ensieh nasli esfahani

This study presents estimates for type 2 diabetes mellitus (T2DM) burden and attributable risk factors in Iran from 1990–2019, using data from the 2019 Global Burden of Disease study.

This study reports prevalence, incidence, death, disability-adjusted life years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs) of T2DM in Iran, by sex, age, and province, from 1990 to 2019. We also present the T2DM burden attributable to risk factors. Results are reported in absolute number and age-standardized rates.

Overall, the burden of T2DM had increased greatly since 1990. In 2019, the T2DM incidence and prevalence cases were 291,482 (a 374% increase) and 5,035,012 (a 417% increase) respectively. Moreover, the number of death and DALYs were 14,191 (a 488% increase) and 716,457 (a 417% increase) respectively. DALYs and YLDs in women were consistently higher than men were, whereas women experienced slower increases in YLLs from 1990 to 2019. The age-standardized DALYs rate increased for all Iranian provinces during study period. High body-mass index, ambient particulate matter pollution, and low physical activity remained the three major attributable risk factors in all provinces in 2019.

T2DM constitutes a major health burden in Iran. The remarkable upsurge in the T2DM burden represents an ongoing challenge, given the rapidly aging population in Iran. Thus, integrated and multi-sectoral actions that decrease exposure to risk factors and improve the prevention and early diagnosis are needed.

In patients with diabetes, transplantation of stem cells increases C-peptide levels and induces insulin independence for some period. Today, this positive therapeutic outcome is widely attributed to the well-documented immunomodulatory properties of stem cells. The aim of this study was to report alternations (the trend of increase or decrease) in different lymphocyte populations in a stem cell clinical trial performed in our institute.  

Recorded data of a clinical trial conducted on 72 patients with type 1 diabetes who had received fetal stem cell transplantation several years ago and were regularly monitored before and after the procedure in 1, 3, 6, 12, 24 months were analyzed. In these regular follow-up visits, insulin demand, HbA1c, C-peptide, and alternation to B cell and T cell populations were analyzed and recorded. For the purpose of the current study, patients were retrospectively divided into 2 groups, namely, those with the positive response to treatment and patients without such response. Temporary positive therapeutic response was defined by 2 different indicators, namely, plasma C-peptide levels and insulin dose-adjusted A1C (IDAA1c), which was calculated as A1C (percent) + (4 × insulin dose (units per kilogram per 24 h). Data analysis was performed by means of SPSS Version 18.  

Besides the short-term therapeutic effect, we observed remarkably significant alternations to the populations of B and T lymphocytes in the recipients. When patients were retrospectively assigned to 2 different groups of patients with a positive therapeutic response (based on C-peptide changes) and those without it, it was observed that alternations to different populations of B-cells and T-cells were significantly different in these 2 groups.  

Our results demonstrated that transplantation of stem cells leads to significant positive therapeutic outcomes in one group of patients who showed totally distinct patterns of alternation to different groups of lymphocytes.

This study was performed to investigate whether social support and other psychological predictors were associated with physical activity during the prolonged social isolation due to the coronavirus disease 2019 outbreak in Iran.

This cross-sectional study was performed on 494 individuals with type 2 diabetes (T2D) in a diabetes specialty clinic. The questionnaire package comprised five parts, including sociodemographic and clinical characteristics, physical activity level, diabetes-specific social support, feelings of isolation, and diabetes-related distress. Clinical and hemoglobin A1c data were obtained from electronic medical records. Descriptive statistics, Pearson’s chi-square test, and multivariable logistic regressions were conducted to analyze the data.

Approximately 71% of the participants participated in low/insufficient levels of physical activity. The participants who received support from family/friends (odds ratio [OR] = 1.77; 95% confidence interval [CI]: 1.47 - 2.74), diabetes care team (OR = 1.42; 95% CI: 1.15 - 1.77), and neighbors (OR = 1.53; 95% CI: 1.20 - 2.08) were more likely to have sufficient physical activity than those who did not receive these supports. There was also an association between physical activity behavior with feelings of isolation and diabetes distress.

This study points to the importance of social support as an amplifier mechanism for the maintenance of physical activity behavior in individuals with T2D during critical times.

