جستجوی مقالات مرتبط با کلیدواژه "دیابت شیرین نوع 1" در نشریات گروه "پزشکی"

Information therapy is one of the new methods of providing health-related information to patients. This method plays an important role in empowering patients to make informed health decisions and participate in the recovery process. In this regard, the present study was conducted to explain the understanding of elderly people with type 2 diabetes regarding information therapy related to self-care.

This study was carried out qualitatively using the content analysis method on 18 patients with type 2 diabetes referred to some specialized diabetes centers in Hamadan City in 2024. Participants were selected based on purposeful sampling method and content saturation with maximum diversity based on gender, education level, marital status, employment status, and duration of diabetes among patients eligible for the study. A semi-structured, in-depth personal interview method was used for data collection. All interviews were recorded, transcribed, and then analyzed using MAXQDA 2020 software.

After data analysis, three categories and thirteen subcategories were extracted in relation to the theme of diabetes control and management. The obtained categories included promoting self-care behaviors, increasing individuals' motivation to perform self-care behaviors, and accessing information therapy communication channels. Subcategories included paying attention to physical, psychological, social, and spiritual self-care; boosting awareness; improving attitude; controlling disease and its complications; reducing costs and making better decisions; and interpersonal media, traditional media, digital media, and social networks.

According to the results, it seems that information therapy is one of the methods of increasing individuals' motivation to perform self-care behaviors and promoting self-care behaviors. Ultimately, it may assist elderly patients in controlling and managing type 2 diabetes.

Non-alcoholic fatty liver disease (NAFLD) is currently the most frequent chronic liver disease affecting individuals of all age groups and is associated with type 2 diabetes mellitus (T2DM). The present study aimed to determine the frequency of NAFLD in adult patients with T2DM and some associated risk factors.

This descriptive cross-sectional study was conducted on patients diagnosed with T2DM at Golestan Hospital in Ahvaz, Iran, in 2020. All participants underwent abdominal ultrasonography to diagnose NAFLD and measure its grade. All the relevant clinical and biochemical characteristics were measured.

A total of 186 diabetic patients, including 75 women (40.32%) and 111 men (59.68%), with a mean age of 46.85±10.50 years, participated in this study. Ultrasound results revealed that all patients with T2DM (100%) had NAFLD, with 51 (27.42%) having fatty liver grade 1, 105 (56.45%) having grade 2, and 30 (16.13%) having grade 3. The severity of fatty liver in ultrasonography was directly and significantly correlated with smoking (P<0.001), weight (P<0.001), body mass index (BMI) (P<0.001), glycemic control (P=0.032), and high-density lipoprotein-cholesterol (HDL-C) level (P=0.001).

Our results indicated that NAFLD was highly prevalent among patients with T2DM in our study population, and all patients exhibited varying grades of NAFLD. This finding demonstrates the importance of screening T2DM patients for NAFLD and the management of related risk factors in routine clinical settings.

Lack of sleep and insomnia are associated with an increase in the risk of diabetes. Sleep disorders in diabetic people are significantly higher than in healthy people. Moreover, sleep duration is related to blood sugar control in diabetes. This study was conducted with the purpose of investigating the level of sleepiness and obstructive sleep apnea in type 2 diabetic patients and its relationship with glycemic levels.

This cross-sectional study was conducted on 200 patients with type 2 diabetes referred to Shahid Beheshti Hospital in Hamadan in 2023 . Diabetes control status was evaluated by hemoglobin A1c, and the frequency of sleepiness and obstructive sleep apnea was assessed by the Epworth Sleepiness Scale and STOP-BANG questionnaires. Data analysis was done using SPSS 26 statistical software.

The mean age of the participants was 56.16 ± 9.77 years. A significant difference was observed between the frequency of daily sleepiness score with gender (P<0.001), smoking (P=0.003), and hypertension and dyslipidemia (P<0.001). There was a significant difference between the possibility of obstructive sleep apnea with smoking (P=0.002) and dyslipidemia (P=0.001). A significant difference was observed between hemoglobin A1c and smoking (P<0.001) and dyslipidemia (P=0.007). There was a positive and significant correlation between hemoglobin A1c and daily sleepiness score (P=0.036) and sleep apnea score (P=0.034).

In patients with type 2 diabetes, obstructive sleep apnea and daytime sleepiness are relatively common, and these disorders are related to poor glycemic control.

