فهرست مطالب ozra tabatabaei malazy

Type 1 diabetes mellitus (T1DM) is a prevalent chronic disease among children and adolescents, necessitating effective self-monitoring of blood glucose (SMBG) levels. Understanding the determinants and factors influencing SMBG behavior is crucial for optimizing diabetes management in this population.

This study aimed to investigate the frequency of SMBG and identify the determinants influencing factors in children and adolescents with T1DM.

This cross-sectional study was conducted in Tehran, Iran, and included 275 participants selected through simple random sampling from the Gabric Diabetes Education Association. The inclusion criteria comprised children and adolescents aged 3 - 18 years diagnosed with T1DM for at least 6 months who were using analog or neutral protamine Hagedorn (NPH) and regular insulin subcutaneously. Patients using insulin pumps were excluded. Data collection involved an online questionnaire covering demographic information (e.g., age, gender, educational status, and parental occupations) as well as clinical information (number of hypoglycemic episodes, hemoglobin A1C (HbA1C) levels, diabetes duration, insulin regimen, diabetes complications, glucose monitoring practices, hospitalizations, and behavioral characteristics). Statistical analyses, including descriptive statistics, correlation tests, and Poisson regressions, were performed using SPSS software (version 21). A significance level of P-value < 0.05 was considered statistically significant.

The participants had a mean age of 10.00 ± 3.77 years, with 54.2% being males. Most of the participants (87.3%) were students, and the mean age of diagnosis was 6.56 ± 3.73 years, with a mean duration of 44.72 ± 36.32 months. Anthropometric investigations revealed mean height, weight, and body mass index (BMI) values of 136.69 ± 21.11 cm, 37.45 ± 15.51 kg, and 18.31 ± 3.55 kg/m2, respectively. The majority of participants (93.5%) used insulin pens, and the mean daily insulin dosage was 35.34 ± 22.20 IU. Parents reported consistent glucose level monitoring in 64.7% of cases. The mean HbA1c level was 7.91 ± 1.58%. Factors such as the price and availability of glucometer strips influenced glucose level monitoring. In univariate analysis, only age and HbA1C levels showed a negative correlation; however, parents’ consistent checking showed a positive correlation with the frequency of daily, weekly, or monthly glucose checking.

This study underscores the significance of SMBG in children and adolescents with T1DM. The findings emphasize the critical role of price and availability of glucometers and strips in achieving standard care for T1DM patients.

Due to the worldwide spread of COVID-19, various countries have designed scientific studies on different aspects of the disease. Patients with diabetes mellitus (DM) have been proven to be at higher risk of COVID-19-related complications, hospitalization, and death.

The aim was to conduct a scientometric analysis of scholarly outputs on diabetes and COVID-19.

Web of Science was searched for scientific publications on diabetes and COVID-19 by Middle Eastern researchers until September 14, 2021. Collected data were analyzed for document type, subject area, countries, top journals, citation number, and authors’ collaboration network using VOS viewer 1.6.15 and bibliometrix R-package 4.1.1.

Overall, the characteristics of 603 documents on DM and COVID-19 were analyzed. The top three productive countries in the field were Iran, Turkey, and Saudi Arabia. The top affiliation was from Iran; “Tehran University of Medical Sciences” (n = 168), followed by "Shahid Beheshti University of Medical Sciences" (n = 82). The total citation number was 3704 times. The highest cited paper (348) was a systematic review from Iran, published in arch Acad Emerg Med. The top source was "Diabetes & Metabolic Syndrome: Clinical Research & Reviews," with 26 documents.

The current study provides an overview of the quantity and quality of published scholarly documents on the intersection of DM and COVID-19 in the region. Our findings help scientists find the existing gaps, manage the research budgets, identify active authors and scientific institutes to collaborate with, and use their experience to produce new knowledge in the future.

One of the most widely used anti-diabetic drugs is sulfonylureas, which is often used as one of the first-line drugs in the treatment of type 2 diabetes. Due to the effect of the patient's genetic structure on the drug response (personalized medicine), the identification of genetic variations not only reduces the rate of adverse drug reactions but can also predict the effectiveness of drugs. This study aimed to systematically review the pharmacogenomics of glibenclamide in type 2 diabetes.

This systematic review was performed based on PRISMA flowchart. Using the search terms including "variant", “sulfonylurea”, "glibenclamide", "diabetes mellitus", "SNP" or their equivalents, a comprehensive search of the PubMed, Scopus and Web of Science databases was conducted until January 1, 2021. An initial search yielded 125 articles.