This study aimed to investigate the economic evaluation of remote monitoring of type 2 diabetic patients for controlling glycosylated hemoglobin compared to routine care for type 2 diabetics.

Economic evaluation was carried out to calculate the unit cost of the remote monitoring technology and the routine treatment for type 2 diabetics, incremental cost-effectiveness ratio, and sensitivity analysis using the key variables such as population size and cost items (in five categories of equipment and devices, building, staff, overhead costs, and consumables costs).

Considering the incremental cost-effectiveness ratio in the base-case model and in comparison with routine treatment of type 2 diabetes, remote type 2 diabetes monitoring system was placed in the second quarter (more effective and affordable technology) of the graph as the most dominant alternative (RPM vs. Routine care: Total annual cost difference: -38476.477 US$ / “Unit- reduction in HbA1C” difference: 0.488).  The results of the sensitivity analysis revealed that in all scenarios, RPM was dominant compared to the routine treatment (The optimum ICER: -610.128 US$ per “Unit reduction in HbA1C” for the scenario with A 10% increase in the costs of the control and intervention group).

Remote patient monitoring is a dominant alternative compared to routine treatment. Results indicated that remote type 2 diabetes monitoring interventions play an effective role in reducing HbA1c, which may be considered the rationale for policymakers to use this technology.

Diabetes is one of the most important health problems in the world, and controlling its risk factors and complications is very important. The aim of this study was to determine the effects of interval training on inflammatory markers among type II diabetic patients.

in this randomized controlled trial 30 eligible patients randomly allocated to one of two parallel groups. Fifteen patients received interval training exercise with 18 sessions (three sessions per week), and fifteen patients in control group had usual physical activity. The primary outcome was measured before and after the intervention.

Interleukin-10 levels were significantly reduced (reduction: 0.96 pg/ml) in patients in the intervention group and increased (0.35 pg/ml) in control group, and this difference was statistically significantly between group (p: 0.015). The levels of interleukin-6 and CRP in the pre- and post-measurement measurements of the two groups did not show a significant difference (p>0.05).

Interval training exercise can be effective in reducing some inflammatory factors, and given that these factors affect the course of the disease and complications associated with diabetes, the use of this type of exercise can be useful for controlling the disease and its complications. More investigation in interval training exercise and its effects on various inflammatory factors are required.

Considering an individual’s characteristics such as genetics along with other characteristics and dietary habits can help to provide an effective diet for prevention and controlling metabolic disorders. Accordingly, in the present study, we aimed to review evidence on personalized nutrition (PN) and its roles in metabolic disorders.

In the present narrative review, publications on PN and metabolic disorders published between 2010 and 2020 using PubMed, Scopus, and Google Scholar were searched and collected.

Our findings showed positive effects of precision medicine and PN on controlling metabolic disorders, diabetes, postprandial glucose level, obesity, and lipid profile. Interactions of genetic differences, lifestyle, microbiota patterns, and behavioral and psychological characteristics can affect developing and controlling diseases.

Due to the effects of genetics, gut microbiota, and other individual characteristics in designing and providing a suitable diet, paying attention to PN in the prevention and controlling metabolic disorders is important. PN vs. general dietary recommendations or diet can be more effective; although it needs high expenditure and more equipment.

Context: 

There has been an increasing emphasis on the role of education in diabetes prevention and management, and shedding light on evidence gaps is mandatory for national action plans establishment.

Data Sources: 

This scoping review was part of the Iranian Diabetes Road Map project that used a systematic method based on the Arksey and O'Malley approach.

 After the screening, 173 articles were included, most of which were published in 2018 and focused on self-management. Only a limited number of articles studied healthcare provider education and educational establishment.

 Education is an important part of diabetes, and specific needs for Iranian patients should be addressed in future studies. Paying attention to new topics and conducting high-quality interventional studies will help fill evidence gaps in this field in Iran.

