masoud rahmanian

Elevated serum levels of osteopontin (OPN) have been associated with cardiovascular disease, diabetic nephropathy, and autoimmune disease activity. The aim of this study was to investigate the relationship between OPN serum levels and renal damage in type 2 diabetes patients. This analytical cross-sectional study was carried out in Yazd, Iran from April to September 2017. Micro-albuminuria and creatinine (Cr) in 750 patients were measured and 180 included patients were divided into the three groups of 60 subjects based on the level of micro-albuminuria; normal (group A), micro proteinuria (group B) and macro proteinuria (group C). Body weight, height, blood pressure, body mass index (BMI), HbA1c and OPN were assessed. Among 179 patients, 60 of them were normal for proteinuria, 59 patients had micro-proteinuria and 60 ones had macro- proteinuria. The mean age of participants was 58.96 ( ± 11.10) years (range 26-80 years), 90 patients (50.8%) were males and 88 ones (49.2%) were females. The mean OPN levels were significantly higher in group C compared to group B, and in group B compared to group A (P = 0.0001). Serum OPN was correlated positively with HbA1c (P: 0.012), Cr (P = 0.010) and glomerular filtration rate (GFR) (P = 0.002). There was a significant difference in the mean of OPN level among the subgroups with the history of ischemic heart disease (IHD) and HbA1C (P=0.035, and 0.047 respectively). These findings suggest that OPN is involved in chronic disease activity, and there is an independent association between plasma levels of OPN, and nephropathy in diabetic patients.

Obesity is a major public health concern and there are different ways to detect it in population. The aim of the present study is to evaluate the neck circumference (NC) in a simple and practical way.

This cross-sectional survey utilized data from the Yazd Health Study (YaHS) which is a population-based cohort study. In brief, 9962 individuals aged 20-70 years with measurement of body weight, height, waist circumference (WC) and NC were available for analysis. To determine the relationship between NC and other anthropometric measurement, we utilized of Pearson's correlation coefficient. Receiver operator characteristic (ROC) curve analysis was used to find out an optimal cut off value for detecting general and central obesity as well as to determine the sensitivity and specificity of NC in predicting general and central obesity. The whole analysis was performed using SPSS version 22.

NC correlated positively with body mass index (BMI) (r= 0.608, P< 0.001 in men and r= 0.541, P< 0.001 in women) and WC (r= 0.662, P< 0.001 in men and r= 0.542, P< 0.001 in women). The best cut-off point for NC to determine people with general obesity was 40.25 cm for men and 35.75 cm for women.

The NC has an acceptable correlation with BMI and WC. In addition, NC is a simple free measurement which may be utilized in various health-care settings. These properties make the NC as the best anthropometrics to determine overweight and obesity and it can be used as an appropriate predictor for overweight and obesity in population-based screening programs.

 Due to the important role played by knowledge in controlling and managing diabetes in most educational interventions, the assessment of the individuals’ levels of knowledge is regarded as a key variable when planning the given interventions.

 This study aimed to design and evaluate the psychometric properties of the Diabetic Knowledge Questionnaire for Iranian diabetic patients.

 This cross-sectional study was conducted from March 2020 to May 2021 in Yazd, to examine 400 type 2 diabetes mellitus (T2DM) by adopting the simple random sampling method. Exploratory factor analysis was carried out to evaluate the validity, and 2 methods of test-retest and internal consistency were used to evaluate the reliability. Data were analyzed using SPSS 20 and Amos 21 software.

 The questionnaire’s items were classified into 6 factors based on factor analysis method; that is, a total of 23 questions with the dimensions of general, hypoglycemia, complications, nutrition, physical activity, and insulin were included. Questions 1 to 20 were allocated to patients with oral therapy, and questions 21 to 23 were allocated to patients under insulin therapy. These factors altogether accounted for 78% of the total variance. The internal correlation coefficient (icc) for the knowledge questionnaire as a whole was 0.85, which demonstrated an acceptable level of reliability. Also, Pearson correlation coefficient of reliability between test times (test-retest) was found to be 0.92.

 The instrument was a valid scale designed to assess the awareness of patients with T2DM about various aspects of the disease. However, it was suggested that further studies should be conducted to investigated the patients with type 1 diabetes mellitus (T1DM) as well as patients with different age groups and education levels.

