. In addition to receiving metformin and glibenclamide, the patients underwent cupping after one month and were analyzed one month later. Blood samples obtained one month before and after the treatment were compared in terms of diabetes and oxidative stress indicators. To evaluate lipid peroxidation, TBA method was used and FRAPS method was employed to measure total serum antioxidants and blood factors by Pars Azmon kit. Results: Hemoglobin A1C, fasting blood sugar, blood sugar 2 hours after fasting, triglycerides, cholesterol, and low-density lipoprotein as well as high-density lipoprotein showed significant increases. Aspartate transferase in diabetic patients significantly decreased after phlebotomy (p<0.05). Conclusion: Cupping improves blood factors in diabetic patients and it is recommended to be used as a complementary treatment in patients with diabetes type II.

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Background: Food insecurity is defined as the limited or uncertain availability of enough food for an always active and healthy life. Diabetes mellitus, one of the most common metabolic diseases, has been associated with significant morbidity and mortality and it is considered a health priority in Iran. Recent studies indicate the widespread prevalence of food insecurity and diabetes mellitus in Iranian society. This study reviews the status of food insecurity and effective socio-economic factors in people with type 2 diabetes.

Materials and Methods: This cross-sectional study was performed on 135 patients, aged between 30 and 55, who had recently been diagnosed with type 2 diabetes. Demographic and socioeconomic characteristics and food insecurity status were assessed using demographic and the 18-item USDA household food security questionnaires, respectively. Physical activity also was evaluated by MET, physical activity questionnaire. Data were analyzed by Chi-square, t-test, and logistic regression.

Results: Prevalence of food insecurity was 66.7%. Food insecurity was significantly associated with economic status, education level, income, having child under 18 years of age, family size, and number of children (p<0.05) however, there was not a significant relationship between food insecurity and occupation, marital status, family history of diabetes, high blood pressure and heart disease, age, and the amount of physical activity.

Conclusion: Considering the higher prevalence of food insecurity in diabetic patients, it can be said that it is likely that the incidence of diabetes is higher in food insecure people.

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Background: Increased insulin resistance, inflammatory factors and parameters of oxidative stress are associated with the development of diabetes complications. This study was designed to determine the beneficial effects of synbiotic Gaz on insulin resistance, inflammatory factor and oxidative stress in patients with type 2 diabetes.

Materials and Methods: This randomized crossover double-blinded controlled clinical trial was performed among 62 diabetic patients aged 35-70 y. Subjects were randomly assigned to consume of either the synbiotic (n=62) or control Gaz (n=62) for 6 weeks. A 3-week washout period considered. The synbiotic Gaz was consisted of a probiotic viable and heat-resistance strain Lactobacillus sporogenes (1×107 CFU), 0.04 g inulin and 0.05 g stevia per 1 g as sweeteners' substances. Control Gaz (the same substance without probiotic bacteria and prebiotic inulin) was. Patients were received synbiotic and control foods in a 7 g package thrice a day. Fasting blood samples were taken at baseline and after 6-week intervention to measure insulin resistance, hs-CRP and biomarkers of oxidative stress.

Results: Consumption of synbiotic Gaz, compared with control, resulted in a significant decrease in serum insulin (p=0.02) and hs-CRP levels (p=0.008). Supplementation with synbiotic Gaz led also to a significant increase in plasma total glutathione (p<0.0001) compared to the control.

Conclusion: In conclusion, consumption of synbiotic Gaz for 6 weeks resulted in decreased levels of serum insulin, hs-CRP and increased levels of plasma total glutathione.

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Background: Considering the high prevalence of diabetes and developing cardiovascular diseases via dyslipidemia and inflammation in type 2 diabetic patients, the aim of the present study was to investigate the effects of Oligofructose-enriched inulin on serum lipid concentrations and inflammation in type2 diabetic patients.

Materials and Methods: In this clinical trial, 52 patients with type 2 diabetes were assigned to one of two groups. Experimental group (n=27) received 10g/d oligofructose-enriched inulin and control group (n=25) received 10 g/d maltodextrin for 8 weeks. Dietary intakes, anthropometric measurements, hs-CRP and serum lipids concentrations were measured at the baseline and at the end of the study. Data were analyzed using SPSS software (verision11.5). Paired, independent t-test and ANCOVA were used to compare comparison of quantitative variables.

