Iranian Journal of Diabetes and Obesity
Volume:6 Issue: 2, Summer 2014

Vitamin D deficiency is a common disorder worldwide and is indicated by low serum 25-hydroxyvitamin D levels. Recent studies have suggested an association of 25-hydroxyvitamin D deficiency with diabetes mellitus. The objective of this study is to investigate the relationship between 25-hydroxyvitamin D concentration and type 2 diabetes in South Indian patients. In a cross sectional study, we recruited 150 patients with type 2 diabetes and 150 age and sex matched controls, Yashoda hospital, Hyderabad, India, from December 2011 to November 2013. All cases and controls were evaluated for fasting serum glucose, fasting insulin, serum cholesterol, calcium, phosphorus, alkaline phosphatase, C-reactive protein (CRP), glycosylated hemoglobin (HbA1c) and 25-hydroxyvitamin D levels. In both 150 cases and 150 controls, mean age was 51.5 years and 70% participants were men. Deficiency of 25-hydroxyvitamin D (42.6%) (P<0.0001) and CRP positivity (48%) (P<0.0001) were significantly more common and mean alkaline phosphatase (143±3.4) (P<0.0001), mean HbA1c (8.3±1.8) (P<0.0001) and mean HOMA IR (3.80 +1.45) (P<0.0001) were higher in cases compared to controls. In type 2 diabetes, 25-hydroxyvitamin D deficiency was significantly associated with elevated longer mean duration of diabetes 15.1±4.3 years (P<0.0001), positive CRP (0.02), increased HOMA –IR (<0.0001), neuropathy 19 (29.6%) (P=0.03), and retinopathy 11(15.6%) (P=0.04).After adjustment using multiple logistic regression analysis, deficiency of 25-hydroxyvitamin D was independently associated with type 2 diabetes (odds: 2.8; 95% CI: 1.80 - 8.09). Our study showed a 42.6% prevalence of 25- hydroxyvitamin D deficiency in type 2 diabetes and was independently associated with type 2 diabetes in Indian adults.

International Diabetes Organization estimates that there are 285 million people worldwide who suffer from diabetes, and this figure is expected to increase to 450 million in next 20 years. According to statistics issued by the World Health Organization, diabetes is considered among ten leading causes ofdeath in world and its prevalence in the population is growing.This paper deals with designing and building an Expert System for Diabetes Mellitus diagnosis. We randomly select 78 knowingly volunteered patients as non-intervention from approximately 17 families in Tovhid town in Sabzevar city to test system hardware. The output of these information and ADA database was used to test the performance of software part of the proposed system. In this system, at first citizen information through a wireless sensor network (WSN) is received and these data is transmitted to the central data processing system (CDPS). In the CDPS, intelligent software uses SVM technique based on 8 features to classify data and warns diabetes person due statistical changes. Acceptable level of accuracy of the proposed system with 95.02%±1.245%, sensitivity 98.30±0.85% and specificity of 97.52±1.06% and Kappa coefficient equal to 0.95 is optimal performance. Accuracy and high speed in data classification make the exact output of the software which is available online information so specialist will be able to alert suspect patients or identity diabetes patients without referring them to therapeutic centers.

There are some studies about the good effects of herbal medicine on blood glucose. This study was designed to evaluate the synergism effect of Peganum Harmala (P.harmala), Quercus Infectoria (Q.i), Vaccinium Myrtillus (V.myrtillus), Citrullos Colocynthis (C.colocynthis), Securigera Securidaca (S.s) on blood glucosein type 2 diabetic patients. Twenty four type 2 diabetic patients were enrolled in this cross over double- blinded clinical trial for receiving two months herbal medication and placebo. The subjects divided into two groups randomly. One group received herbal medication (the doses of 25mg/person of V.myrtillus, S.s and Mazoj and 62.5mg C.colocynthis, P.harmala) and the other group received placebo for 8 weeks. After washout period the herbal medication and placebo were replaced for the next 8 weeks. T-test and Chi-square were used for the comparison of variables between two groups. After two months, mean fasting blood glucose was 135±27.1 and 139±36.8 mg/dl, (P-value=0.64), and mean glycosylated hemoglobin was 6.5±0.75 and 6.6±0.97 percent, with herbal medication and placebo, respectively (P-value=0.51). About 15.4%of patients after herbal medication and 15.4 % after placebo consumption had 0.8% reduction in HbA1C (P-value=1/0). The mean HOMA IR index, after two months intervention with herbal medication or placebo, was 2.9±1.95 and 3.9±1.97, respectively (P-value=0.05). low dose combination of P.harmala, Q.i, V.myrtillus, C.colocynthis, S.s may improve the insulin sensitivity and we did not find significant effect on blood glucose with low dose of this combination.