Almost 90% of people with diabetes have type 2 diabetes and the upward trend of this chronic disease is still ongoing, so that after about four decades, this disease is still one of the top 10 causes of death, while half of these deaths occur in people under 60 years of age. Therefore, prevention is essential and the implementation of the most effective intervention approach is required after recognizing at-risk individuals. This study aimed to evaluate the effect of lifestyle modification interventions and metformin on the prevention of type 2 diabetes and improvement in four risk factors related to diabetes.

The study was conducted by searching PubMed, Scopus, Web of science, and Google Scholar without time and language restrictions. Randomized controlled trials which examined the effect of both lifestyle modification interventions and metformin in a population over the age of 18 years with no history of any type of diabetes were included. After the withdrawal of poor quality studies and those withfollow-up time of less than 6 months, structured review and meta-analysis will be performed to calculate the relative risk of type 2 diabetes incidence and mean difference in weight, body mass index, plasma fasting glucose, and hemoglobin A1c. Data analysis was performed using comprehensive meta-analysis software version 2.2.064.

This study will make it possible to choose between two conventional therapeutic approaches (lifestyle modification and metformin) to prevent type 2 diabetes and its impact on four risk factors.

A new sweetener with the commercial name of Lacritose has been recently produced, which is a combination of four simple sugars (lactose, fructose, sucrose, erythritol), with specific ingredients and percentages. This study aimed to assess glycemic response and short term gastrointestinal reactions in type 2 diabetic patients.

In this triple-blind randomized clinical trial, 30 diabetic patients referred to Yazd Diabetes Research Center in 2018 were included. After collecting the primary data, they were assigned into three groups, including sucrose consumers as the control group, sucrose-lactose, and lacritose as the groups of consumers group. They were followed for two weeks, and fasting blood glucose (FBG), 2-hour postprandial test (2HPP), fructose amine, SGOT, SGPT, urea, creatinine, and insulin resistance index (HOMA-IR) were assessed.

In lacritose consumers, significant reductions were seen in FBG and 2HPP (P < 0.001 and P = 0.05, respectively), although changes among the groups were not significant. In sucrose-lacritose consumers, FBG and cholesterol levels decreased (P = 0.04 and P = 0.03, respectively). In sucrose consumers, no reduction was seen. HOMA-IR did not significantly decrease, but intergroup changes were obvious.

The lacritose effects on FBG and 2HPP were significantly evident, but the other metabolic indices did not show any significant change.

Psychiatric problems like suicide, self-harm, and injurious behaviors are important and common in chronic diseases like diabetes. This study aimed to compare suicidal ideations and self-injurious behaviors in patients with type 2 diabetes with and without complications referring to diabetes research center in Yazd, 2017.

In this case-control study, simple random sampling was used. The data were collected using standard questionnaires. Beck Scale for Suicidal Ideation (BSSI) was used to investigate suicidal ideations and Sanson questionnaire was used for self- injurious behaviors. Finally, the collected data were entered into SPSS version 19. Also, t-test was used to compare the means and Chi-square test was used to compare the frequency distributions.

A total of 360 patients were studied in two groups of 180 (complicated and non-complicated). Of these patients, 189 (52.5%) were male and 171 (47.5%) were female. Moreover, only 1 patient (0.3%) had self-injurious thoughts and 1 patient (0.3%) had high suicidal ideations. There was no significant difference between the frequency distribution of self-injurious thoughts and suicidal ideations in the two groups (p=0.371). There was no significant difference between the frequency distribution of self-injurious thoughts and suicidal ideations in the two groups according to the gender (p=0.285, p=0.432).

The results showed that the frequency of self-injurious thoughts and suicidal ideations in type 2 diabetes mellitus patients is low and the complications of the disease do not affect this abundance.

Oxidative stress plays an important role in the onset and progression of diabetic nephropathy. So antioxidant agents may be one of the key treatment strategies for prevention of diabetic nephropathy progression .The aim of this study was to determine the effect of selenium (Se) on micro-albuminuria in type 2 diabetic (T2DM) patients.

This study was a clinical study on 60 T2DM patients with micro-albuminuria who were referred to Yazd diabetic research center from March 2016 till April 2017. Patients were randomized in to two groups: Se (200 microgram Se daily) and control. The control group did not receive placebo. The intervention duration was 12 weeks. Micro-albuminuria, fasting blood sugar (FBS), cholesterol, triglycerides, HDL-C, LDL-C, urea, creatinine, HbA1c, plasma Se concentration were measured at the baseline and after 12 weeks. 

