جستجوی مقالات مرتبط با کلیدواژه « diabetic » در نشریات گروه « پزشکی »

COVID-19 is a viral respiratory disease caused by SARS-COV-2, which affects the lower respiratory tract, and causes pneumonia in patients. The disease rapidly spread around the world after the outbreak in late 2019, and became one of the challenges of health care systems. Older adults and patients with underlying diseases such as cardiovascular diseases, hypertension, and diabetes are at a higher risk for COVID-19, and need more care. Due to its prevalence in older adults and normal population, diabetes is important in terms of putting a burden on intensive care systems during the COVID-19 pandemic. Diabetes is also one of the most common comorbidities in patients with COVID-19, which is considered a risk factor for these patients. In addition, the association between diabetes and respiratory distress syndrome is not yet fully understood. Some studies have suggested that diabetes is not associated with respiratory distress syndrome while some others suggest that pulmonary dysfunction follows diabetes. It is also unclear what factors are associated with disease prognosis and mortality in COVID-19 patients with diabetes. In the current study, we aimed to investigate the status of demographic factors, comorbidities, lifestyle and laboratory results in diabetic patients with COVID-19, and compare them with the non-diabetic population and determine the prognostic factors in diabetic patients with COVID-19.

This study is a cross-sectional study performed on 415 patients with COVID-19 in the COVID-19 ward of Shahid Mohammadi Hospital of Hormozgan University of Medical Sciences from February to September 2020. Based on their diabetes, these patients were divided into diabetic and non-diabetic groups. Then, data on demographic factors, smoking, opioids and alcohol consumption, comorbidities (chronic lung disease, asthma, obesity, chronic kidney disease, type 2 diabetes, dementia, malnutrition, chronic neurological disease, rheumatic disease, hypertension, hyperthyroidism, hypothyroidism, favism, hyperlipidemia, and malignant neoplasms), some personal lifestyle features were determined in diabetic patients and compared with non-diabetic populations. Also, the information on biochemical variables, including hemoglobin, white blood cells, lymphocyte, neutrophils, hematocrit, platelets, prothrombin time, alanine aminotransferase, bilirubin, aspartate transaminase, lactate dehydrogenase, blood urea nitrogen, creatinine, blood glucose, sodium, potassium, C reactive protein were measured patients of the two groups. Also, heart rate, respiratory rate, systolic blood pressure, diastolic blood pressure, temperature, and oxygen saturation were determined in diabetic and non-diabetic patients.Quantitative variables were described by number (n) and percentage (٪). Qualitative variables were described using mean and standard deviation (SD), median and interquartile range (IQR). The Shapiro-Wilk test was used to assess the normality of quantitative variables. Independent t-test or Man-Whitney U test, and Chi-square or Fisher's exact tests were used to compare variables. In all statistical analyses, a p-value less than 0.05 was considered statistically significant. Statistical analysis was performed by IBM SPSS version 22 (IBM Corporation, Armonk, NY, USA).

The findings of our study showed that in the diabetic patients’ group 82 patients (41.2%) and in the non-diabetic population 135 patients (55.32 %) were men. In the diabetic group, the mean age of recovered patients was 58.52 years and the mean age of those in the deceased was 57.73 years, which was not statistically significant. In the non-diabetic group, the mean age of patients recovered was 47.98 years and the mean age of those in the deceased was 62.58 years, which was statistically significant (p <0.001). In the diabetic population, 773 patients (42.69 %) and in the non-diabetic population, 132 patients (54.09 %) had positive PCR. In the diabetic population, 18 patients (10.59 %) and in the non-diabetic population, 10 patients (4.09 %) had chronic kidney disease. In the diabetic population, 11 patients (6.43 %) and in the non-diabetic population, 13 patients (5.32 %) smoked. In the population of diabetic patients, the mean level of hemoglobin (P = 0.002) and lymphocyte count (P = 0.043) in the living cases were significantly lower than those in the deceased. The mean levels of neutrophils (P = 0.012), aspartate transaminase (P = 0.020), lactate dehydrogenase (P = 0.041), blood urea nitrogen (P = 0.003), and creatinine (P = 0.011) in the diabetic population were significantly higher in the living cases than those in the deceased, but the comparison of these cases in the non-diabetic population did not show a significant difference.In diabetic patients, there was a significant difference between the number of survival and death in each group of positive and negative PCR (P = 0.011); While the difference in mortality and survival between PCR positive and negative groups in non-diabetic subjects was not significant. In diabetic patients, a significant difference was also reported between the number of survival and death in groups with CKD and without CKD; while in non-diabetic participants there was no significant difference between CKD and non-CKD groups in terms of survival and death. Corticosteroid treatment also significantly led to a difference in the number of survival and death cases among the diabetic population, but a comparison of these cases in the non-diabetic population did not show a significant difference.In the group of diabetic patients, respiration rate (number of breaths per minute) was significantly lower among the living cases compared to those in the deceased (P < 0.05), while our findings in this regard did not show a significant difference in non-diabetic individuals. Also, in diabetic patients, the amount of oxygen saturation was significantly higher among the living cases than those in the deceased (P < 0.05), in which case the same results were observed in non-diabetic patients (P < 0.05).