This study aimed to compare high intensity interval training and continuous endurance training on the gene expression of mir-1 and IGF-1 in cardiomyocytes of diabetic rats. After induction of diabetes, 21 male Wistar rats were randomly divided into three groups (each group 7 subjects): control, continuous endurance training, high intensity interval training). The training program included 5 days a week for 8 weeks. Each endurance session consisted of 30 minutes of running with the intensity of 60% VO2max. Each interval session consisted of 4 intervals, each interval 3 minutes, with the intensity of 90% VO2max and 1 minute of recovery with the intensity of 30% VO2max between each two intervals. Gene expression of IGF-1 and mir-1 of left ventricle tissue was assessed by qRT PCR. The results showed that both types of training significantly reduced the gene expression of mir-1 compared to the control group, but this decline was severer in the high intensity interval group than the endurance group (P≥0.05). Also, the gene expression of IGF-1 significantly increased in both training groups compared to the control group but this increase was severer in high intensity interval group than the endurance group (P≥0.05). It seems that high intensity interval training can be an effective intervention to reduce the complications of diabetic cardiomyopathy by repression of mir-1.

The important role of physical activity in the prevention and management of diabetes necessitates a review of current research to shed light on gaps in national diabetes guidelines.

This scoping review was part of the Iran Diabetes Research Roadmap (IDRR) study. A systematic search was used based on the Arksey and O’Malley method consisting of six steps. The descriptive analysis was done with SPSS software. Additionally, VOS veiwer software was used to draw the knowledge map of the included studies.

There were 169 articles included from the beginning of 2015 to the end of 2019 in Iran. Aerobic and resistance exercises were types of physical activity with more number of articles. Most of the included clinical studies were randomized clinical trials in design and had a level of evidence two. Also, there was more interest in outcomes such as glycemic control and insulin sensitivity, metabolic syndrome, metabolism, and cardiovascular health. The network of co-authorship was drawn, and "controlled study", "male", and "rat" were the most frequent keywords.

The number of Iranian diabetes researchers on physical activity has been increasing, and the majority of clinical studies had a high level of evidence. With maintaining previous interests and investigations, there should be more emphasis on research in elderly and children age groups as evidence gap in Iran. Also, longitudinal cohort studies should be highlighted, and Iranian researchers should be encouraged to participate in new topics of research worldwide.

The association between dietary patterns and cardiovascular disease (CVD) risk factors has been investigated in very limited studies in patients with type 1 diabetes mellitus (T1DM). The aim of this study was to determine the relationship between the major dietary patterns and CVD risk factors in these patients.

A cross‑sectional study was performed on 169 females of 18‑‑35 years who were diagnosed with T1DM attending Iranian Diabetes Association in Tehran. Anthropometric measures, blood glucose, and lipid levels of all participants were measured. Dietary data was collected using a food frequency questionnaire. Dietary patterns were determined by factor analysis. Using the analysis of covariance (ANCOVA), mean value of the biochemical factors across the tertiles of dietary patterns was compared.

Three major dietary patterns were identified: the grain, legume and nut (GLN), the fruits and vegetables (FV), and the high calorie foods, salty snacks, sweet and dessert (HSD). After adjustment for age, body mass index and energy intake, subjects who were in the highest tertile of FV pattern had significantly lower levels of LDL‑c (P = 0.01), triglyceride (TG) (P = 0.02), and total cholesterol (P = 0.01). GLN and HSD patterns had no significant relationship with blood glucose and lipids.

This study demonstrates that a dietary pattern rich in vegetables and fruits may be inversely associated with dyslipidemia in patients with T1DM. The results can be used for developing interventions that aim to promote healthy eating for the prevention of CVD in these patients.

A highly prevalent problem in patients with type 2 diabetes is depression; it can directly affect patients’ biologically derived substances, e.g., fasting blood glucose and HbA1c. Depressive symptoms significantly impact self–care and wellbeing. Multiple demographic, socioeconomic, and social support factors can facilitate self–care activities in diabetic patients; however, a health psychologist’s role in promoting self–care is vital. Psychological interventions, such as Hope Therapy (HT) and Spiritual Therapy (ST) might be effective in managing biological variables, depression, and quality of life in patients with diabetes. Thus, this study aimed to compare the effects of HT and ST on depression, self–care, and HbA1c in patients with type 2 diabetes.