Micro-albuminuria decreased after 12 weeks in both studied groups but it was not statistically significant. Cholesterol and LDL levels improved statistically in both studied groups at the end of study (P-value: 0.034, 0.023 respectively). Plasma Se level increased in intervention group (P-value< 0.001). There were clinically improvement in other studied variables after 12 weeks in two studied groups but not statistically significant

Our study demonstrated that Se supplementation for 12 weeks among patients with micro-albuminuria had no beneficial effects on micro albuminuria.

Insulin resistance (IR) is the major cause in Type 2 diabetes mellitus (T2DM). Expression of some miRNAs can be changed in response to a drug treatment for IR, and used as the biomarker in IR. This study set out to determine the effect of cinnamon extract (cinnamaldehyde) on some miRNAs expression in IR adipocytes.

In this In-vitro study the 3T3L1 cells were expanded in Dulbecco’s modified Eagle’s medium (DMEM), differentiated into adipocytes phenotype and insulin resistant with high glucose medium, then the cells were treated with cinnamaldehyde. To determine of the miRNAs profiling in 3T3L1 adipocytes, insulin-resistant adipocytes and treated insulin-resistant adipocytes quantitative real-time PCR method was performed.

IR adipocytes exhibited a significantly increase in miRs 29a, 223 and 320 expression, and decrease in miR26-b expression in compare to the normal adipocytes
(P-value<0.001 and P-value= 0.024 respectively). However in response to cinnamaldehyde in IR adipocytes, expression of miRs 29a, 223 and 320 were down-regulated while expression of miR26-b was up-regulated neared it to the normal level (P-value= 0.003 and P-value= 0.002 respectively).

IR changes expression of intended miRs, so that cinnamaldehyde treatment helps to improve and normalize the changes. Cinnamon as the herbal product can be helpful for IR particular in adipose tissue.

We conducted this study to compare the psychological effects between diabetic patients taking fast and non-fasting counterparts to better investigate the effects of fasting on mental health of diabetes sufferers.

This study was a prospective cohort conducted among diabetic patients. In this study, two types of fasting and non-fasting patients were invited to take part. During One week before and after the Ramadan, all patients were asked to complete 28-scale General Health Questionnaire (GHQ).

In this study, 116 patients who were suffering from diabetes completed the study. They were compared with each other in format of three groups (two fasting and one non-fasting). Mean changes of total and subscales' score were negative in nearly all groups but there were no significant difference between groups. In addition, total and subscale A, B and C scores significantly increased (positive change) but subscale D score didn’t change in fasting patients during this month.

The results of present study revealed that fasting during the whole month of Ramadan can exacerbate patients' general health in comparison with non-fasting patients. However, because we can't determine whether this finding is attributed to fasting regardless of diabetes or has been resulted from the co-existence of fasting and the disease, it is recommended to design a study to compare diabetic and healthy fasting individuals.

Diabetes mellitus (DM) is a major epidemic public health problem of the 20th century. One of the most common complications of DM is peripheral neuropathy. This complication remains a big unsolved challenge for DM patients, endocrinologists, and nurses. The purpose of this study was to investigate the effectiveness of a warm foot bath on peripheral neuropathy in diabetic patients.

This randomized clinical trial was conducted on 70 diabetic patients at the Yazd Diabetes Research Center, Yazd, Iran. The study population was selected using the convenience sampling technique. They were randomly assigned into two groups of control (receiving routine care) and intervention (receiving routine care plus a warm foot bath). A warm foot bath was administered for 8 sessions lasting 20 min every other day, over 2 weeks. The data collection tool (i.e., a questionnaire) was completed by interviewing and examination in three phases (i.e., before the intervention and two weeks and one month after the intervention). The data were analyzed in SPSS software.

According to results, the mean neuropathy scores were obtained as 7.24, 4.51, and 4.39 before the intervention, two weeks post-intervention, and one month after the intervention, respectively. Based on the physical examination, these values were estimated at 4.09, 3.12, and 2.90 for the mentioned time points, respectively. With regard to the control group, the mean neuropathy scores in the three phases were respectively 7.48, 7.7, and 6.78 based on the history taking and 4.33, 4.7, and 3.84 according to the physical examination. The results revealed a significant difference between the intervention and control groups in terms of the posttest mean neuropathic score (P<0.001).