Finally, in nine articles included in this systematic review, glibenclamide monotherapy was performed in 3032 patients. Most studies were conducted in China and the most common methods of genotyping were RFLP-PCR and direct sequencing. The most common genes studied were CYP2C9, KCNJ11 and TCF7L2. The results of studies showed a significant effect of CYP2C9 polymorphism on appropriate therapeutic response and KCNJ11 gene polymorphism on failure of glibenclamide treatment.

Among all genetic factors and specific genotypes of proteins involved in the metabolism of glibenclamide, CYP2C9 gene polymorphism has a role in proper response to treatment and KCNJ11 gene polymorphism has a role in treatment failure and hypoglycemic effects of glibenclamide.

Context:

 Prevalence of metabolic disorders, type 2 diabetes mellitus (T2DM), dyslipidemia, obesity, metabolic syndrome (MetS), and osteoporosis has been increased. Herbal medicine is an accessible, safe, and low-cost option in managing and caring for metabolic disorders. We conducted a bibliometric analysis of global scientific productions in herbal medications and metabolic disorders in the Middle East countries.

Study Selection: 

Our search terms were “diabetes”, “dyslipidemia”, “obesity”, “osteoporosis”, “metabolic syndrome”, “herb”, and “herbal medicine” in Middle East countries through the Scopus database until January 2020. We analyzed the data regarding publication year, main journal, geographical distribution, document type, subject area, co-authorship network, the h-index of citations by Scopus analysis tools, Visualizing Scientific Landscapes (VOSviewer) version 1.6.4, and SPSS version 15.

 Among 6408 global publications, most of the papers (> 85%) were original articles, and mostly (44.26%) were about dyslipidemia. A significant time-trend was shown in the number of documents (P < 0.001), mostly in 2019. Medicine and pharmacology were subject areas in > 80% of papers. The top country in the global publication number was Iran. The highest cited papers in dyslipidemia, obesity and osteoporosis were original articles from Turkey and Egypt, but in T2DM and MetS the highest cited paper was a review article from Iran. The top sources were “Phytotherapy Research” and “the Journal of Ethnopharmacology”. The top institutes were from Egypt, Iran, and Saudi Arabia and the principal author in the co-authorship network assessment was from Iran.

 The time-trend growth in producing scholarly papers in the studied disorders is appreciated, but more evidence-based articles are still needed.

Gastrointestinal symptoms along with respiratory symptoms recorded in patients with Covid-19 indicate the role of microbiota in this disease. The purpose of this scientometric study was to assess the articles published on the relationship between microbiota and Covid-19 in order to control the pandemic by reaching new strategies.

Relevant articles were searched in Scopus database by titles and abstracts, published from January 1 to October 15, 2020. Data analysis was performed by analysis tools available in Scopus database, SPSS and VOSviewer network analysis version 1.6.15.

Overall, 87 papers were included. The most productive time was July in which 20 articles were published. The top subject area was medicine (n=66 papers). The first productive country was the USA (24.14%), and the top institute was the Chinese University of Hong Kong (8.54%) in China. The top source was the Lancet Gastroenterology and Hepatology journal that published 8.05% of the articles. Total number of citations were 401 and their H‑index was 9. Top author and top country in the co-authorship network assessment or international collaboration were from China and the USA, respectively. From the Middle East, six articles were published on microbiota and Covid-19 by Iran, Jordan, Qatar, and Turkey and the highest cited article (5 times) was  from Jordan.

Some research has been carried out to investigate the role of microbiota in developing Covid-19. However, further studies are needed to clarify this role.

Non-Communicable Diseases (NCDs) are the major cause of premature death and disability due to diseased globally, imposing a heavy burden on the health systems. Four main categories of NCDs are cardiovascular diseases, neoplasms, diabetes, and chronic respiratory diseases. Iran, the second greatest country in the Middle East Region, has been through an important transition period of communicable diseases toward NCDs in the last decades. One of the effective approaches to control NCDs is implementation of population-based studies and interventions, trying to reduce risk factors and incidence of NCDs through investigations in the populations. Endocrinology and Metabolism Research Institute (EMRI) and Non-Communicable Diseases Research Center (NCDRC) are the pioneers trying to study and control various NCDs during the last decades in Iran. In this review, we are going to inspect some of the major completed and ongoing projects of this research institute to highlight valuable efforts to reduce burden of NCDs in Iran, and make a successful example for national and regional public health policy makers and authorities.