This was a quasi–experimental study with pretest–posttest–follow–up and a control group design. The statistical population included all middle–aged women with type 2 diabetes referring to Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute in Tehran City, Iran, in 2020. In total, 45 eligible volunteers were selected by the convenience sampling method. They completed Beck Depression Inventory (BDI; Beck et al., 1961) before and after the interventions. Individuals with a depression score of >11 were randomly assigned into 3 research groups (n=15/group). The inclusion criteria of the study included having a minimum literacy to complete the questionnaires, providing an informed consent form, willingness to participate in the study, obtaining a minimum depression score of 11, and being in the 45–60 years age range. The exclusion criteria of the study included receiving psychological therapies during the study, severe physical illnesses due to diabetes, such as kidney failure, vision, etc., consuming psychiatric drugs during the study, increasing the dose of related drugs due to diabetes, and the patient's unwillingness to continue treatment. The experimental groups received HT according to Snyder’s treatment protocol (2002) in 8 weekly sessions and ST according to Richards et al.’s treatment protocol (2007) in 8 weekly sessions; however, the controls received no intervention. The necessary data were collected using the BDI, the Self–Care Questionnaire ‎(Tobert et al., 2000), ‎and the HbA1c blood test. Pretest and posttest steps were performed in all research groups. A month after the posttest, all measures were repeated (follow–up). Descriptive statistics, such as mean and SD were used to describe the obtained data. The collected data were analyzed using repeated–measures Analysis of Variance (ANOVA) and Bonferroni posthoc test in SPSS at the significance level of 0.05.

The present study data indicated that HT and ST reduced depression (p<0.001) and HbA1c (p=0.024), and enhanced self–care (p<0.001). The mean score of depression (p<0.001), HbA1c (p<0.001), and self–care (p<0.001) significantly reduced over time. The significant time*groups interaction effect was observed for depression (p<0.001), HbA1c (p<0.001), and self–care (p<0.001) in the experimental groups, compared to the controls. Bonferroni posthoc test data revealed a significant difference between the intervention groups and the controls concerning depression (p<0.001 & p<0.001, respectively), HbA1c (p=0.046 & p=0.034, respectively), and self–care (p<0.001 & p<0.001, respectively); however, there was a significant difference between HT and ST in depression (p=0.038). There was a significant difference between pretest and posttest phases and the follow–up phase respecting depression (p<0.001), HbA1c (p<0.001), and self–care (p<0.001); however, there was no significant difference between posttest and follow–up phases for depression (p=1.000), HbA1c (p=0.974), and self–care (p=0.143), highlighting the positive and persisting (until follow–up) effects of HT and ST.

Based on the current research findings, HT and ST reduced depression and HbA1c, and increased self–care among the explored middle–aged women with type 2 diabetes; however, there was a significant difference between the effects of HT and ST concerning depression where ST was more effective than HT.

Endocrinology and Metabolism Research Institute (EMRI) is one of the largest research institutes in Iran, which has been established to develop research strategies and manage endocrine and metabolic diseases such as diabetes. The purpose of this report is to review and summarize research activities related to diabetes over a quarter of a century at EMRI.

A comprehensive search of PubMed, Scopus and EMBASE was conducted to find diabetes-related studies in EMRI. After extracting the data, the articles were classified according to the type of article, the level of evidence, the types of diabetes and their subject.

After eliminating duplicates and screening, finally 228 articles were classified. Most diabetes research conducted at the Diabetes Research Center (DRC) was on type 2 diabetes (37%). By article type, most of the articles were original. In addition, clinical studies provided the most evidence in the obtained documents. By topic, most of the articles were related to the basic sciences and factors related to diabetes, followed by studies on the management and prevention of diabetes.

Most of the research conducted in the Diabetes Research Center in the past quarter of a century is of original studies in the field of basic sciences in the field of type 2 diabetes and most of the evidence produced is related to observational studies.

Type 2 diabetes mellitus (T2DM) is a metabolic disorder with growing prevalence and increasing economic burden. Based on the role of genetics and epigenetic factors on T2DM, we aimed to carry a systematic review and meta‑analysis for all miRNA gene polymorphisms and risk of T2DM.