Considering the mean changes in peripheral neuropathy in diabetic patients, a warm foot bath can be recommended as an effective and simple nonpharmacological and home care intervention. However, it is required to perform further research in this domain.

Diabetes is one of most widespread diseases that disturb the mental and physical health of patients.

The aim of study was searching a therapeutic method to enhance the diabetic’s health by supposing the effectiveness of positive psychotherapy on the well-being and glycemic of patients with type 2 diabetes in Iran.

In a randomized, single-blinded clinical-trial study, from January 2016 to February 2017, a total of 30 type 2 diabetic patients of Yazd Diabetes Research Center, with purposeful sampling method, were selected randomly and put in two groups (Experimental and Control groups). While participants of both groups continued their drug therapy, the experimental group received 10 sessions of 90 minutes (a session per week) group positive psychotherapy while the control group remained on the waiting list. Data were gathered before the intervention and two weeks after intervention. At the end of the treatment sessions three of the experimental group (n = 12) and two of the control group (n = 13) were excluded from the study for their absence in post-test. Data were gathered by demographic form, general well-being questionnaire (GWB), and Glycemic test (HbA1c). SPSS software, version 16 with P = 0.05 level, Kolmogorov-Smirnov (K-S), chi-square, and analysis of covariance (ANCOVA) were used for analyzing data.

The results showed that positive psychotherapy significantly increases mental well-being, and its subscales in comparison with the control group (P < 0.01). Also, other results showed that glycemic in the experimental group in comparison with the control group significantly decreased (P < 0.05).

It can be deduced that positive therapy intervention can be effective in mental well-being and to some extent, blood glucose of diabetics. So, this therapy can be used when diabetic patient’s psychological factors should be carefully considered.

Fatigue is one of the most common causes of disability in most elderly people affected with diabetes. Considering the growing population of this group, the present study aimed to determine the effect of warm foot bath on the fatigue of the elderly people with diabetes.

The randomized clinical trial study was carried out on 66 elderly diabetic patients who had referred to the Diabetes Research Center in Yazd. Eligible participants were selected by convenience sampling and randomly divided into two experimental and control groups. Participants of the experimental group performed a warm foot bathing for 20 minutes during two weeks. The Piper Fatigue Scale was completed in three steps (at the beginning of the study, two and four weeks after intervention). Data were analyzed by SPSS software, using ANOVA for repeated measures, independent t-test, Chi-Square and Fisher exact test.

The mean ± standard deviation of fatigue in the three phases of evaluation in the experimental group was 5.91 ± 0.81, 4.80 ± 1.19, 4.55 ± 1.57 and in the control group was 5.95 ± 0.97, 6.06 ± 1.13 and 5.79 ± 1.33, respectively. The difference in the mean of fatigue scores in both groups after the intervention was significant (p < 0.001).

Revealing the positive effects of warm foot bathing, this method, as a non-pharmacological and easy-to-use method, is recommended to improve fatigue condition in the elderly patients with diabetes.

Both canola and sesame oils consumption have been associated with favorable effects on cardio-metabolic biomarkers. However, to the best of our knowledge, no study has compared their effects on cardiovascular risk factors. The present study aimed to assess the effect of canola, sesame, and sesame-canola oils consumption on cardio-metabolic biomarkers in patients with type 2 diabetes mellitus (T2DM‎). This study was a randomized, triple-blind, three-way, crossover clinical trial. The study participants included 102 individuals with T2DM‎. Their spouses were also included in the study. The participants were entered into a 4-week run-in period. After that, their regular dietary oil was replaced with canola, sesame, or sesame-canola oils (a blend of sesame and canola oils) in three 9-week phases, which were separated by two 4-week washout periods (sunflower oil was consumed during the run-in and the washout periods). Dietary, physical activity, blood pressure, and anthropometric measurements were assessed at the beginning, middle (week 4-5), and end of each treatment phase. Blood samples were taken at the beginning and at the end of each phase. Serum, plasma, buffy coat, and whole blood samples were extracted and kept at -80 ºC for further analysis. Serum fasting blood sugar (FBS), triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol‎ (HDL-C)‎, and low-density lipoprotein cholesterol (LDL-C) were selected as the primary outcomes. 102 participants with T2DM were randomly assigned to one of the 6 rolling methods. Through them, 93 individuals (91.2%) completely participated in all phases. The present study will provide an exceptional opportunity to examine the effect of canola, sesame, and sesame-canola oil on cardio-metabolic markers in adults with and without T2DM‎. This trial will also provide a good medium for the investigation of gene-dietary oils interaction in the future.