Emotional intelligence enables nurses to manage their patients effectively. This study aims to assess the relationship between the emotional intelligence of nurses, the quality of care provided by them, and the anxiety of patients with type 2 diabetes in Iran.

This descriptive-correlational study was performed on 150 nurses working in the internal wards of Koosar Hospital (in Semnan), Khatam Al-Anbia Hospital (in Iranshahr), and Rofeideh Rehabilitation Hospital (in Tehran) in 2020-2021 and their patients with type 2 diabetes who were under their care for at least three consecutive days. A demographic form, Siberia Schering’s emotional intelligence questionnaires, the quality of nursing care scale, and Spielberger’s state-trait anxiety inventory (only the state anxiety subscale) were used for data collection. Pearson correlation test and multiple linear regression analysis were used for data analysis.

There was a significant negative correlation between nurses’ emotional intelligence and patients’ anxiety (r=-0.375, P<0.001). However, there was no significant relationship between the quality of nursing care (and its dimensions) and nurses’ emotional intelligence (P>0.05). A significant negative correlation was found between the quality of nursing care (and its dimensions) and patients’ anxiety (P<0.05).

Emotional intelligence educational courses for graduated and undergraduate nurses in universities or hospitals, are recommended to improve their emotional intelligence and consequently, help diabetic patients manage their anxiety and have a better experience of nursing care.

Cytokine production was shown to be changed in Type 2 diabetes mellitus (T2DM). Nonetheless, the relationship of pro-inflammatory interleukin (IL)-32α with anti-inflammatory IL-35 and transforming growth factor (TGF)-β is unclear in T2DM. The present study aimed to evaluate the IL-32α, IL-35, and TGF-β levels produced by peripheral blood mononuclear cells (PBMCs) in patients compared to healthy controls (HCs). Correlations between the IL-32α and IL-35 and TGF-β, as well as between those cytokines and paraclinical parameters [(fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c), GFR, albumin, and creatinine)] were assessed.

Blood samples were taken from 38 patients and 38 HCs. The PBMCs from each donor were isolated with the ficoll method and cultured with in vitro stimulator for four days. The production of IL-32α, IL-35, and TGF-β in culture supernatants was determined with ELISA. Paraclinical parameters were evaluated by standard laboratory methods.

High levels of IL-32α and low levels of IL-35 were found in patients compared to in HCs (P=0.006; P<0.001). A negative correlation between IL-32α and IL-35 was detected in patients (P<0.001). IL-32α was positively correlated with FPG and HbA1c (P=0.002, P=0.005), whereas IL-35 was negatively correlated with them in patients (both P<0.001). No correlations were detected between the cytokines and BMI, GFR, albumin, and creatinine, as well as between the TGF-β levels.

Increased IL-32α but diminished IL-35 production are linked with each other and with the glucose metabolism parameters in T2DM. It seems that IL-32α and IL-35 have a potential role in T2DM pathogenesis.

Dysfunction in the autonomic nervous system can cause cardiovascular complications in patients with type 1 diabetes (T1D). The present study aimed to investigate the effect of combined exercise training on heart rate variability (HRV-5min), aerobic capacity (VO2max), and glycemic index in boys with T1D.

In this semi-experimental research, 24 adolescent boys with insulin-dependent T1D and 12 healthy boys of the same age with an age range of 12 to 18 years were selected and divided into three groups: healthy, control diabetic, and exercise diabetic. The exercise diabetic group performed combined exercises for 12 weeks, three sessions a week. Blood variables and cardiac variables were measured 48 h before and 72 h after the intervention. Dependent t-tests and one-way analysis of variance were used for statistical analysis.

After the intervention, a significant increase in VO2max variables, high frequency HRV (HF) and a significant decrease in Resting Heart Rate Variables (HRrest), the ratio of low frequency to high frequency HRV (LF.HF) and glycemic index were observed in the exercise diabetic group (P<0.05). In addition, in the inter-group analysis of the difference between the pre-test and post-test results, a significant difference was observed in VO2max, HRrest, HF, LF.HF, and blood glucose indices in the exercise diabetic group compared to the healthy and diabetic control groups (P<0.05).

Our results showed that combined exercise training along with insulin-dependent treatment could help to strengthen the cardiovascular system (HRV) in boys with T1D by improving the function of the parasympathetic branch of the autonomic nervous system.

Type 2 diabetes is a chronic disease and one of the major public health problems in societies due to its prevalence and complications. This study aims to assess the prevalence of type 2 diabetes complications and their related factors.