A computerized literature search was carried out on PubMed, Web of Science, Scopus, Embase, as well as references of relevant review/meta‑analysis. Key search terms were “Diabetes Mellitus, Type 2,” “MicroRNAs,” and “Polymorphism, Single Nucleotide.” All types of observational studies from January 1, 1992, to November 30, 2019, were included, without language restriction. Data analysis was performed using R programming language (3.5.2). Level of heterogeneity was obtained by Cochran’s Q test (P ˂ 0.05), and subgroup analysis was performed based on ethnicity.

Thirty‑two polymorphisms from fifteen articles were included. Meta‑analysis was carried out based on minor allele frequencies. Seven studies with 2193 cases and 3963 controls were included for rs2910164 polymorphism. In subgroup analysis, there were significant results in Caucasian population in dominant model (odds ratio [OR] =1.12; 95% confidence interval [CI]: 0.83–1.51), homozygote model (OR = 1.78; 95% CI: 1.06–3.00), heterozygote model (OR = 1.77; 95% CI: 1.03–3.05), and recessive model (OR = 1.78; 95% CI: 1.07–2.96). Four studies with 2085 cases and 1933 controls were included for rs895819 polymorphism. Overall, there was no significant result for association with rs895819, but subgroup analysis revealed that minor allele significantly decreased the risk of T2DM in Caucasians by recessive model (OR = 0.34; 95% CI: 0.18–0.66), dominant model (OR = 0.70; 95% CI: 0.52–0.94), homozygote model (OR = 0.32; 95% CI: 0.16–0.62), heterozygote model (OR = 0.37; 95% CI: 0.19–0.74), allelic model (OR = 0.67; 95% CI: 0.52–0.85).

The minor allele of rs2910164 may increase the risk of T2DM by leading to lower level of miR‑146a. In contrast, minor allele of rs895819 may decrease the risk of T2DM by leading to higher level of miR‑27a.

Diabetes mellitus is one of the most common endocrine diseases. Cardiovascular disease (CVD) is one of the leading causes of death in patients with type 2 diabetes. The aim of this study was to investigate the metabolic profile of plasma amino acids in diabetic patients with cardiovascular disease.

The present study is a descriptive-analytical cross-sectional study on 140 patients including 35 patients with type 2 diabetes and cardiovascular disease (CVD.DM), 35 patients with type 2 diabetes and non-cardiovascular disease (DM). 35 non-diabetic patients with cardiovascular disease (CVD.nDM) and 35 non-diabetic patients with non-cardiovascular disease (HS) were referred to Diabetes Clinic No. 1 of Tehran University of Medical Sciences.

76 (54.3%) were male and 64 (45.7%) were female. The highest concentrations of glutamine and isoleucine were observed in DM.CVD, asparagine, serine, arginine, threonine, alanine, tyrosine, valine in DM.nCVD and methionine in CVD.nDM. The lowest concentrations of tyrosine and tryptophan in DM.CVD has been detected , and  methionine has been detected in DM.nCVD. The amino acids alanine, glutamine, tyrosine, valine, methionine, leucine, lysine and arginine significantly increased the chances of developing DM.nCVD. For each increase in Z-score per plasma concentration of isoleucine, the chances of developing cardiovascular disease without diabetes were significantly increased.

The amino acids alanine, glutamine, tyrosine, valine, methionine, leucine, lysine and arginine are involved in predicting the risk of DM.nCVD and isoleucine and methionine are involved in predicting the risk of CVD.nDM.

Nephropathy is a common diabetes complication. ERRFI1 gene which participates in various cellular pathways has been proposed as a candidate gene in diabetic nephropathy. This study aimed to investigate the role of +808T/G polymorphism (rs377349) in ERRFI1 gene in diabetic nephropathy. In this case-control study, patients including diabetes with nephropathy (DN=104), type 2 diabetes without nephropathy (DM=100), and healthy controls (HC=106) were included. DNA was extracted from blood, and genotyping of the +808T/G polymorphism was carried out using PCR-RFLP technique. The differences for genotype and allele frequencies for +808T/G polymorphism in ERRFI1 gene between DN vs. HC and DN+DM vs. HC were significant (P<0.05) while no significant difference between DN and DM was observed. The allele frequencies were significantly different in DN vs. HC and DN+DM vs. HC in males but not in females. G allele of +808T/G polymorphism in ERRFI1 gene has no significant role in development and progression of diabetic nephropathy in diabetes patients while it is a risk allele for developing diabetes in Iranian population.