Diabetes is one of the most common metabolic diseases. Earlier diagnosis of diabetes and treatment of hyperglycemia and related metabolic abnormalities is of vital importance. Diagnosis of diabetes via proper interpretation of the diabetes data is an important classification problem. Classification systems help the clinicians to predict the risk factors that cause the diabetes or predict people who are at risk of developing diabetes. In this study, Pima Indian diabetes dataset taken from the UCI machine learning repository was used which contains 786 samples of normal and diabetes with 8characteristics.Selection of efficient features of this dataset was analyzed using correlation criterion, information gain and CfsSubsetEval. Then diagnosis of diabetes diseases on Pima dataset was considered using proposed by-level dimensionality reduction method and classification algorithms. Classification algorithms used in this study are KNN, quadratic, Naïve Bayes, nearest mean classifier, non-parametric Gaussian and Mahalonobis kernel and linear discriminant. In all feature selection methods, plasma glucose concentration a 2-hours in an oral glucose tolerance test, body mass index and age have been selected as the top-ranked features in intelligent diagnosis of diabetes. Proposed method has achieved the accuracy of 82.09 using KNN and quadratic methods and bi-level dimensionality reduction on Pima dataset. The best performance has been achieved by performing PCA algorithm on the features, namely, number of pregnancy, plasma glucose concentration a 2 hours in an oral glucose tolerance test, body mass index, diabetes pedigree function and Age. The results of this study showed that bi-level dimensionality reduction and classification algorithm scan be very helpful in assisting the physicians to diagnosis diabetes.

Lack of exercise is the fourth cause of death in the world. There is an inverse relationship between physical activity and the risk of diabetes. The aim of this study was to determine physical activity status and its related factors among type 2 diabetic patients in Hamadan, west of Iran. This analytical-observational study was performed on320 type 2 diabetic patients recruited with a convenient sampling method. The participants completed a selfadministered checklist including demographic characteristics, International Physical Activity Questionnaire (IPAQ) and psychological factor such as Knowledge, attitudes and self-efficacy. Data analysis was done with the SPSS software (version 16), using, one way ANOVA, chi-square tests and Fisher's exact test. Physical activity of most patients (57.5%) was moderate. The associations between physical activity and age, education, occupation and marital status were significant (P<0.05). One way ANOVA indicated that attitude and self-efficacy were significantly associated with physical activity. The demographic and psychological variables relationship with physical activity is important. These findings can be used as an introduction to design effective intervention to promote physical activity.

Diabetes Mellitus is one of the most common metabolic disorders which have several oral complications such as hypofunction of salivary glands. The aim of present study was to compare the unstimulated whole saliva (UWS) flow rate in diabetic type II patients and healthy peoples who admitted in Yazd Diabetic center. In this analytic-observational study, 78 patients with diabetic type II and 74 healthy people were selected. At first the xerostomia was checked and then the UWS flow rate was measured by spitting method. Data were analyzed by ANOVA, Chi-square and Multiple way variance tests using SPSS software version 11. the participants were between 30-69 years old including 103 female (diabetic (53), healthy (50)) and 49 male (diabetic (25), healthy (24)) were selected. The mean of UWS flow rate in diabetic patients was (0.07±0.03 ml/min) which was statistically less than healthy people (0.13±0.036 ml/min) (P< 0.002).The mean of UWS flow rate in relation to age was significantly different and adverse relationship between UWS flow rate and FBS was found in diabetic type 2 patients (P<0.000, r=-0.389). Also diabetic patients complain about xerstomia more than healthy people significantly (83% versus 28.4%, P< 0.001). The complaint of xerstomia and decrease of UWS flow rate was more common in diabetic patients than healthy people; also good FBS control can prevent xerostomia.

Adipocyte and skeletal muscle are important tissues which contribute the development and progression of metabolic disorder. Insulin has a major regulatory function on glucose metabolism in these tissues by redistributing glucose transporter (GLUT4) from intracellular vesicles to the cell surface. Today, due to the side effects of chemical medications attendance to herbal medicines is growing. In this study, the effect of Curcumin extract as main polyphenols in Turmeric on gene expression of GLUT4 was evaluated. Curcumin was extracted using alcohol and chloroform from turmeric powder.TLC chromatography was used to confirm purity of Curcumin extracted. Mouse C2C12 myoblasts were grown in Dulbecco’s Modified Eagle Medium (DMEM 1.5 g/l glucose) supplemented with 10% fetal bovine serum, 50 U/ml penicillin, and 50 μg/ml streptomycin. After differentiating of C2C12 cells during 4 days to myotubes, cells were treated separately in the presence of insulin (100 nM), Curcumin (25 μM) and co-treatment for 24h.RNA extraction from C2C12 cells was performed and GLUT4 expression levels were examined by semi-quantitative RT-PCR. The results showed a significant increase in the GLUT4expression in Curcumin treatment group, in compare with negative control but less than insulin as a positive control. The synergistic effect of Curcumin and insulin was lower in comparison with insulin as a positive control. Curcumin could increase the gene expression but synergistic effects of Curcumin and insulin is more powerful than Insulin which can be due to the competitive action of insulin and Curcumin in activation of gene expression pathway.