This cross-sectional study included 400 diabetic patients (51% males vs. 49% females) in Semnan, Iran in 2023. The study tool was a researcher-made questionnaire whose content validity was confirmed by experts (CVR=0.90 and CVI=0.87). The descriptive results were calculated and reported as frequency (percentage) for qualitative variables and mean (standard deviation) for quantitative ones. Also, due to the qualitative nature of the variables, the statistical relationship between demographic and background variables with the prevalence of disease complications was evaluated using the chi-square test.

The mean age of participants was 51.93 years. According to the results, 19% of patients experienced type 2 diabetes complications, so that 8.5% had neuropathy (95% CI: ±2.73), 8% had retinopathy (95% CI: ±2.65), and 2.75% had nephropathy (95% CI: ±1.60). Among the demographic and background variables, the following items were significantly associated with the prevalence and severity of the complications: education level, employment status, nativity, urban or rural residency, type of basic health insurance, the time elapsed since diagnosis of the disease, the time interval between diagnosis of the disease and commencement of care, disease control status, and place of receiving care (P<0.05).

The findings of the study indicated that the prevalence of type 2 diabetes complications was at an acceptable level compared to the national and international statistics. Moreover, in addition to factors such as the patients’ access to appropriate diagnostic and treatment facilities and improving self-care among patients, some geographical, occupational, and financial factors play a role in the prevalence of type 2 diabetes complications

Tuberculosis is the leading cause of death from infectious diseases worldwide. Diabetes has been suggested as an important risk factor for tuberculosis. To date, few studies have examined the association between diabetes and tuberculosis. In this study, the prevalence of latent tuberculosis in diabetic patients was investigated.

In this study, 195 patients with type 2 diabetes were studied in a cross-sectional study to diagnose latent tuberculosis infection with a tuberculin skin test. Individuals with symptoms of active tuberculosis were excluded from the study, and individuals with a positive tuberculin test were evaluated for active tuberculosis by chest x-ray. For analyzing the data, SPSS software version 16 was run, a t-test was used to analyze quantitative variables, and for qualitative variables, Chi-square was applied.  The significance level of 0.05 was considered for all the results.

Out of 195 diabetic patients, 115 patients were referred for tuberculin test results. 43 out of 115 patients (37.39%) had an induration diameter greater than or equal to 5 mm, 29 patients (25.21%) had an induration diameter greater than or equal to 8 mm, and 3 patients (2.61%) had an induration diameter greater than or equal to 10 mm (Positive tuberculin test) (p>0.05).

False tuberculin skin test results can hide the true prevalence of latent tuberculosis infection. The sensitivity of the tuberculin test decreases in immunocompromised patients and leads to limitations in assessing the prevalence of latent tuberculosis infection. Although not enough information was available in this study to establish a significant association between diabetes and latent tuberculosis infection, further studies will help to investigate this association.

Diabetes is the most common chronic metabolic disease in the world and one of its control principles is the patient's adherence to the physician's treatment recommendations. This study aimed to determine the adherence to medication treatment and related factors in type 2 diabetic patients referring to the Diabetes Clinic of Shahid Beheshti Hospital, Hamadan, Iran, in 2020.

The present cross-sectional study was conducted on 284 patients with type 2 diabetes referring to the Diabetes Clinic of Shahid Beheshti Hospital. The data collection tool was a researcher-made questionnaire whose validity and reliability were confirmed in a pilot study. Data were analyzed in Stata software (version 11) at the significance level of 0.05.

Most of the patients were women (64.08%) and urban dwellers (79.08%). The mean age of the patients was obtained at 54.78 years, and 47.89% of the patients had poor medication adherence. Patients' medication adherence showed a statistically significant relationship with gender, marital status, education, physician's respectful behavior, respect for patient privacy, physician skill, the satisfaction of the physician, a history of other diseases, and a history of hypertension (P<0.05).

It was revealed the medication adherence rate was not satisfactory in patients with type2 diabetes. In this study, the identified causes associated with poor medication adherence included factors related to the patient, care team and health system, treatment, and disease status.

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

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

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

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

The increased response of T helper (Th) 22cells might be involved in thepathogenesis ofType 2 Diabetes Mellitus (T2DM). The present study aimed to investigate the transcription factor of Th22 cells (aryl hydrocarbon receptor [AHR]) and interleukin 22 (IL-22) in CD4+ T cells as well as the impact of oral empagliflozin treatment. The correlation between the aforementioned factors and clinical parameters was also determined among the patients.