The prevalence of overweight and obesity in all age groups, especially in childhood, has become alarming. Identification, intervention, and prevention are important factors affecting it. The purpose of this study was to investigate the association the body mass index (BMI) in children and transportation to school in greater areas of Yazd during 2014 - 2015. This is an analytical cross-sectional study. It was conducted on 2000 primary school students between six to 13 years old who lived in the greater areas of Yazd. Data were collected using a validated questionnaire. Anthropometrics were collected using standardized instruments. In this study, 2000 students were enrolled and 1700 students’ information aged between six to 13 years were recruited completely. About 42% of the participants were male. The mean ± SD age of students was 9.55 (± 1.9) years old. The frequency of normal weight was 56%, overweight was 10.9%, and obesity was 20.6. Students who actively commuted to school had a lower BMI (P = 0.035). The results of this study showed that the way students can travel could affect their BMI. The use of vehicle was higher in obese and overweight students.

Anti-Müllerian hormone (AMH) is made by the granulosa cells of preantral and small antral follicles which blocks the transition from the primordial to the primary follicular stage. Metformin may be associated with a decrease in AMH serum level and antral follicles in women who suffer from polycystic ovary syndrome (PCOs) It was reported that metformin in women with polycystic ovary syndrome (PCOs) is associated with a decrease in both AMH serum level and antral follicles. The objective of the current letter was the evaluation of the effects of metformin on hormonal profile of women with PCOs. In this prospective, randomized, doubleblind controlled clinical trial, 42 women (aged 17–45 yr) with PCOs who were randomly allocated to receive 500 mg Metformin orally three times a day or placebo for three months were included. Fasting plasma glucose, follicular stimulating hormone, luteinizing hormone (LH), prolactin (PRL), testosterone and AMH levels were measured at baseline and at the end of the period. In this study, independent and paired t-test were used for quantitative comparison and chi-square analysis for qualitative variables. Logistic regression analysis was done to identify independent risk factors, and Pvalue of lower than 0.05 were considered significant. All of the statistical analyses were done by SPSS software, version 20.0. We didn’t find any significant change after the study between treatment and control groups in hormonal profiles especially AMH. However, in subgroup analysis, we revealed that AMH and LH levels decreased significantly in normal weight patients (p= 0.024, 0.048, respectively) and prolactin levels in subgroup of overweight patients (p= 0.001). Moreover, patients in metformin group at the end of study had more regular menses, more weight loss, and lower hair loss (p= .001, 0.04, 0.014, respectively). Women with PCOs have elevated levels of LH that is secondary to increased sensitivity of pituitary to GnRH. Increased levels of LH lead to hyperandrogenism. Metformin can improve this condition. In this study, we observed that LH was decreased significantly in the metformin group of PCOs patients (p= 0.05). It is in agreement with some of the previous studies, however, De Leo and et al. reported a non-significant decrease in LH levels after treatment with metformin (1). Pieces of evidence showed that AMH levels in PCOs patients are 2 to 3 times higher than age-matched normal women (2), and this condition is a marker for PCOs and can be a surrogate test of hyperandrogenism (3). Metformin in our study improved the irregularity in the menstrual cycle (p< 0.001), hair loss (p= 0.014), and prolactin secretion (p= 0.024), as well as LH secretion (p= 0.05); however, it didn’t show any significant decrease on AMH levels. Metformin can reduce ovarian volume in PCOs patients especially in hyperinsulinemic subgroups (4); however, we observed that in normal weight subgroup of patients, metformin decreased AMH significantly (p= 0.024), and in overweight or obese patients, prolactin decreased in response to metformin, significantly (p= 0.001). Moreover, metformin leads to improvement in follicular development with fewer percentage of preantral follicles and cysts and higher percentages of antral follicles (5). Considering these pieces of evidence, it seems that AMH after metformin treatment in PCOs patients was secret in comparable amounts of pretreatment; however, the source of secretion after starting metformin is different from pretreatment and switched from small follicles and cysts to more developed follicles and structures such as antral follicles and corpora lutea. Further investigations that can differentiate secreted AMH from a different source will shed more light on this field. The most important limitation of our study is the small sample size. GI side effects of metformin caused some patients in metformin group to refuse getting the treatment. Studies with more attendants can display the difference between different phenotypes of PCOs patients in response to metformin. In conclusion, this study showed that metformin can cause favorable effects on the hormonal profile of PCOs patients, and although AMH levels were not decreased significantly, menstruation improved in the treated group. The most important limitation of our study is the small sample size. GI side effects of metformin caused some patients in metformin group to refuse getting the treatment. Studies with more attendants can display the difference between different phenotypes of PCOs patients in response to metformin. In conclusion, this study showed that metformin can cause favorable effects on the hormonal profile of PCOs patients, and although AMH levels were not decreased significantly, menstruation improved in the treated group.