Diabetes is one of the most dangerous and common diseases of the modern world. Since medical research usually has limited data available and medical data is very ambiguous, it seems appropriate to use the fuzzy model to find out the relationship between input and output in medical data. None of the previous articles of fuzzy regression have been used to predict complications of diabetes, including nephropathy. Therefore, in this study, a fuzzy regression model was used to predict nephropathy in a diabetic patient. In the present study, GFR results of previous patient experiments were used to predict a deeper horizons of GFR and ultimately to predict renal disease. Chronic kidney disease has been stratified based on the amount of GFR, that fuzzy data has been constructed based on these levels. The GFR prediction was performed in the following steps. Step 1: Define fuzzy sets based on the GFR level, which is considered for each level of a fuzzy set. Step 2: Fuzzify patient data Based on fuzzy sets. Step 3: GFR prediction with fuzzy regression model. Step 4: Defuzzifying the predictions. Step 5: Evaluating the model efficiency. The RMSE error is used to compare the performance of the model. The results of GFR prediction showed that comparison RMSE was 10.09 with using simple linear regression model and 4.24 in fuzzy model. fuzzy regression model can predict nephropathy in diabetic patients.

  Diabetic foot ulcer is one of the most painful complications of Diabetes and affects various aspects of a person's life. Therefore, involvement of the patient in self-care can minimize its complications. The purpose of this study was to identify the effective factors in the Diabetic foot self-management for designing a managed-care based app for people with Diabetes who have risk factors for foot ulcers or wound infections. In this cross-sectional study all physicians and nurses employed at ‘Diabetes and Metabolic Diseases Research Center’ of Tehran University of Medical Sciences who had a history of working with Diabetic patients at various levels of Diabetes and foot ulcers participated. The data collection tool was a questionnaire based on the likert scale that made by researchers, which included demographic and clinical information, education and lifestyle management and capabilities of application for self-management in Diabetic foot patients. Finally, descriptive statistics used to analyze the results in SPSS. After reviewing the rate of experts’ agreement with the components of the survey, all the cases over 51% approval rate were considered as required components. According to the opinion of the physicians respectively capabilities of application, education and lifestyle management and patient information and according to the opinion of the nurses’ education and lifestyle management, patient information and capabilities of application were important respectively. Beside proper treatment of the disease, self-management strategies can be effective and useful. Effectiveness of the patients’ self-care by acquiring the necessary skills and involvement in self-care might be achievable.

Most adult patients with diabetes have at least one comorbid chronic condition and approximately 40% have three or more. The purpose of this study was to investigate detailed characteristics of studies examining comorbidities of diabetes in Iran and to identify knowledge gaps in this field.
All documents published by Iranian authors in national and international journals until 2015 were evaluated. A wide search was performed in PubMed, Web of Science, SCOPUS as well as SID, IranMedex and Magiran databases using proper keywords. The obtained documents were categorized into eleven subgroups of complications, comorbidities, management, psychiatry, nutrition, prevention, physical activity, genetics, basic sciences, education and gestational diabetes mellitus (GDM). Documents were categorized based on WHO and Australian National Health and Medical Research Council (NHMRC) classification, the study methodology and topic.
Overall, 311 documents were obtained. The trend of publications was ascending since 2000. About 70% of studies were about epidemiology and causes of comorbid disease and more than 90% of studies were clinical research. The design of the most studies was cross-sectional followed by case-control and randomized clinical trial. The most common subject of documents was related to endocrine (28.61%) followed by gastrointestinal (18.32%) and cardiovascular disease (14.14%).
Epidemiological studies are the most common type of studies about diabetes comorbidity in Iran and cross-sectional design is the most frequent methodology used while there are few cohorts. There is no study about physiopathology and shared etiology and pathogenesis of these comorbidities and diabetes.