In this case-control study, 50 patients under the treatment of metformin and gliclazide were divided into two equal groups, including the patients receiving empagliflozin (EMPA+) and not receiving empagliflozin (EMPA, as the control group). The peripheral blood CD4+ T cells were isolated on the initiation day of the study and after 6 months of therapy, and the gene expression levels of AHR and IL-22 were evaluated by real-time polymerase chain reaction. In addition, the production of IL-22 after activation was measured using enzyme-linked immunosorbent assay.

The levels of fasting plasma glucose and hemoglobin A1c diminished in the EMPA+ group after empagliflozin therapy, compared to those reported at the baseline (initiation day; P<0.001 and P=0.04). The gene expression level of IL-22 and production of IL-22 significantly reduced after 6 months of empagliflozin therapy (P=0.011 and P=0.001). A significant positive correlation between IL-22 production and its gene expression with AHR as well as between fasting plasma glucose and hemoglobin A1c was observed in the EMPA+ patients after therapy (P˂0.05).

In addition to antidiabetic effects, empagliflozin has anti-inflammatory impacts on the immune system, especially on Th22 cell-related factors.

The alterations of the adaptive immune system are involved in type 2 diabetes mellitus (T2DM) pathogenesis. T helper 1 (Th1) cells or CD4+ T cells are the pro-inflammatory components of adaptive immunity with the main feature of interferon-gamma (IFN-γ) secretion. The aim of this study was to evaluate the percentage of IFN-γ, assess the expression of related-genes in CD4+ T cells, including T-bet, IRF1, RUNX3, and NFκB, and determine the correlation between them and clinical parameters in T2DM patients.

In this case-control study, peripheral blood CD4+ T cells were isolated from 40 patients and 40 healthy controls (HCs). The percentage of IFN-γ secreting CD4+ T cells was assessed using flow cytometry, and the related-genes were evaluated using real-time polymerase chain reaction.

The percentage of IFN-γ secreting CD4+ T cells significantly increased in the patients in comparison to that of the HCs (P<0.001). The expression levels of IRF1 and NFκB were higher in the patients in comparison to those of the HCs (P=0.02 and P<0.001, respectively). A significant positive correlation between IFN-γ secreting CD4+ T cells and both IRF1 and NFκB was observed in the patients (P=0.001 and P=0.002, respectively). There was a significant positive correlation between IFN-γ secreting CD4+ T cells, IRF1, and NFκB with fasting plasma glucose and hemoglobin A1c in the patients (P<0.001).

Due to the increased response of Th1 cells (the production of IFN-γ and expression of related genes) in the patients and existing correlation between them and plasma glucose level, it seems that these inflammatory factors are involved in T2DM pathogenesis, and the use of IFN-γ pathway antagonists could be considered a novel therapeutic approach.

Inflammatory cytokines increase in patients with type 2 diabetes (T2D) and metabolic syndrome. This review focuses on inflammatory cytokines such as C-reactive protein (CRP), tumor necrosis factor (TNF-α), and adiponectin, a cytokine produced by adipose tissue and associated with insulin sensitivity. Despite the major role of cytokines in the development of T2D, in the case of adiponectin still is a matter of debate as the best strategy to change proper inflammatory response.

Type 1 diabetes is the most common metabolic and chronic disease in children and adolescents. This study aimed to evaluate the factors influencing diabetic control among adolescents with Type 1 diabetes.

This cross-sectional descriptive study was conducted on 205 patients aged 11-19 years with type 1 diabetes who referred to Endocrine Clinic of Besat Hospital, Hamadan, Iran, in 2019. The participants were selected based on a census sampling method and investigated in terms of factors affecting diabetic control. The data were analyzed in SPSS software (version 16). A p-value less than 0.05 was considered statistically significant.

The mean age of the patients was 13.96±3.17 years, and 58% of the participants were female. Moreover, the mean values of diabetes duration and Hemoglobin A1c (HbA1c) were estimated at 5.71±3.16 years and 8.89±1.84%, respectively. Regarding treatment adherence, 35.2% of the patients had poor adherence. The prevalence rate of depression, anxiety, and stress were 51.2%, 72.2%, and 13.2% in patients, respectively. Poorly controlled diabetes based on HbA1c correlated significantly with father's unemployment status and poor family support. Furthermore, the status of diabetes control based on HbA1c level had a significant correlation with the scores of stress, anxiety, and depression. However, there was a negative and significant relationship between the status of diabetes control and the number of annual referrals to the clinic.