There are changes in plasma glucose and HbA1c of type 2 diabetes mellitus (T2DM) patients in different seasons. HbA1c levels may increase during winter season in most T2DM patients without weight gain. In this study, we described the seasonal changes of HbA1c levels in T2DM patients. This analytical cross-sectional study conducted from 2013 to 2017 on 402 patients with T2DM, aged 20–80 years old who referred to Yazd diabetic research center. Body weight, height, waist circumferences (WC), blood pressure (BP), body mass index (BMI), fasting plasma glucose (FPG), 2 hours post-prandial (2hpp), and HbA1c measured and compared during four seasons. Four hundred and two T2DM patients invited and fulfilled this study. Most of them (56%) were women. The mean age of patients was 58.96 (± 11.10) years old. The mean HbA1c, 2hpp, systolic and diastolic blood pressure were significantly different in four seasons (P-value respectively: 0.022, 0.007, 0.001 and 0.005). The mean difference of HbA1c was significant in the warm and cold seasons (P-value: 0.047). The percentage of people who were below 7% had a significant difference between the warm and cold seasons (P-value: 0.015). The results of this study showed that, in Yazd with desert climate, postprandial hyperglycemia is more prominent in summer. The seasonal changes of glycemic status are an important factor in management of T2DM patients.

Gestational diabetes mellitus (GDM) is known as a degree of glucose intolerance that occurs for the first time during pregnancy. There is paucity of evidence regarding the effect of oat bran on GDM. Oat as a source of β-glucan can be effective in reducing the blood sugar levels. This study aimed to investigate the effect of oat bran on fasting blood sugar (FBS) and glycosylated hemoglobin (HbA1c) in patients with GDM. This single-blind clinical trial was conducted on 90 pregnant women with GDM. The experimental group (EG) consumed 30 g of oat bran daily with 100 g of low-fat yogurt before lunch and dinner for 4 weeks. The control group (CG) consumed only low-fat yogurt and both groups received nutrition counseling. The present study investigated the FBS, HbA1c, and weight gain at the beginning and after four weeks of intervention. Out of 90 patients, 80 completed the study. FBS decreased in the EG (P = 0.04, -2.75 ± 8.22), whereas, it increased in the CG (P = 0.003, 4.37 ± 8.72). No significant difference was observed between the two groups in terms of HbA1c levels. Weight gain was controlled more efficiently in the EG than the CG (P = 0.001). The use of oat bran for four weeks decreased the FBS,; whereas, it did not affect HbA1c levels. Weight gain was controlled better in the EG than the CG.

  Taking into consideration the high impact of Diabetes Mellitus type II (DM II) on human's health, identification of risk factors to prevent its development seems essential. Further studies are needed to ensure the positive role of uric acid in the onset of diabetes. This study targeted at investigating the attributed risk of hyperuricemia for the onset of DM II. In the present study, 1641 non-diabetic people, selected through multi-stage random cluster sampling, were followed up for 10 years (2006 - 2016). During the study, data on the variables of the study were collected and entered in SPSS 16 which was used to analyze the data. To calculate the attributions of hyperuricemia in the risk of developing diabetes, Levin's formulas and attributable risk related to the prevalence of exposure during these ten years were used. Findings showed that 54.8% of people with hyperuricemia suffered from DM II., whereas 28.2% of people with normal uric acid level developed diabetes. The Attributable Risk (AR) of hyperuricemia and 75th percentile of serum uric acid for DM II were calculated by the weighted attributable risk formula which was 3.6 % and 24.2 %, respectively. With the treatment of high uric acid, the probability of the incidence of diabetes in hyperuricemia patients was reduced to 24.2% over a 10-year period. In this study, there was a significant correlation between high uric acid level and the risk of diabetes. Therefore, necessary measurements should be taken to treat the hyperuricemia patients in order to prevent the incidence of diabetes caused by high blood acid uric.