Due to high cost and burden of osteoporosis, it is reasonable to focus on the reduction of fractures as the main goal of treatment. We compared the efficacy and safety of a new biosimilar recombinant human parathyroid hormone (CinnoPar®, CinnaGen, Iran) to the reference product (Forteo®, Eli Lilly, USA) in a randomized double-blind clinical trial (RCT).
Overall, 104 osteoporotic postmenopausal women aged 45-75 yr were randomized to receive 20 µg daily subcutaneous injections of either Forteo® or CinnoPar® for 6-months from 2011-2012. Bone biomarkers were measured at baseline, and during first, third, and sixth month's follow-up along with lumbar spine, total hip, and femoral neck bone mineral density (BMD) assessment at the baseline and six months after that. The study was registered in Iranian registry of clinical trials under the registration number of IRCT138810121414N5. The endpoints were to compare bone biomarkers, BMD and drug safety between groups. Data analysis was performed using SPSS 11.
Age range of ninety-four patients who completed the study was 42-81 yr. Participants were divided into Forteo (45 subjects) and CinnoPar (49 subjects) groups. No significant difference in terms of bone biomarkers or BMD scores was shown between groups (P≥0.05). The most prevalent side effects were hypercalcemia and hypercalciuria without any significant statistical differences between groups.
CinnoPar® can be considered as a good alternative therapy for Forteo® in postmenopausal osteoporotic women due to its comparable efficacy and safety properties.

Diabetes mellitus (DM) is one of the most important health problems with increasing prevalence worldwide. Oxidative stress that is a result of imbalance between reactive oxygen species (ROS) generation and antioxidant defense mechanisms has been demonstrated as a main pathology in DM. Hyperglycemia-induced ROS productions can induce oxidative stress through four major molecular mechanisms including, the polyol pathway, advanced glycation end-products formation, activation of protein kinase C isoforms, and the hexosamine pathways. In development of type 2 DM (T2DM) and its complications, genetic and environmental factors play important roles. Therefore, the aim of this review is to focus on assessment of single-nucleotide polymorphisms within antioxidant enzymes including superoxide dismutase, catalase, glutathione peroxidase, glutathione-S-transferase, nitric oxide synthase, and NAD(P)H oxidase and their association with T2DM. The results will be helpful in understanding the mechanisms involved in pathogenesis of disease besides discovering new treatment approaches in management of DM.

More than 80% cardiovascular disease (CVD) is preventable despite the fact that it is currently the ultimate cause of disability in the world. Assessment of the nationwide prevalence of dyslipidemia as a major CVD risk factor is essential to efficiently conduct prevention programs. We extracted data according to the cut‑off points of dyslipidemia used in each study. All published papers on this topic in Iranian and international journals with affiliation of “Iran” were reviewed using standard keywords up to September 2011. We included all available population‑based studies and national surveys conducted in individuals aged ≥ 15 years. We excluded studies with < 300 individuals, non‑population‑based studies, or duplicated citations. We analyzed by random effect method due to between‑study heterogeneity. The estimated prevalence and 95% confidence intervals in 29 eligible articles and one un‑published data for hypercholesterolemia (≥200 mg/dl),hypertriglyceridemia (≥150 mg/dl), high levels of low density lipoprotein cholesterol ([LDL‑C] [≥ 130 mg/dl]) and low levels of high density lipoprotein cholesterol ([HDL‑C] <40 mg/dl in males, <50 mg/dl in females), in Iranian people were 41.6% (36.1‑47.0), 46.0% (43.3‑48.7), 35.5% (24.0‑47.1) and 43.9% (33.4‑54.4), respectively among both sexes and in both rural and urban areas. Hypercholesterolemia, high LDL‑C and low HDL‑C were more prevalent in women, whereas hypertriglyceridemia was more prevalent in men. All types of lipid component abnormalities were more prevalent in urban residents. Prevalence of dyslipidemia is considerable in Iran. It is necessary to enforce current measures of dyslipidemia control in the Iranian people to reduce CVD burden.