This study showed that anxiety, depression, and stress led to poor control in patients with type 1 diabetes. On the other hand, increased income and family support, as well as frequent visits to the clinic improved diabetic control.

Regular exercise training has been shown to be a useful option to treat and prevent type 2 diabetes. Correspondingly, the purpose of this study was to investigate effects of 12 weeks of combined aerobic-resistance exercise training on levels of chemerin, omentin and insulin resistance in men with type 2 diabetes.

In this clinical trial research, 20 male patients with type 2 diabetes were randomly divided into two groups combined aerobic-resistance training (n=10) and control (n=10). Subjects in training group performed 12 weeks aerobic-resistance training, 3 weekly training sessions with given intensity (aerobic: intensity of 60-70% maximum heart rate resistance: intensity 60-70% repetition maximum). Blood sampling was taken measurements of for chemerin, omentin resistance, fasting glucose and insulin resistance in the beginning and after 12 training protocol weeks were conducted.

After 12 weeks, in the combined training group chemerin (p=0.01), resistance insulin (p=0.01) and fasting glucose (p=0.001) decreased significantly and Vo2max increased significantly (p=0.001) than the control group. Significant change was not observed at the levels of omentin (p=0.37).

12 weeks of aerobic-resistance training in men with type 2 diabetes decreased the levels of chemerin, insulin resistance and also fasting glucose, but did not affect the level of omentin.

Psoriasis is one of the most common skin diseases affecting 2-4% of the population. Based on the related literature, patients with psoriasis are at increased risk of developing type 2 diabetes. The present study aimed to compare the patients with psoriasis to healthy individuals in terms of prevalence of diabetes.

This cross-sectional case-control study was carried out in Sina Hospital, Hamadan, Iran. A total of 35 patients with psoriasis were allocated to the case group and 35 healthy subjects who were comparable in terms of age and gender were assigned to the control group. All participants were examined concerning fasting plasma glucose (FPG) and body mass index. In both groups, the FPG≥126 mg/dl indicated diabetes. The collected data were analyzed in SPSS software (version 16.0; SPSS Inc. Chicago, IL). A p-value less than 0.05 was considered statistically significant.

In each group, 19 individuals (54.3%) were male. Mean age in case group was 43±11.5 and in controls was 45.1±12.8 (p-value=0.481). The mean Psoriasis Area and Severity Index (PASI) of the patients was 20.6±12.7 (1.4 to 49.8). The most frequent severity of psoriasis regarding PASI was moderate including 16 patients (45.7%). The mean FPG in the patients was 108±33.6 and in controls 99.6±20.5mg/dl (P=0.755).Eight patients (22.9%) had diabetes while only 3 healthy controls (8.6%) had it (P=0.188). Multivariate logistic regression analysis demonstrated that psoriasis patients with the same gender, BMI and age have almost 4- fold increased risk of developing diabetes rather than healthy controls (P=0.08). As evidenced by the obtained results, eight patients with psoriasis (22.9%) suffered from diabetes, whereas only three (8.6%) of them had diabetes in the control group (P=0.188). Multivariate logistic regression analysis demonstrated that patients with psoriasis had almost 4-fold increased risk of developing diabetes, compared to healthy people (P=0.08).

Based on the findings of the current study, the probable association between type 2 diabetes and psoriasis should be taken into account given hyperglycemia in patients with psoriasis.

Diabetes type 2 has been estimated as the seventh leading cause of death worldwide. Diabetic patients are 2-3 times more likely to be at the risk of atherosclerosis, compared to normal people. It has been reported that exercise prevents atherosclerosis in diabetic patients. Therefore, the aim of this study was to investigate the effect of exercise on vascular variables of patients with type 2 diabetes. 

This clinical trial was conducted on 40 patients out of 702 volunteers with diabetes who were randomly assigned into two groups of combined (aerobic and resistance) and control. The intervention protocol included 24 30-min sessions of aerobic exercise on the treadmill without any slope during 8 weeks (three sessions per week). The protocol intensity was set at 50-70% maximum heart rate and volunteers wore a weighted vest during exercise. On the other hand, the control group had no exercise for two months. All variables were measured before the intervention and after 24 sessions of the intervention protocol.

According to the results, there were no differences between the groups regarding demographic characteristics and a history of type 2 diabetes before the intervention. After 24 sessions, there was a significant decrease in the intima-media thickness. Moreover, the ratio of the intima-media thickness to the lumen in three sections of Carotid Bulb, Internal Carotid, and Common Carotid was significantly reduced in the combined exercise group, compared to the control group (P<0.05); however, no significant difference was observed in the lumen diameter (P>0.05). All vascular parameters remained unchanged in the control group (P>0.05).