Remote Ischemic Preconditioning (RIPC) as the transient ischemia and reperfusion of the arm is a promising method for protecting different tissue from future ischemia. These effects might be mediated through vascular and endothelial growth factor (VEGF) pathway. We investigated the influence of RIPC on diabetic macular edema (DME) as a chronic ischemic condition in patients who were candidate to receive anti-VEGF therapy. In this Single blinded, randomized controlled trial, 40 eligible type 2 diabetes mellitus (T2DM) patients with macular edema who were candidate to receive anti-VEGF therapy randomized into intervention (CP) and sham controlling (SP). The CP received RIPC in three consecutive days before anti-VEGF injection. Data of optical cochrane tomography (OPC) before and 10 days after procedure were compared as outcomes. Central foveal volume and visual acuity mean difference before and after intra-vitral anti-VEGF injection in both groups was significant. There were no significant mean differences in central macular thickness in case groups. Comparing the mean between two groups did not show a significant difference in visual acuity, central foveal volume (P-value: 0.69) and central macular thickness (P-value: 0.62). There were no significant differences in the desired changes pattern of DME between two groups (P-value: 1.00). This pilot study did not show any additive positive effect of RIPC on retinal outcomes especially visual acuity in T2DM patients with DME who were received anti-VEGF treatment.

According to traditional beliefs, chamomile products have anti-depression effect. The aim of this study was to investigate the effects of chamomile tea on glycemic control, depression status and lipid profiles in type 2 diabetes (T2D) with depression.
This randomized clinical trial was carried out on 74 depressed patients with T2D. Participants were randomly divided into two 37-people groups, chamomile tea (CG) and black tea group (BG). The CG received 3 cups of chamomile tea daily and the BG received 3 cups of black tea daily half an hour after meals for 12 weeks. To examine the status of depression, Beck II test was utilized. Anthropometric measurements, 24-h dietary recalls, glycosylated hemoglobin A1c (HbA1c) and blood lipids profile were measured at the baseline and at the end of the intervention.
The HbA1c mean was significantly reduced in CG after the intervention, when compared with BG (7.15 ± 1.23% vs. 7.98 ± 1.76%, P = 0.02). In the same vein, the mean changes in CG and BG were -0.74 ± 1.29 and 0.04 ± 1.07 (P = 0.006), respectively. No significant changes were observed in mean of serum lipids within and between groups. The Beck score also showed a significant reduction in the CG after the intervention (P The results of this study demonstrated that drinking three cups of chamomile tea daily for 12 weeks by T2D suffering from depression lead to improve glycemic control and depression state. Therefore, drinking this kind of tea by these patients is recommended

Diabetes is a chronic disease that influences mental and physical health. Regarding the importance of diabetic patients’ psychological status, this research studied the effect of group positive psychotherapy on life expectancy and general health of type 2 diabetic patients.
This clinical-trial study was done on 30 type 2 diabetic patients in Kermanshah diabetes research center. The experimental and control groups were randomly selected. Data were gathered before and 10 weeks after intervention. Demographic, life expectancy and general health (GHQ) questionnaires were used for gathering data. SPSS-16 and Kolmogorov-Smirnov (K-S), Chi-square and analysis of covariance (ANCOVA) were used for analyzing data.
Results showed that group positive psychotherapy caused significant enhancement on life expectancy in intervention group than control group (P-value: 0.001). Although positive psychotherapy caused significant reduction on anxiety disorder and somatic symptoms in mental health, there was no significant difference of general health between two groups (P-value: 0.347).
Positive psychotherapy was effective on increasing diabetic patients’ life expectancy. So this efficient psychotherapy can be used for increasing type 2 diabetic patients’ life quality.