Results: At the end of study, we observed significant decrease in total cholesterol (28.00 mg/dL, 14.10%), LDL-c (22.00 mg/dL, 21.7%), TC/HDL-c ratio (-0.73, 20.7%) and LDL-c/HDL-c ratio (-0.55, 27.5%) in oligofructose-enriched inulin compared with the maltodextrin group (p<0.05). Changes in concentrations of triglycerides and high-density lipoprotein were not significant in oligofructose-enriched inulin compared to maltodextrin group.

Conclusion: Oligofructose-enriched inulin supplementation with improving in inflammtion and lipid profile help in management of type 2 diabetes and its complications.

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Background: Considering that pre-diabetes is one of disorders that increases developing of diabetes, this study was performed to investigate the effect of L-Arginine supplementation on antioxidant enzyme activity, total antioxidant capacity, and body composition in patients with pre-diabetes.

Materials and Methods: A double-blinded randomized clinical trial was performed on 46 pre-diabetic patients. Patients in intervention (n=23) and  placebo groups received  3g/day L-arginine and placebo (three 1gr L-arginine capsules), respectively for 8 weeks. Anthropometric, body composition, and dietary intake assessments, and also biochemical tests were done at baseline and end of study. Total Antioxidant Capacity (TAC), glutathione peroxidase enzyme and superoxide dismutase activity were measured. Paired t-test, independent t-test and ANOVA were used to analyze quantitative variables.

Results: Thirty eight patients (19 subjects in each group) completed the study. After adjusting confounding factors, no significant difference in body composition, anthropometric indices and dietary intake was observed at the end of study (p<0.05 in all factors), but a significant difference in TAC level was observed in the intervention group at the end of study (p<0.001).

Conclusion: Supplemenation with 3gr/day L-arginine for 8 weeks led to raised serum TAC level without changes in body composition in pre-diabetic patients.

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Background: Wolfram syndrome is a rare neurodegenerative autosomal recessive disorder. That occurs in association with diabetes mellitus, diabetes insipidus, and optic nerve atrophy, hearing loss, urinary tract infection and nervous complication.

Case: The present report belong to a 24 years old girl who was effected by diabetes mellitus in 10 years old & has been effected by Diabetes insipidus, recurrent UTI, hearing loss and other type of disorders in 20 years old.

Conclusion: Strict control of blood glucose and regular fundoscopy, for early detection of optic atrophy are important. Step in management of this syndrome and quality of life is improved with hearing and vision aid tools.

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Background: Derived hormones from Adipokines include leptin, adiponectin, resistin, apelin, omentin.The aim of present study was to investigate the effect of 12 weeks aerobic exercise on plasma levels of Apelin, Omentin and glucose in obese older women with diabetes type 2.

Materials and Methods: In this study, 30 obese older women were chosen. They were also divided in to two groups: control (n=15 Age: 53.3+5.88 BMI: 28.7+2.2) and experimental (n=15 Age: 52.6+ 7.12: BMI: 30.03+3.6) according to their fat percentage and BMI. The training program included aerobic exercises which were conducted increasingly, 3 times a week for 12 weeks. Blood samples were taken before starting the exercise training and also 24 hours after the last training session. U Mann-Whitney Test was used to evaluate the data and in order to compare each group's pretest and posttest, Wilcoxon test was used at the significance level of p&le 0.05.

Results: There were significant changes in apelin and glucose plasma levels in the training group (p=0.001 and p=0.006 respectively). Furthermore, no significant difference was observed between each group's omentin levels.

Conclusion: It was finally concluded that exercise training can facilitate the process of glucose entrance into a cell because of the continuous muscle contractions and also decrease the plasma glucose. Also each adipokine response might be depend on the intensity and duration of exercise training, separately.

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Background: Considering to the frequency of occurrence of hypoglycemia in diabetes, alternative substrates for glucose play an important role in maintaining brain metabolism. The aim of the present study was to investigate the long-term effects of endurance training on brain lactate uptake during hypoglycemia in type 1 diabetic rats.

Materials and Methods: In this experimental study, seventy-two male Wistar rats were equally divided into four groups: Control, Trained, Diabetic control and Diabetic trained. Diabetes was induced by intraperitoneally injection of streptozotocin. After 8 weeks of endurance training, Hypoglycemia was induced by an intraperitoneally injection of insulin. One-half hours after hypoglycemia, lactate (4 mmol/kg) was injected intraperitoneally into animals. Animals were killed at intervals of 10, 20, and 30 min after injection, plasma and brain concentration of lactate and glucose were measured.

