سیما هاشمی پور

self-care is one of the best and most cost-effective measures to deal with diabetes, which has attracted a lot of attention today. The aim of the current study was psychometric self-care tools for diabetic patients in Qazvin medical centers in Iran.

The present study was of methodological type. The statistical population was all the patients in the medical centers of Qazvin city. The sample size was determined to be 256 people. After collecting the data, it was subjected to exploratory factor analysis with the principal component analysis (PCA) method. SPSS software was used for data analysis. Also, Kaiser-Meier and Bartlett's test was used to measure the adequacy of the sample and the significance of the results.

The average age of the participants in the study was 59.12±11.14 and the average years of diabetes was 10.76±7.55. The results of exploratory factor analysis showed that self-care of diabetic people was observed in four factors. The first factor was healthy eating, the second factor was physical activity, the third factor was blood sugar monitoring, and the fourth factor was checking the health of the feet. The results showed that four explanatory factors of self-care can explain 95.22% of the variance of self-care in diabetic patients.

The psychometric analysis of the diabetes self-care Scale in the Iranian population showed that the self-care Scale (DSCS-I) had very good validity and reliability. Therefore, it is necessary to use this Scale to check the self-care status of diabetic patients.

Pathophysiological changes in the mouth of patients with diabetes mellitus (DM) predispose to overgrowth of Candida albicans. Various virulence factors such as proteinase and phospholipase production are involved in the process of degradation of the host cell membrane. These enzymes are involved in binding Candida species, especially in the hyphae stage, to the target tissue. In this study, the proteinase and phospholipase activity of 51 C. albicans strains was evaluated. Overall, the rates of proteolytic and phospholipase activities in controlled and uncontrolled diabetic patients were 90.2% and 72.5%, respectively. No significant difference was observed between proteinase and phospholipase activities in both groups of patients (P>0.05), while there was a significant difference between the activity of hydrolytic enzymes with HbA1C and dentures in the uncontrolled diabetic group (P<0.05). According to the importance of hydrolytic enzymes activity of C. albicans species in diabetic patients, oral health of diabetic patients to control and prevent disease progression in these patients is essential.

The beneficial effects of polyphenols to improve glycemic status in patients with type 2 diabetes have been reported in scientific studies. The aim of this study was to investigate the effect of oral ellagic acid (EA) supplement on glycemic index and insulin resistance in type 2 diabetic patients.

In this double blind randomized clinical trial, 44 diabetic patients were selected, and were randomly assigned to the intervention group (22 subjects) and placebo (22 subjects) and received a capsule containing 180 mg of EA per day or placebo for 8 weeks, respectively. At the beginning and end of the study, demographic information, anthropometric indices, food intake and physical activity, biochemical factors of fasting and two-hour blood sugar, plasma insulin level, glycosylated hemoglobin percentage (HbA1c) and insulin resistance (IR) were measured.

At the beginning and end of the study, there was no significant difference between the two groups in terms of anthropometric indices, food intake and physical activity (P>0.05). At the end of the study, receiving EA in the intervention group significantly reduced fasting and two-hour blood sugar means, plasma insulin levels, HbA1c percentage, and IR levels compared with placebo group (P<0.05).

EA supplementation can be helpful as a dietary antioxidant supplement in patients with type 2 diabetes by improving chronic side effects. This may be due to the antioxidant power of this polyphenol.

 Despite the widespread obesity epidemic in the world, not all obese people are equally susceptible to the complications of obesity. Inflammatory factors play an important role in the complications of obesity.

 This study aims to evaluate the association of White Blood Cell (WBC) count with metabolic syndrome in overweight/obese men and women.

 This cross-sectional study is a part of the Qazvin Metabolic Disease Study (QMDS) conducted in 2010 in Qazvin, Iran. Participants were 622 obese people with a body mass index (BMI) ≥25 kg/m2, recruited from the QMDS. Metabolic syndrome was defined according to the Adult Treatment Panel III criteria. Data were analyzed using chi-square test, t-test, and logistic regression analysis (to evaluate the relationship between WBC count quartiles and metabolic syndrome).

 Prevalence of metabolic syndrome was not significantly different between men and women. In men, prevalence of metabolic syndrome and its components were not different between WBC quartiles. In women, 2.23% and 5.06% had metabolic syndrome in the first and fourth quartiles of WBC count, respectively (P<0.001). Moreover, the prevalence of insulin resistance was higher in fourth quartile compared to the first quartile (7.74% vs. 6.52%, P<0.001). After controlling the effects of age and BMI factors, the risk of metabolic syndrome in the fourth quartile of WBC count remained significant in women (OR=2.56, P<0.01).

 Association of WBC count with metabolic syndrome is significant in obese women compared to obese men.

Changes of serum minerals and vitamin D have been reported in anticonvulsant drugs user patients. The present study aimed at comparing the changes of serum minerals and vitamin D among two groups of enzyme-inducing and non enzyme-inducing anticonvulsant drug users.

In this study 22 patients treated with enzyme-inducing drugs (carbamazepin، phenytoin، phenobarbital) were compared to 25 patients of matched sex، age، and BMI treated with non enzyme-inducing drugs (sodium evaporate، lamotrigine). Serum calcium، phosphate، parathormone، and 25-hydroxy vitamin D were calculated in both groups. Calcium was measured by Calorimetery method. Parathormone and vitamin D were measured using ELISA method.

The mean serum vitamin D level was lower in enzyme-inducing than non enzyme-inducing drugs users (15. 9±8. 3 and 24. 2±14. 8، P=0. 02). Frequency of vitamin D deficiency was higher in enzyme-inducing compared to non enzyme-inducing drugs users، 84% and 48%، respectively (P=0. 016). The mean serum calcium level was significantly lower in enzyme-inducing drugs users. (8. 7±0. 2 vs. 9. 0± 0. 7، p= 0. 05). Four percent in enzyme-inducing group compared to twenty four percent of non enzyme-inducing group had secondary hyperparathyroidism (P=0. 016).

While vitamin D deficiency is more frequent in enzyme-inducing drug users، secondary hyperparathyroidism is less frequent.

Insulin is administered for glycemic control in type 2 diabetic patients with secondary failure to oral antidiabetic drugs. Achieving good glycemic control requires a long time with relatively high insulin dose.

The aim of this study was to compare the effect of treatment with insulin alone versus insulin plus sulfonylurea in type 2 diabetic patients.

In this randomized clinical trial, 45 patients with secondary failure to oral antidiabetic drugs who referred to Bou-Ali hospital during 2009-2010, were randomly allocated into two groups of insulin alone and insulin plus sulfonylurea. Fasting and postprandial blood sugar, insulin dose, and weight gain were measured monthly up to 3 months. Data were analyzed by T-test and Chi-square test.

A t the end of the first and the third month of the treatment, mean fasting blood sugar was 146.3 ±21.1 mg/dl and 126.9±10.2 mg/dl in combination therapy group and was 166.1 ± 28.7 mg/dl and 144.5 ± 20.9 mg/dl in insulin alone group, respectively (P =0.01 and P=0.001, respectively). Mean postprandial blood sugar in combination group was lower than insulin alone group at the end of the third month (P=0.009). The difference in mean insulin dose between 2 groups was statistically significant at the end of the third month (P<0.001).

With regard to the results, combination therapy with insulin plus sulfonylurea versus insulin alone would result in faster improvement of glycemic control and lower daily insulin dose.