In total, 24 sessions of aerobic and resistance exercise had a positive effect on vascular parameters. According to the simulation of a backpack by a weighted vest, the method used in this study was considered as a cheap and useful technique for patients with type 2 diabetes.

Neuropathic pain is one of the common, important, and irritating complications in diabetes.  Despite the importance of this pain, there is still no effective treatment for that. The aim of this study was to determine the effect of evening primrose oil and gabapentin on neuropathic pain in patients with type 2 diabetes. This triple-blind clinical trial was performed on 70 patients with diabetic neuropathy who obtained score 2 from the Michigan Questionnaire and referred to the Department of Endocrinology at Khayyam clinic affiliated to Hakim Hospital in  Neyshabour from December 2017 to May 2018. The participants were divided into two groups of 35 people. The intervention group was treated with a capsule of evening primrose oil orally  (1000 mg) twice daily for three months and gabapentin (300 mg) daily. On the other hand, the control group was treated with gabapentin (300 mg) and placebo. The neuropathy pain severity was measured before and after the end of three-month intervention using Michigan and McGill Pain Questionnaires. Data analysis was performed in SPSS software (version 21) through Fisher's exact test, ANCOVA, multilevel logistic regression, Mann Whitney U test, Kolmogorov-Smirnov test, and the Chi-square tests. P-value less than 0.05 was considered statistically significant. According to the results obtained from the McGill questionnaire, the mean scores of neuropathy before the intervention were obtained at 10.12±0.57 and 9.85±0.65 in the intervention and control groups, respectively. However,  the mean scores of neuropathy after the intervention were estimated at 6.18±0.48 and 8.31±0.60 in the intervention and control groups, respectively, which was statistically significant (P<0.02). Evening primrose oil is effective in reducing neuropathic pain in type 2 diabetic patients. Therefore, this can be a supplementary treatment for reducing pain associated with diabetic neuropathy.

Diabetes mellitus is a common metabolic disease. Its association with testosterone has already been shown in many studies. Considering the role of testosterone hormone in impotency, fatigue, osteoporosis and fracture this study aimed to investigate the free testosterone in type 2 diabetes and its association with glycemic control index. In this cross-sectional study, 50 male diabetic patients over 20 years based base on inclusion criteria registered. Malignancy, history of head trauma, surgery or radiation, dysfunction of kidney, thyroid or pituitary and any previous chronic disease and drugs that may interfere with testosterone levels, excluded for all subjects, blood samples were taken to measure serum free testosterone levels, fasting blood glucose, and hemoglobin A1C. Demographic information was also completed by the patient The mean ± standard deviation of patients' age was 57.5 ± 10.6 years. 22% of patients had BMI> 30 kg/m² and 54% had abdominal obesity. Only 14% of patients had good glycemic control index (HBA1c< 7%) There was not a significant correlation between free testosterone level with BMI (P=0.963, r=0.007), waist circumference (P=0.152 and r=0.206), and HbA1c levels (P=0.223 and r=0.172). In general, although the results of this study showed that free testosterone level was not statistically significant correlation with glycemic index in type2 diabetic patients, but, more studies are recommended considering the wider statistical sample size for better conclusions.

Sleep disorders are one of the most important problems in patients with diabetes. The most commonly used method for treating sleep disorders is medication therapy. Therefore, it is important to perform an uncomplicated intervention to relieve sleep disorders in these patients. The aim of this study was to investigate the effect of foot reflexology massage on the quality of sleep in women with type 2 diabetes mellitus in Arak city in 2017. This study was a simple randomized clinical trial performed on 54 women with type 2 diabetes mellitus. Patients were randomly divided into control and intervention groups. Before the intervention, Pittsburgh sleep quality questionnaire was completed for both groups. In the intervention group, foot reflexology massage was performed for 8 sessions. After the intervention, sleep quality questionnaire was completed for both patients. Data was analyzed using SPSS version 24 by Mann-Whitney, Chi-square and T-test. Foot reflexology massage improved sleep quality in the intervention group (P<0.001). There was no significant difference in the quality of sleep in the control group (P>0.05). Foot reflexology massage improved the sleep quality of women with type 2 diabetes mellitus. Foot reflexology massage can be used as an effective intervention to improve the quality of sleep in these women.