Results: A significant difference was found for plasma lactate concentration at intervals 20 (p<0.05) and 30 (p<0.05) between healthy groups and also between diabetic groups (p<0.05). Thirty minutes after injection, significant increase in brain lactate concentration was found between control and trained (p<0.05) and control diabetic and diabetic trained (p<0.05). Brain/plasma ratio of lactate had a similar pattern with brain lactate concentration. Increase in brain lactate concentration had no effect on decreased level of brain glucose concentration.

Conclusion: Endurance training can increase the brain lactate uptake of diabetic rats during hypoglycemia.

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Background: This study aimed to compare the efficacy and safety of insulin versus oral hypoglycemic drugs for gestational diabetes treatment, using evidence based medicine approach.

Materials and Methods: This secondary study was conducted by selecting a comprehensive systematic review through searching the Cochrane library. To calculate the number needed to treat (NNT), outcomes such as cesarean section, macrosomia, birth weight more than 90th percentile, operative vaginal delivery, labor induction, post partum hemorrhage, and shoulder dystocia has been considered while neonatal hypoglycemia, NICU hospitalization and fetal distress were considered for calculating number needed to harm (NNH). To calculate the likelihood of helped versus harmed (LHH), macrosomia and hypoglysmia were selected. Data were analyzed with Wilson score test.

Results: The NNT for above outcomes were 3, -14, -5, 16, -3, 31, and 32, respectively. Among them cesarean section was significance. Calculated NNH for side effects were 6, 15, and -17 which only was significance for neonatal hypoglycemia (p<0.05). The LHH was estimated -0.43.

Conclusion: Considering LHH, it seems that the benefit of insulin in management of gestational diabetes is more than metformin. But with respect to issues such as low sample size of trials, lack of assessment the maternal hypoglysemia as complication of insulin therapy, the findings should be considered cautiously.

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Background: It is expected that affected people with diabetes will increase to 439 million in 2030, 15% of them are affected with chronic leg ulcer disease. Increasing number of researches implicate the positive influence of pentoxifylline (PTX) on the skin wound healing. Pentoxifylline is a xantin derivative that modifies or inhibits inflammatory factors, reduces blood viscosity, improves peripheral blood currency and increases oxygenation of tissues the In this study the effect of Pentoxifylline (PTX) on skin biomechanical indices in acute phase of skin wound healing in diabetic rat is in considerable interest.

Materials and Methods: It is an experimental- interventional study in which fourteen adult male wistar rats were divided into experimental group (n=7), receiving pentoxifyllineintraperitoneally and control group (n=7) receiving distilled water (DW). Diabeteswas induced by intraperitoneal administration of streptozotocin in both groups then full thickness incisional wound (20mm length) in identical pattern was made on the dorsum of rats. After 15 days a band of skin (4×60mm) containing wound was extracted and used to evaluate skin biomechanical indexes (work up to maximum force-Nm and Tensile strength= Rm-N/mm2). Results were analysed by SPSS software version 19 and K-S, Levens Test and Student SampleT-Test were used.

Results: Pentoxifylline administration improved skin biomechanical indices after 15 days after skin incisional wound. Differences between experimental and control’s indices were significant (p<0.05).

Conclusion: Pentoxifylline accelerated wound healing and improved tensile strength of skin in diabetic rats of experimental group.

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Background: Diabetes mellitus is a common metabolic disorder that is associated with many complications such as peripheral neuropathies. This study was designed to investigate the effect of Brassica juncea on peripheral neuropathic pain in diabetic rat.

Materials and Methods: In this experimental study, male Wistar rats (250±20 g) were divided randomly to normal and diabetic (control, B. juncea extract at doses 150 and 300 mg/kg) groups. Experimental diabetes was induced by the intraperitoneal injection of streptozotocin (60 mg/kg). After four weeks treatment, animals were subjected to Tail-flick test to evaluate pain threshold and data were analyzed using SPSS software. Statistical significance was considered at p<0.05.

Results: The results of this study showed that diabetes significantly decreased pain threshold in the rats. Also diabetes-induced hyperalgesia was significantly decreased by treatment with extracts of B. juncea at doses 150 and 300 mg/kg (p<0.05 and p<0.01, respectively).

Conclusion: Our observation indicates that B. juncea could be a therapeutic option for control and treatment of hyperalgesia associated with diabetic neuropathy in diabetic patients. However, further studies are required to elucidate the antinociceptive effects of B. juncea.

