مجله غدد درون ریز و متابولیسم ایران
سال بیستم شماره 3 (پیاپی 99، امرداد و شهریور 1397)

Lactating mothers and breastfed infants are most vulnerable to iodine deficiency. The aim of this study was to assess the iodine status of lactating mothers and its association with certain demographic characteristics in an area of iodine sufficiency. In this cross-sectional study, 264 lactating mothers, 3–5 days postpartum were randomly selected from health care centers. Breast milk, urine, and salt samples were collected from each mother. Demographic factors including age, education, occupation, date of last pregnancy, parity, gravidity, type of delivery and use of iodine containing supplement during pregnancy were assessed. A total of 254 lactating mothers, aged 28.2±4.9 years completed this study. Median (interquartile range [IQR]) maternal urinary iodine concentration (UIC) and breast milk iodine concentration (BMIC) was 82 (42-146) and 241 (167-337) µg/L, respectively. Significant correlations were observed between maternal UIC and BMIC (r =0.177, P=0.007). In multiple linear regression, maternal UIC value was associated with occupation (P=0.010) and parity (P=0.014); a significant association was observed between BMIC and occupation (P=0.039) and the iodine content of salt (P=0.043). The present findings indicate that despite lactating mothers being mildly iodine deficient, as defined by median UIC, the iodine levels of breast milk were within an optimal range. In an area with iodine sufficiency, parity, occupation and iodine content of salt are major determinants of iodine status among lactating mothers.

The purpose of this study was to investigate the effects of high intensity interval training (HIIT) and moderate intensity continuous training (MICT) on irisin, FGF-21 and insulin resistance in obese male rats. Material and Forty male rats were divided into two groups: high-fat diet (n=32) and standard diet (n=8), for 10 weeks. After inducing obesity, eight rats from the high-fat diet group (O) and eight from the standard dietary group (C) were sacrificed, and the other obese rats were randomly divided into three groups: obesity control (OC), moderate intensity continuous training (MICT) and high intensity interval training (HIIT). The HIIT protocol, including 10 bouts of 4-minute activity with equivalent intensity of 85-90% vo2max and 2 minute active rest periods, and the MICT protocol with equivalent intensity of 65-70% VO2max, with covered distance matched to that of the HIIT protocol, were performed for 12 weeks and 5 sessions per week. Serum samples were collected in two steps (after completion of diet and training protocols) to measure serum levels of irisin, FGF-21, insulin and glucose by ELISA. In the comparison of the HIIT group to the OC group, serum levels of irisin (6.43 ±0.93 ng/ml vs. 4.61±0.61 ng/ml, p=0.003) and FGF-21 (1658±206.5 ng/l vs. 1093±125.97 ng/l, P=0.007) significantly increased, while MICT had no significant effect on these two hormones (P=0.29, P=1.00 respectively). Also, when comparing both the HIIT and MICT groups to the OC group, serum levels of glucose (HIIT: 111.16±4.07 mg/dl, MICT: 117.5±1.37 mg/dl vs. 154.66±13.21 mg/dl, P=0.001, P=0.001 respectively) and insulin resistance index (HIIT: 1.96±0.20, MICT: 2.53±0.46 vs. 3.89±0.54, P=0.001, P=0.01 respectively) significantly decreased; although, serum insulin reduction (1.49±0.15 ng/ml vs. 2.14±0.43 ng/ml, P=0.018) was only significant in the HIIT group (P=0.018). It seems that both HIIT and MICT training protocols lead to improved insulin resistance in obese rats. However the increase in serum irisin and FGF-21 was significant only in the HIIT group, suggesting that exercise intensity plays an important role in regulating the secretion of these hormones.

Self-confidence in adolescents gradually diminishes during puberty due to changes in identity and in their responsibilities. It decreases more in adolescents suffering from chronic disease of diabetes, in whom promotion of self-confidence for self-management behaviors, has a significantly positive effect. The purpose of this study was to investigate the effect of spiritual care on the self-confidence of adolescents with type 1 diabetes. This quasi-experimental clinical trial study was performed on 52 adolescents with type 1diabetes, selected through convenience sampling and randomly assigned in two groups, the intervention and control (n=26 each). The intervention was implemented daily for 6 sessions in the experimental group. Data were collected using the demographic and Rosenberg scale and analysis was done by SPSS-19 software. Descriptive and inferential statistics and repeated measure ANOVA, Mann-Whitney, Fisher, and Chi-square tests were used. The mean scores of self-confidence in the control group before/after the intervention, and also in the follow up period were 0.46, 1.5, and 1.46, respectively. The values in the intervention group were 3.92, 5.69, and 6.38, respectively. Results of analysis of variance showed the significant effects of intervention (p<0.001). The results indicate the effect of spiritual care on the self-confidence of adolescents with type 1 diabetes, emphasizing that nurses, as part of the health care system, must pay attention to spiritual care and its continuity in the care of these patients.

A low level of health literacy is common among patients with Type 2 diabetes, and may be a barrier to self-efficacy and self-care behaviors. The purpose of the current study was to examine the relationship between health literacy, and self-care and self-efficacy in Patients with Type 2 diabetes. A cross- sectional analytical study was conducted in 2017. Participants were type 2 diabetes patients from the rural health clinics in khorramshahr city, of which 121 were selected via random cluster sampling methods. Data collection tools were a health literacy scale (14-items), self-care scale (12 items) and self-efficacy scale (8 items). Data were analyzed using the SPSS software version 22, and by Pearson’s correlation, T-test, ANOVA, and Stepwise Regression analytical statistics. The mean scores of health literacy, self-care and self-efficacy in patients were 2.90±0.53, 3.39±1.31 and 6.77±1.80, respectively. Pearson correlations indicated a positive relationship between health literacy, and both self-care and self-efficacy (P<0.0001 for both). Designing a curriculum for diabetes patients with low health literacy is required, and improving their information and health literacy, through a curriculum and regular training programs in health education centers is recommended.

The growing rate of medical information on the Internet and its effect on community health has necessitated the evaluation and validation of health websites. Therefore, the aim of this study was to evaluate the quality of Persian diabetes websites, based on the WebMedQual scale, as one of the modern and comprehensive health website evaluation methods. The research population comprised of all Persian Diabetes Websites (12 websites) which were retrieved using the keyword diabetes in Persian language, in the search engines of Google, Yahoo and Bing. The WebMedQual checklist, containing 83 questions, was used to collect data. Data were analyzed with descriptive statistics, using SPSS. Regarding the three indexes: information content, design and links, Persian Diabetes Websites obtained about 50% of WebMedQual scores and were generally at a moderate level. They obtained less than average, regarding other scores, including: credit resources, accessibility and usability, privacy and user support. The "Gabric Diabetes Education Association" website, with 75.9% of the necessity scores, achieved the first rank among Persian diabetes websites. It is recommended that the producers and designers of Persian diabetes websites consider the strength and weaknesses of websites for improving their quality. Health custodians could contribute to community health by introducing reputable websites to the users.