This study conducted to assess publications of diabetes treatments to understand research gaps and priorities to guide a management map for future strategy of diabetes research in Iran.
All studies published from the beginning until 2015 in national and international journals by Iranian authors conducted in the field of diabetes. This comprehensive search strategy without any limitation obtained 8668 publications in international journals and 16921 documents in national journals (25589 documents). Finally, 1019 diabetes management articles were included in this study. Each article categorized based on the study design, subject area, the World Health Organization (WHO) classification and Australian Standard Research Classifications.
There was an increasing trend in a number of publications. Top subject areas were “traditional treatment” with global publication share of 25.8% and “Control of diabetes” ranked the second (24.9%). According to WHO classification, the highest number of productions was in “Basic Research” area (39%) and Australian Standard Research Classification showed 59% of the articles were in “Clinical Medicine and Science” area. Study design of 39.9% articles was basic studies, 23.1% were randomized clinical trial and 21.9% were cross-sectional.
This study showed a relatively ascending trend of scientific publications in the field of diabetes managements in Iran. We can identify the research gaps and research priorities for diabetes management research for future studies. In Future, management map with other diabetes area research maps will be compiled into a single “Roadmap for Diabetes Research in Iran”.

Diabetes mellitus (DM) is the most common metabolic disorder worldwide. This study aimed to report characteristics of genetic studies in DM in Iran and to identify knowledge gap in genetics of diabetes in Iran.
All publications of Iranian authors in national and international journals up to 2015 were included. Comprehensive search was performed in PubMed, Web of Science, Scopus, SID, IranMedex and Magiran using "Diabetes mellitus" and "Iran*" keywords and their combination. This search obtained 25589 documents. The obtained documents were categorized into eleven groups of complications, comorbidity, management, psychology, nutrition, physical activity, genetics, basic sciences, prevention, education and gestational diabetes mellitus (GDM). Documents were categorized based on publication year, WHO and Australian National Health and Medical Research Council (NHMRC) classification, study design and subject area.
After screening, 293 documents remained. The trend of publications was increasing and reached peak in 2013. Case-control was the most common method used in the documents. Most of the studies were association study with case-control design while there was no genome-wide association study (GWAS). Genetic risk factors for DM and its complications were the most common topics in the obtained documents followed by DM management.
The most of genetic studies in diabetes in Iran are association studies about genetic risk factors of diabetes while GWAS and pharmacogenetic studies are rare or absent. This may indicate low priority of personalized medicine in the field of diabetes in Iran.

The study aim was to reports detailed characteristics of nutrition research in field of diabetes, and recognize knowledge gap in nutrition science in diabetes in Iran.
Online databases of PubMed, Web of Science and Scopus as well as national databases including SID, IranMedex, and Magiran were searched up to 2015 to identify eligible articles. Finally, 378 articles were included.
Final articles were categorized based on WHO and Australian classifications, study design and subject area. The most number of studies (80%) was related in strategies and interventions of health-related outcome group the WHO classification. The most percentage of publications in Australian classification system was allocated to clinical researches (78%) and the least studies were health service studies (0.08%). The most common designs used in the obtained documents (41%) were Randomized Clinical Trials (RCT) and about 17% of publications were animal studies. Cohort studies were the least studies among the obtained documents. The most common subject was type 2 Diabetes Mellitus and its complications followed by DM management (64%, n=241). The least numbers of publications were dedicated to GDM (Gestational Diabetes Mellitus). There was a large ascent in studies during 2010-2011 and 2012-2013.
Available evidence provides very good support for the role of nutrition diets in the prevention and management of all types of diabetes. This systematic review indicates trend of nutrition researches in diabetes was noticeable flourished, while the important subjects in diabetes studies are forgotten or unimportance.

Diabetes has become a daunting health and medical challenge as well as a hefty economic burden for societies over the past decades. This study was designed to shed light on the overall trend of research across Iran regarding mental health status of diabetic patients.
Search process of the present study is part of search strategy of Iran Diabetes Research Roadmap (IDRR) study. We performed a thorough search about Iran diabetes research output in national (Iranmedex, Magiran, and SID) and international (Pubmed, ISI and Scopus) databases up to 2015. After removing duplicates, 426documents were remained and categorized by subject category, methodology, WHO classification and NHMRC criteria.
Most of obtained studies were concerned with quality of life, treatment, intervention, and behavioral disorders. Based on WHO categories, most studies revolved around epidemiology, causes and determinants of health-related outcomes. Methodological classification showed cross-sectional as the favored method of research. In the Australian classification system, most studies were clinical studies. The year 2010 and 2011 had the greatest spike during the study period.
Overall trend in publication rate of papers related to the mental health is relatively growing. However, the lack of priority setting is obvious and there is a pressing need for more in-depth evaluations, prioritization of study type and interventional studies based on the needs of patients suffering from diabetes.