Obese and overweight women are more prone to gestational diabetes. Body mass index and weight gain during pregnancy play an important role in pregnancy and is considered as an important indicator of maternal and neonatal health. Because the prevalence of obesity in Yazd is remarkable, we studied the relationship between gestational diabetes with Pre-pregnancy BMI and weight gaining during pregnancy in pregnant women in Yazd.
This case-control study was conducted on 336 pregnant women who had just given birth, who they consisted of 168 pregnant women with gestational diabetes and 168 healthy pregnant women as case and control group, respectively. We gathered data from the information recorded in the health information system. In this study, Chi-square, independent t-test, and correlation test were used to analyze the data by using the SPSS23 software.
The present study showed that the average pre-pregnancy BMI and the average weight gaining during pregnancy until screening for gestational diabetes were significantly higher in cases than controls (P Since BMI is one of the modifiable risk factors, we should give all women good training on the quality of their diet for having proper weight before pregnancy and appropriate weight gain during pregnancy.

Gestational Diabetes Mellitus (GDM) is an important condition in diabetes categories causing significant complications including pre-eclampsia and eclampsia among pregnant women. The aim of this study was to estimate the trend of annual GDM incidence and its risk factors in Yazd province, Iran, from 2008 to 2013.
The present study was conducted as a prospective cohort study in which all pregnant women who had attended primary health care centers were screened for GDM. Annual GDM incidence was calculated for all and also according to 5-year age groups and residential area (urban/rural). Secular trends for GDM incidence and its risk factors were also evaluated.
In this study, 67320 pregnant women were screened for GDM and 5425 pregnant women were diagnosed as GDM with 6-year incidence of 8,6%. Annual incidence of GDM increased from 3.1% in 2008 to 18.9% in 2013. Assessment of crude and age-adjusted incidence across the years of follow up revealed incremental secular trend (P-value Clinicians should have specific regard to pregnant women with some risk factors for timely diagnosis and treatment. Meanwhile returning to previous life style of rural area can help to decrease GDM incidence.

Remote ischemic preconditioning (RIPC) is a phenomenon where a short period of ischemia in one organ protects against further ischemia in the other organs. We hypothesized that RIPC occurring in diabetic patients with ankle brachial index (ABI) between 0.70 and 0.90 were included with peripheral arterial disease, would make the better coronary flow resulted in the increasing ABI.

This randomized clinical trial study was done in the Afshar Cardiovascular Hospital in Yazd between 2013 and 2014. Sixty participants were randomly divided into two groups (intervention and control groups). The intervention group was undergoing RIPC, and the control group was tested without RIPC. RIPC was stimulated by giving three cycles of 5 min of ischemia followed by 5 min of reperfusion of both upper arms using a blood pressure cuff inflated to 200 mm Hg (n = 30). This was compared with no RIPC group which consisted of placing a deflated blood pressure cuff on the upper limbs (n = 30).

The mean of ABI level before intervention in the RIPC and control group group was 0.82 ± 0.055 and 0.83 ± 0.0603 (P = 0.347) respectively, with no significant difference. It was 0.86 ± 0.066 in the RIPC group compared the control 0.83 ± 0.0603 (P = 0.046). So levels of ABI were greater after intervention in the RIPC group. The mean of ABI level increase from 0.82 ± 0.05 to 0.86 ± 0.06 in RIPC group (P = 0.008). So the intervention group showed a significant increase in ABI.

RIPC through using a simple, noninvasive technique, composing three cycles of 5 min‑ischemia of both upper arms, showing a significant increase in ABI level in diabetic patients.

Diabetes mellitus is a common endocrine disease . The number of people with diabetes over the last twenty years has doubled . Asia as a result of rapid economic growth , as the center of the epidemic in the world . Iran is among the countries with a high prevalence of diabetes mellitus . Use of medicinal plants as adjunctive therapy along with medication always been original . In recent years the tendency of patients to alternative therapies and traditional medicine has increased.
Among patients referred to clinics of University of Medical Sciences, Yazd, Iran , 67 people were selected and randomly divided into two groups,intervention or placebo. Patients in the intervention group received 3 tablets of 300 mg bee propolis and in the control group received placebo . The study lasted 12 weeks . Serum insulin and insulin resistance index were evaluated at the beginning and end of the study.
57 patients completed the study . The average demographic characteristics , anthropometric indices , serum insulin and insulin resistance index at the beginning and end of the study between the two groups showed no significant difference.
In this study , supplementation with bee propolis for 12 weeks , on the serum insulin and indices of insulin resistance in patients with type II diabetes is not effective . Further studies are needed to make a final decision.