Little is known about the degree of utilization of information resources on diabetes by general practitioners (GPs) and its impact on their clinical behavior in developing countries. Such information is vital if GPs’ diabetes knowledge is to be improved. This cross-sectional study recruited 319 GPs in the summer of 2008. Questions were about the updates on diabetes knowledge in the previous two years, utilization of information resources (domestic and foreign journals, congresses, the Internet, reference books, mass media, and peers), attitude toward the importance of each resource, and impact of each resource on clinical behavior. A total of 62% of GPs had used information resources for improving their knowledge on diabetes in the previous two years. Domestic journals accounted for the highest utilization (30%) and the highest importance score (83 points from 100); with the importance score not being affected by sex, years elapsed after graduation, and numbers of diabetic visits. Clinical behavior was not influenced by the information resources listed; whereas knowledge upgrade, irrespective of the sources utilized, had a significantly positive correlation with clinical behavior. Domestic journals constituted the main information resource utilized by the GPs; this resource, however, in tandem with the other information resources on diabetes exerted no significant impact on the GPs’ clinical behavior. In contrast to the developed countries, clinical guidelines do not have any place as a source of information and or practice. Indubitably, the improvement of diabetes knowledge transfer requires serious interventions to improve information resources as well as the structure of scientific gatherings and collaborations.

Diabetes among Eastern Mediterranean (EM) population above age of 20 years is around 10.5% and is ranked among the leading causes of blindness, renal failure and lower limb amputation. While 50% of EM people with diabetes will die of cardiovascular diseases. This means that in our region, there are pandemic trends in prevalence of diabetes and associated complications. Globally, people with diabetes are 25 times more likely to have a leg amputated than those without the condition, and up to 70% of all leg amputations happen to people with diabetes. Somewhere in the world, a leg is lost to diabetes every 30 seconds. Foot ulcer is the most common single precursor to lower extremity amputations among diabetics. Hyperglycemia, impaired immunologic responses, neuropathy, and peripheral arterial disease are the major predisposing factors leading to limb-threatening diabetic foot infections. Diabetic foot represents a health problem and economic burden among majority of EM Countries. Infection in a diabetic foot is limb-threatening and must be treated empirically and aggressively. Treatment of infected foot wounds is the most common reason for diabetes- related hospitalization. The good news is that up to 85 percent of diabetic amputations can be prevented. As to above challenge, the best approach for EMR is education, community awareness and prevention of diabetic foot. The public approach and education that emphasize on proper footwear and foot care are best preventive and cost-effective modalities that can be easily implemented among EM Countries. EM Countries need to strengthen national health services that promote the concept of prevention and tight control of diabetes in order to prevention diabetes complications. This also necessitates building/strengthening diabetes registry and complications.

Pump therapy (CSII) is offered as a safe and effective treatment for patients with type 1 Diabetes. We examined the efficacy and safety of continuous subcutaneous Insulin Infusion Therapy for six months as a before-after clinical trial study among type 1 diabetic patients. This is the first survey of this experience in Iranian patients. We recruited, type 1 diabetic patients without chronic complications of diabetes (retinopathy, nephropathy and etc.) and followed them for six months as a before-after clinical study with use of the pump. The efficacy of this way was assessed with HbA1C and fasting blood sugar measurements. Safety was estimated by frequency of clinical hypoglycemia episodes. Our patients were 7 men and 2 women aged 15 - 39 years with past history of diabetes by ranging from 0.1 to 15 years. Mean level of HbA1C at the beginning of study and after six months follow-up were %8.6 and %7.1, respectively, with significant statistically difference between them (P= 0.02). During pump therapy the mean dose of insulin were decreased to 10 units with statistically significant difference to before investigation (P = 0.03). No case of hypoglycemia and weight loss was seen. One patient had 4 kg weight gain without any significant statistical effect. It seems CSII Therapy in Iranian patients with type 1 Diabetes mellitus was effective and safe. We can not conclude about possible side effects of pump based on this study.