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Background: Gestational diabetes mellitus (GDM) is defined as glucose intolerance with first dignosis during pregnancy. There is some evidence indicating that chemerin play a role in the development of GDM. In this study, for the first time, a possible association of rs17173608 polymorphism in the chemerin gene with the risk of GDM in Arak population was investigated.

Materials and Methods: In this case-control study, 120 GDM and 150 pregnant women with normal glucose tolerance were selected. GDM was confirmed by oral glucose tolerance according to the new IADPSG criteria. Genomic DNA was extracted from EDTA treated whole blood. The polymorphism of chemerin gene was determined using tetra-amplification refractory mutation system-polymerase chain reaction (T-ARMS-PCR).

Results: The genotype frequencies of  TT, GT and GG at rs17173608 were respectively 81.7%, 17.5% and 0.8% in the GDM group and 73.3%, 25.3% and 1.3% in the control group. There were no statistical differences in genotype frequencies between case group and the control group. Also, allele frequencies in the GDM group  (T 90.4% , G 9.6%), did not differ significantly from the control group ( T 96% ,G 14%). No association was found between genotype frequencies and FBS, 1h, 2 h and BMI.

Conclusion: The present study show that the rs17173608 polymorphism in the chemerin gene is not associated with the development of glucose intolerance and GDM in the studied population.

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  Background: The physiological role of apelin, an adipokine secreted by adipose tissue , in insulin resistance and type 2 diabetes has been identified . The aim of this study was to determine t he correlation of plasma level s of apelin-13 with insulin resistance index (HOMA-IR) and plasma leptin of diabetic male rats after 8-week aerobic exercise .

  Materials and Methods: Peresent study was an experimental study with animal model. Twenty eight diabetic male Wistar rats were divided into 3 groups: Non-diabetic (n=9), control diabetic (n=9) and trained diabetic (n=10). Type 2 diabetes was induced by intraperitoneal injection of nicotinamide and streptozotocin. The trained diabetic rat ran 8-week on treadmill progressively. After the training period, plasma levels of glucose, insulin, leptin and apelin-13 were measured and HOMA-IR was calculated. One-way analysis of variance (ANOVA) and Pearson’s correlation were used for analyzing data. p<0.05 was considered to be statistically significant.

  Results: A significant decrease in plasma levels of glucose, insulin and leptin and HOMA-IR in trained diabetic vs control diabetic rats, a significant increase in plasma levels of apelin in trained diabetic vs non-diabetic and control diabetic rats and a significant negative correlation of plasma levels of apelin with HOMA-IR and plasma leptin in trained diabetic rats was observed.

  Conclusion: In present study, 8-week aerobic training by improvement of insulin sensitivity (decrease of HOMA-IR and plasma leptin) increased plasma levels of apelin-13 in diabetic male rats.

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Background: Metabolic syndrome, a concurrence of overweight and abdominal fat distribution, disturbed glucose and insulin metabolism, mild dyslipidemia and hypertension is among the most important issues that man deals with, in today's world. Probiotics are live microorganisms which, when administered in adequate amounts, can confer a health benefit on the host. The aim of the present study was to review the clinical evidence available regarding the role of probiotics in improvement of disorders associated with metabolic syndrome.

Materials and Methods: In this research, clinical trials performed between 2000-2014 were searched in two databases, Pubmed and ScienceDirect. In both databases “Probiotics”, “metabolic syndrome” and each of its elements were used as the key words.

Results: Probiotics may reduce body weight through manipulating the gut flora. Through reducing inflammation and immune-regulation, probiotics decrease insulin resistance. They also improve lipid profile through reducing cholesterol absorption and producing short chain fatty acids, as well as deconjugating bile acids and converting cholesterol to coprostanol. Moreover, probiotics have been suggested to have a hypotensive effect through release of angiotensin-converting enzyme inhibitory peptides, through proteolytic action. 

Conclusion: Although some clinical trials have failed to obtain beneficial effects of probiotics on metabolic syndrome related situations, a majority of the studies have shown positive results for these microorganisms in this regard. Thus, probiotics can be looked upon as a novel approach when either prevention or alleviation of metabolic syndrome is aimed.

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Background: Irisin, a recently identified myokine that seems had important role in hemostasis regulatation and improving insulin resistance. The effect of exercise training on serum irisin levels in type 2 diabates (T2D) is controversial. This study aims to investigate the effect of 6 weeks selective aerobic training on serum irisn levels and insulin resistance in women with T2D.