In this study, the mortality rate in diabetic patients was significantly associated with lymphopenia, elevated aspartate transaminase, lactate dehydrogenase, blood urea nitrogen, and creatinine compared to non-diabetic patients.  Our findings suggest that individuals with type 2 diabetes are more prone to complications of COVID-19 and its related mortality; therefore these patients need more medical attention in the COVID-19 pandemic. Also, considering that so far limited studies have focused on the possible differences in the complications of Covid-19 disease and its mortality in diabetic individuals compared to non-diabetic individuals, it is recommended that more studies with higher sample sizes in other populations be performed to confirm the results of the present study.

Diabetes is one of the most expensive chronic diseases and a global public health problem. One of the objectives of implementing the Health Reform Plan (HRP) was to reduce the out-of-pocket payments for hospitalized patients. The present study was carried out with the aim of determining the direct medical costs in hospitalized diabetic patients after implementation of the HRP.

This cross-sectional descriptive-analytical study was conducted in 2019. The records of diabetic patients hospitalized in Imam-Ali Hospital of Zahedan from March 2017 to June 2018 was reviewed by the census method and the direct medical costs were recorded in a researcher-made checklist. Data were analyzed using the SPSS version 22

In this study, the direct medical costs of 704 hospitalized diabetic patients were evaluated. The majority of the study population was female (517, 73/5%) and 237 had gestational diabetes. The mean direct medical cost per hospitalized diabetic patient was 29,264,465 Rials and the mean out-of-pocket payment was 11.8%. Moreover, direct medical costs of diabetic patients increased with age (P<.001).

Diabetic hospital care imposes a high burden on basic health insurance. Despite the HRP, out-of-pocket payments for hospitalized diabetics are still significant. Government subsidies should focus on expanding access to care for diabetics, financial protection for disadvantaged residents and expanding public education on diabetes.

Diabetes may be associated with an imbalance between the protective effects of antioxidants and increased production of free radicals. Oxidative stress also appears to contribute to the pathogenesis of diabetic complications. In this study the effect of endurance exercise with cinnamon bark extract on antioxidant activity levels and cardiac index in streptozotocin- (STZ) induced DM in male rats were investigated.

In this experimental study, 50 male Wistar rats weight: 200-232 g were randomly divided into 5 groups (n=10): 1. Healthy control (CO), 2. Diabetic control (CD), 3. Diabetic + cinnamon extract treatment (D+CZ), 4. Diabetic + exercise training (D+EX), 5. Diabetic + cinnamon extract treatment + exercise training (D+EX+CZ). In D+EX+CZ group, the animals practiced endurance training for 8 weeks after becoming diabetic, and at the same times each rat has received 200 mg/kg cinnamon hydro alcoholic extract by gavage daily for 8 weeks.

Exercise training in D+EX and D+EX+CZ significantly prevented the decrease in heart weight compared to DC and D+CZ groups. The activity of the antioxidant enzyme (catalase) in the D+EX+CZ group increased significantly compared to the control group. Superoxide dismutase also increased significantly in all groups compared to the control group. Also, the activity of GPX enzyme (glutathione peroxidase) in D+EX+CZ and D+CZ groups showed a significant increase compared to the control group.

The increased GPX, CAT and SOD activity and prevented the decrease in heart weight induced by combined intervention of cinnamon extract and endurance training may attenuate oxidative stress in diabetic rats

In recent years, the relationship between the complications due to diabetes along with an increase in glucose levels, blood lipid profile, decreased antioxidant defenses and subsequently, an increase in oxidative reactions in the body has been investigated. The results of extensive studies show that increasing the formation of free radicals, as a result of hyperglycemia, plays a important role in the pathogenesis and progression of complications diabetes (1). The combination of using herbal medicines and performing various physical activities to inhibit oxidative reactions has been considered by many researchers, as well. In this regard, the researchers found that Resveratrol, whit chemical formula: trans 3, 4 and 5-trihydroxyethylene, is a natural polyphenol and phytoalexin that protects plants against fungi in nature (10). As animal studies progressed, the effects of Resveratrol on various diseases were investigated, and some researchers reported the prophylactic effects of this chemical on cancer, cardiovascular disease, ischemic injury, and Alzheimerchr('39')s (10). On the other hand, it is also a factor in improving plasma markers related to type 2 diabetes (11).In adition, botanical studies show that Resveratrol contains important anti-inflammatory and antioxidant elements such as flavonoids and saponins (12). Therefore, the aim of current study was to evaluate the effect of interval and continuous exercise with Resveratrol on selected oxidative indicator in the heart tissue of mice with type 2 diabetes.