Diabetes among Eastern Mediterranean (EM) population above age of 20 years is around 10.5% and is ranked among the leading causes of blindness, renal failure and lower limb amputation. While 50% of EM people with diabetes will die of cardiovascular diseases. This means that in our region, there are pandemic trends in prevalence of diabetes and associated complications. Globally, people with diabetes are 25 times more likely to have a leg amputated than those without the condition, and up to 70% of all leg amputations happen to people with diabetes. Somewhere in the world, a leg is lost to diabetes every 30 seconds. Foot ulcer is the most common single precursor to lower extremity amputations among diabetics. Hyperglycemia, impaired immunologic responses, neuropathy, and peripheral arterial disease are the major predisposing factors leading to limb-threatening diabetic foot infections. Diabetic foot represents a health problem and economic burden among majority of EM Countries. Infection in a diabetic foot is limb-threatening and must be treated empirically and aggressively. Treatment of infected foot wounds is the most common reason for diabetes- related hospitalization. The good news is that up to 85 percent of diabetic amputations can be prevented. As to above challenge, the best approach for EMR is education, community awareness and prevention of diabetic foot. The public approach and education that emphasize on proper footwear and foot care are best preventive and cost-effective modalities that can be easily implemented among EM Countries. EM Countries need to strengthen national health services that promote the concept of prevention and tight control of diabetes in order to prevention diabetes complications. This also necessitates building/strengthening diabetes registry and complications.

Pump therapy (CSII) is offered as a safe and effective treatment for patients with type 1 Diabetes. We examined the efficacy and safety of continuous subcutaneous Insulin Infusion Therapy for six months as a before-after clinical trial study among type 1 diabetic patients. This is the first survey of this experience in Iranian patients.
We recruited, type 1 diabetic patients without chronic complications of diabetes (retinopathy, nephropathy and etc.) and followed them for six months as a before-after clinical study with use of the pump. The efficacy of this way was assessed with HbA1C and fasting blood sugar measurements. Safety was estimated by frequency of clinical hypoglycemia episodes.
Our patients were 7 men and 2 women aged 15 - 39 years with past history of diabetes by ranging from 0.1 to 15 years. Mean level of HbA1C at the beginning of study and after six months follow-up were %8.6 and %7.1, respectively, with significant statistically difference between them (P= 0.02). During pump therapy the mean dose of insulin were decreased to 10 units with statistically significant difference to before investigation (P = 0.03). No case of hypoglycemia and weight loss was seen. One patient had 4 kg weight gain without any significant statistical effect.
It seems CSII Therapy in Iranian patients with type 1 Diabetes mellitus was effective and safe. We can not conclude about possible side effects of pump based on this study.

Metformin is usually using for glycemic control in type 2 diabetes mellitus. The drug is the first line for obese patients without renal or liver failure. Different pharmaceutical types of Metformin are available. As a clinical trial, we compared effects of Aria Metformin (product of Aria pharmaceutical company, Iran) with Merck Metformin or Glucophage (product of Merck pharmaceutical company, France), in diabetic patients. This double blind randomized clinical trial study performed with 60 non- pregnant diabetic patients, in order to comparison of therapeutic effects of combination therapy (Glibenclamide + Metformin "Aria or Merck") in a 12 weeks period. We evaluated FBS, BS 2hpp, HbA1c, lipid profile, liver function tests, weight, BMI and common or uncommon side effects. Not only each of two pharmaceutical types of Metformin had the same therapeutic effects for controlling of glycemia, lipid profile and weight, but also there were not difference between them in side effects. Distention was the most common side effects of two types products (33%). There is not significant difference between them in common side effects. 70% of patients were satisfied with each two kinds of Metformin. It seems, in view of beneficial therapeutic effects of Aria Metformin, low rate of side effects, and finally low cost, Aria Metformin is a good choice.

Metformin is usually using for glycemic control in type 2 diabetes mellitus. The drug is the first line for obese patients without renal or liver failure. Different pharmaceutical types of Metformin are available. As a clinical trial, we compared effects of Aria Metformin (product of Aria pharmaceutical company, Iran) with Merck Metformin or Glucophage (product of Merck pharmaceutical company, France), in diabetic patients.
This double blind randomized clinical trial study performed with 60 non- pregnant diabetic patients, in order to comparison of therapeutic effects of combination therapy (Glibenclamide Metformin "Aria or Merck") in a 12 weeks period. We evaluated FBS, BS 2hpp, HbA1c, lipid profile, liver function tests, weight, BMI and common or uncommon side effects.
Not only each of two pharmaceutical types of Metformin had the same therapeutic effects for controlling of glycemia, lipid profile and weight, but also there were not difference between them in side effects. Distention was the most common side effects of two types products (33%). There is not significant difference between them in common side effects. 70% of patients were satisfied with each two kinds of Metformin.
It seems, in view of beneficial therapeutic effects of Aria Metformin, low rate of side effects, and finally low cost, Aria Metformin is a good choice.