saeedeh jam ashkezari

Diabetes is a non -communicable disease. The patient satisfaction with treatment is a key point of patient’s compliance. Definitive treatment for patients with type 1 diabetes is lifelong insulin injections, but type 1 diabetic patients are commonly in poor glycemic state due to poor compliance. Therefore, it is necessary to check insulin treatment satisfaction in this population. Therefore, the main purpose of this study was to evaluate the satisfaction of insulin treatment in patients with type 1 diabetes in Yazd.

In this cross -sectional study, 114 patients with type 1 diabetes participated. Persian version of Insulin Treatment Satisfaction Questionnaire (ITSQ) used. All analyzes were performed by SPSS 22.

The overall satisfaction mean score in this study was 49.72(± 8.88). Insulin treatment satisfaction score had a significant positive correlation with BMI ( P: 0.00) and age (P: 0.04). Hypoglycemic control sub - scale showed a positive correlation with BMI ( P: 0.01) and age ( P: 0.01). Also, inconvenience of insulin therapy regimen sub -scale showed a significant positive correlation with age ( P: 0.04). Overall satisfaction and sub -groups had no significant correlation with other variables.

The overall satisfaction in type 1 diabetics was unacceptable. Understanding the pathogenesis of this problem could guide health care providers for better and effective management of type 1 diabetes. Also, a more comprehensive approach with consider all potentially relevant variables is necessary.

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.

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.

Pioglitazone is one of the oral medications of type 2 diabetes (T2DM). The purpose of this study was to evaluate the effect of pioglitazone on asthma and diabetes treatment outcomes among patients with concurrent asthma and T2DM.

We conducted a quasi-experimental study on 11 patients with concurrent asthma and T2DM in Yazd Afshar Hospital and Yazd diabetic research center 2014-2017. The inclusion criteria were patients between 20-60 years old, at least one year with concurrent asthma and T2DM (documented with spirometer, bronchodilator test), ejection fraction more than 50%. Patients who were smoker, on oral corticosteroids, phenobarbital, methotrexate, rifampin, phenytoin and gemfibrozil were excluded. Laboratory tests (FBS, HbA1c, 2hpp, leptin), spirometer test, exhaled nitric oxide were done before and after 10 weeks of pioglitazone medication. All patients were visited every two weeks. The before and after pioglitazone treatment differences were checked by paired t-test and Wilcoxon Rank sum test.

The mean (± SD) age of participants was 55.81 (±7.66). The median of differences of leptin (p-value: 0.885), FEV1 to FVC (P-value: 0.185), FEV1 (p-value: 0.386), NO (P-value: 0.574), FVC percent (P-value: 0.477), FEV1 percent (P-value: 0.515) did not differ before and after pioglitazone treatment.   

Our finding suggested that pioglitazone may not be effective in the treatment and improvement of respiratory function in T2DM with concurrent asthma.

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.

The relative stroke risk is increased in patients with diabetes. Awareness and knowledge of the risk factors and symptoms of stroke are essential for prevention and immediate effective treatment of stroke. The aim of the study was to determine baseline knowledge about the warning symptoms and risk factors of stroke in patients with type 2 diabetes (T2DM). This analytical cross-sectional study was conducted in Yazd-Iran 2015-2016. The pilot section included 10 T2DM patients. The main data was collected from 281 patients. The self-conducted checklist about knowledge of stroke risk factors, warning signs as defined by national institute of neurological disorder and stroke was prepared in three following parts. 1) Socio-demographic information. 2) Open-ended question about stroke risk factors, warning sign & symptoms and first action information. 3) Multiple choice questions related to the stroke risk factors, warning sign & symptoms and first action information. 408 T2DM patients were invited and 281 patients fulfilled in study. Most of them (70.4%) were women. The mean age of patients was 54.09±12.54 years. The most common general risk factors of stroke listed were “high blood pressure (92.9%), unhealthy diet” (86.8%), and “stress” (82.2%).The most common sources of stroke information were friends and family members (73.7%). Education program to increase T2DM knowledge of stroke may contribute to reducing the risk of stroke and increasing the speed of hospital presentation after the onset of stroke.

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.

The aim of this study was to evaluate the effect of zinc and magnesium supplementation on glycemic control and serum insulin in type 2 diabetic patients.
In this randomized clinical trial 70 diabetic patients who referred to Yazd Diabetes Center were selected. Subjects received 500 mg/day magnesium oxide or 100 mg/day zinc sulfate randomly for 8 weeks. At the start and end of treatment period fasting blood sugar (FBS), 2 hour postprandial glucose (2-hpp), glycated hemoglobin (HbA1C) and fasting insulin level were measured.
Magnesium and Zinc supplementation for 8 weeks cause significantly decrease in HbA1c (P=0.005, P=0.001).No significantly difference was observed after trial between magnesium and zinc groups in FBS (42.08 ±7.43 vs. 35.15 ± 6.52) (P=0.97), HbA1C (1.22±0.21 vs. 1.77±0.32) (P=0.07) and fasting serum insulin (39.81 ±7.03 vs.36.68±6.81) (P=0.83) respectively.
Results of this study showed that 500 mg/day magnesium oxide or 100 mg/day zinc sulfate administration for 8 weeks could improve HbA1C in type 2 diabetic patients and this effect is same in two groups. But more studies for evaluating effect of magnesium and zinc supplementation on type 2 diabetic patients were suggested.

In order to identify some endophytic fungi in common yew trees, healthy plant samples were investigated. In this study, 10 fungal species including Absidia spinosa, Aureobasidium pullulans, Lecanicillium lecanii, Nemania serpens,Pseudodictyosporium elegans, Leucostoma persoonii, Epicoccum nigrum, Stachybotrys chartarum, Gibberella tricincta and Gibberella baccata were identified as endophytic fungi of native common yew trees in Iran. Two taxa including P. elegans and N. serpens are being reported as new for the Iranian mycobiota. Also, all identified species except G. baccata, are reported for the first time as endophytic fungi of common yew trees (Taxus baccata) in the world.

In the present study, five species of Cladosporium including C. perangustum, C. basi inflatum, C. cladosporioides, C. herbarum and C. subtilissimum, and three species assigned to other fungal genera including Truncatella angustata, Alternaria atra and Nigrospora oryzea are reported as endophytic fungi of common yew (Taxus baccata L.), native to Iran. Out of these, C. perangustum, C. basi-inflatum and C. subtilissimum are new taxa to the Iranian mycobiota. Common yew is a new host for all identified species, except N. oryzae in the world.