Materials and Methods: This research is a semi experimental study with pre-and post-test design. Research subjects were 20 women with T2D (mean age 47.4±5.6 years and BMI 29.92±3.42). Subjects were randomly divided into 2 groups: exercise group (n=12) and control group (n=8). Training protocol performed in 6 weeks (4 times a weeks, 40-65 min per session) and main training intencity and time were increased per week (50%-80% Hrmax). Main aerobic training was performed in 6 blocks, each block consisted of 32. Blood sample was collected before the and after end of training protocol.

Results: The results showed significant decrease in blood glucose, insulin and insulin resistance index and significant increase in serum irisin levels in exercise group compared with the control group (p≤0.05), but there is no significant correlation between serum irisin levels and insulin resistance.

Conclusion: It seems that aerobic training can have considerable impact on serum irisin levels, fasting blood glucos and insulin resistance index in women with T2D.

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Background: Diabetes is one of the most common disease resulted from metabolism disorders. Thus, Studying medication adherence in patients to explain educational interventions to improve the health of these patients is necessary. Therefore, the present study aimed to assess the factors affecting medication adherence in diabetics patients based on health belief model in Arak 2014.

Materials and Methods: In this analytical study, 366 diabetic patients in Arak in 2014 were selected and data were collected through a researcher made questionnaire about patients behavior in the field of medication adherence and its influencing factors based on the health belief model. Linear regression model was used to determine the predictive power of structures.

Results: The mean knowledge score and the medication adherence was 31.34 and 84.34, respectively. In this study, perceived susceptibility, perceived barriers and internal action guide were as the strongest predictors of medication adherence behavior in patients and predicted their behavior variance 0.36. Between function and susceptibility and severity and perceived benefits and self- efficacy of manual internal and external action guides in the field of medication adherence with diabetes, there was a direct correlation that the highest correlation was related to the perceived susceptibility structure (r=0.42 , p<0.001).

Conclusion: The results showed that the educational interventions with an emphasis on building the perceived sensitivity of patients with diabetes for medication adherence and emphasis on internal incentives as motivators and incentives for patients to achieve better results in the field of medication adherence should be at the heart of educational interventions.

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Background: Irisin is an exercise-induced myokine that is reduced with type 2 diabetes and improves insulin resistance via the browning of white adipose tissues. However, irisin response to two types of exercise in patients with type 2 diabetes is unknown.

Materials and Methods: In this study, 22 diabetic Wistar rats (Induced by high-fat diet and injections Stz) were randomly assigned to 3 groups: high intensity interval exercise (HIIT), low intensity continuous training (LICT) and control (C). Both HIIT and LICT groups trained on the treadmill 5 sessions per week for 8 weeks. Blood samples were taken 24 hours after the last training session and plasma irisin, insulin and glucose levels were measured. ANOVA and Tukey post hoc tests were used to analyze data and the level of significance has been considered at p≤0.05.

Results: Data analysis showed that plasma irisin levels in the HIIT group were significantly increased compared to the control group (p<0.05). However, there was no significant difference between other groups (p>0.05). Plasma glucose in both HIIT and LICT groups was significantly decreased compared to the control group (p<0.05). But plasma insulin levels and insulin resistance index were not different between groups (p>0.05).

Conclusion: The results of this study showed that exercise training can increase plasma irisin in rats with type 2 diabetes. However, these changes are partially dependent on the type of exercise training.

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Background: Known inflammatory factors in type II diabetes and complications are delaying adjustment this factor, it is an effective approach in preventing complications.The aim of this study was to evaluate the effect of eight weeks aerobic interval training on interleukin-6 and interleukin-10 serum levels, in women with type II diabetes.

Materials and Methods: In this study, 18 patients with type II diabetes in Ahvaz city, were randomly divided into the two experimental group (n=10) and control group (n=8). The experimental group did the aerobic interval training and pedaling on the ergometer bicycle with 65 to 80 percent of their maximum leg power for three times a week during the eight weeks. The blood samples were prepared in two pre-test and post-test steps to measure the interleukin-6  and interleukin-10 serum levels through ELISA method.

Results: Statistical analysis showed that after eight weeks of aerobic interval training, interleukin-6 and interleukin-10 serum levels, related to the experimental group had no significant difference in comparison with control group (p>0.05).

Conclusion: The results indicate that doing the aerobic interval training for three times a week during eight weeks with 65 to 80 percent of maximum leg power, it has no effect on inflammatory and anti-inflammatory indices, in women with type II diabetes.