Despite the benefits of diabetes patient education, it is imperative to analyze the status of researches in this field and identify research gaps and priorities if our limited health resources are to be used wisely and effectively. This study is a part of Iran Diabetes Research Roadmap study to find the knowledge gap in the field of diabetes patient education in Iran.
All publications of Iranian authors about diabetes patient education in national (SID, IranMedex, and Magiran) and international journals (PubMed, Web of Science and Scopus) up to 2015 were reviewed. Overall, 306 studies were categorized by subject category, methodology, WHO classification and NHMRC criteria.
Most numbers of samples in the subject category were about the effect of self-care training (28%) and then model-based educational interventions (13%). Moreover, trend in publication rate of papers related to the patient education topic is relatively increasing with time, despite some difficulties points. Half of the papers were cross-sectional and 46% of them were interventional studies.
Although trend of papers subjects was relatively scattered, most of patient education studies in Iran were about assessing the positive effects of self-care education similar to other countries. However, quality assessment for all studies should be carried out in future research.

Diabetes mellitus (DM) is a common non-communicable diseases associated with different complications. The study aim was to analyze and report characteristics of research output in the field of diabetes complication in Iran in details and identify research gap in this field.
All scientific diabetes output published by Iranian authors in national and international journals until 2015 was included and analyzed. National and international databases including PubMed, Web of Science, SCOPUS, SID, IranMedex, and Magiran were searched. The obtained results were categorized into eleven subgroups. of complications, comorbidities, management, psychiatry, nutrition, prevention, physical activity, genetics, basic sciences, education and gestational diabetes mellitus (GDM). In each category, documents were classified based on the study design and topic as well as WHO and Australian National Health and Medical Research Council (NHMRC) classification.
After screening, 1262 documents remained. Trend of publication was growing during the study period. However, small temporary drop was seen in 2012 and 2014. The most common type of studies in WHO and NHMRC classification belonged to distribution and causes and clinical research, respectively. Cross-sectional and animal designs were the most common methodologies used and vascular complications were the most common subject area in the obtained documents.
Subject trend of Iranian studies in the field of diabetes complications is compatible with the prevalence of such complications. However, results show lack of studies with high level of evidence including cohorts and systematic reviews in Iran. Although the trend of publications is growing but considering the importance of this issue, it is not enough and more funds should be allocated in this field. Considering the increasing frequency of basic research close collaboration between basic and clinical research is required to apply these findings in our diabetes guidelines.

Basic science studies evaluation is important feature for an effective implementation of diabetes research and funding policy. This study aimed to provide an evaluation of diabetes basic research output up to 2015 in Iran.
Data were retrieved from scientific search engine including PubMed, Web of science, SCOPUS as well as Iranian science databases including SID, IranMedex, and Magiran using “Diabetes mellitus” and ‘Iran” keywords. After classification of total collected publications, basic sciences category was considered as one of the main groups. Specific areas of research activity in the main basic sciences disciplines, methodology of publications as well as proportionality of publications to WHO and Australian classification were identified.
Overall, 1249 basic science items were published up to 2015 in Iran. The greatest number of outputs were published in 2013 (n=201). The annual average growth rate was 38.45%. The Biochemistry contributed 63.7% to the overall output, followed by the Physiology (15.9%) and Histopathology & Anatomy (14.5%). The least participation was attributed to basic microbiology (1%). Animal study was the most common method (64%) followed by the Case-Control method (10.6%).
The present study is the first large-scale analysis of Iranian basic researches in the field of diabetes. It identified single areas of research heavily focused or have been neglected. These areas should be reconsidered aiming to close the knowledge gaps and good policymaking. Basic researches and clinical relevance are approached based on old theories with slight originality in our country.