The present study was experimental. For this purpose, 56 male rats (mean age 40 to 50 weeks and weight average 250 to 300 g) were divided into eight groups including: control-healthy, control-diabetes, diabetes-saline, diabetes-supplement, diabetes-continuse, diabetes-interval, diabetes -continuous-supplement, diabetes-interval-supplement. Rats became diabetic by injecting a single dose of 50 ml / kg streptozotocin intraperitoneally. Continuous training consisted of 8 weeks, five sessions per week, which started with a speed of 15 meters per minute and a duration of 5 minutes, and got to 28 meters per minute, finally. Interval training included 10 sets of 1-minute activity with an intensity of 50% and 2 minutes of rest between sets. Resveratrol was injected intraperitoneally into the supplement group at a dose of 20 ml / kg and with daily program. The rats were slaughtered 48 hours after the last training session, and then their heart muscle tissue was removed and transferred to the laboratory for measuring the desired indicators.

One-way analysis of variance related to Catalase levels demonstrated a significant difference between the groups (p<0.001). The report of Tukeychr('39')s post hoc test was as follows: Significant difference among healthy-control group with control-diabetes (p=0.001) and diabetes-saline (p=0.001) groups, diabetes-control group with continuous-diabetes (P = 0.020) groups, Diabetes-continuous-supplement (p=0.004) and diabetes-interval-supplement (p=0.043), diabetic saline group with groups of continuous-diabetes (p=0.014), diabetes-continuous-supplement (p=0.003) and diabetes-interval-supplement (p=0.030). The assessment of intergroup changes of data related to MDA variable also showed a significant difference among groups (p<0.001). Tukey post hoc test indicated a considerable difference among healthy control with control – diabetes groups (p=0.001) and diabetes-saline (p=0.001), diabetes control with continuous-diabetes groups (p=0.020), diabetes- continuous -supplement (p=0.004) and diabetes-interval-supplement (p=0.043), saline group with continuous diabetes (p=0.001), interval diabetes (p=0.021), diabetes-continuous- supplement (p=0.001) and diabetes-interval - supplement (p=0.006). Tukey post hoc test reported there is a significant difference in SOD among healthy-control group with control-diabetes (p=0.001), diabetes-saline (p=0.001) and supplement-diabetes (p=0.046) groups, diabetes control group with continuous-diabetes groups (p=0.010), diabetes-Continuous-Supplement (p=0.002) and diabetes-interval-Supplement groups (p=0.033), saline diabetes group with continuous diabetes group (p=0.015), diabetes-Continuous-Supplement (p=0.003) and diabetes-interval-Supplement groups (p=0.049). Finally, Tukey post hoc test showed that insulin levels in the study groups increased significantly (p=0.001) and glucose levels decreased significantly (p=0.001) compared to the control-diabetes and diabetes-saline groups.

The results of the present study showed that eight weeks of interval and continuous training can decrease blood sugar levels and increase insulin levels along with increasing SOD and Catalase levels and decreasing MDA levels in the heart tissue of diabetic rats. SOD exerts its function when the intensity of training is such that it does not require high excretion of hydrogen peroxide, howeverat high training intensities the release of Catalase is stimulated (23). The past evidence has shown that increasing the concentration of hydrogen peroxide prevents the function of insulin in glucose transport. Hydrogen peroxide, as well as other exercise-generated free radicals, regulate several cellular functions and act as a secondary messenger; they, also, activate factors sensitive to hydrogen products such as AP-1 and NF-κB. The combination of these two factors and the other factors sensitive to hydrogen products can determine the release of the type of antioxidants (24). In line with this theory, a study reported that the expression of SOD and catalase antioxidants is inhibited by the use of a specific inhibitor NF-κB (25).  Besides, the increase in VO2max after a period of aerobic exercise is another reason for the improvement in antioxidant indices. The assessment of effect of the training intensity and duration on changes in antioxidant indices, especially SOD and catalase showes the amount of oxygen consumption during exercise is one of the reasons for the difference in the effects of different exercises (23). In high-intensity interval training, the production of oxidative anions increases, and at low-intensities, oxidation anions are neutralized by the greater release of antioxidants (26). Regarding the positive effects of this type of exercise in reducing lipid peroxidation in diabetics, a research has been done that indicates a decrease in MDA levels following exercise. It has been suggested that at low training intensities, increased SOD production may cause MDA uptake, and at high training intensities through GPX production, the antioxidant system is activated (27). In the present study, Resveratrol intake decreased blood glucose levels and increased insulin levels in rats with type 2 diabetes. Studies have shown that Resveratrol can help treat diabetes by lowering blood glucose levels, protecting the beta cells of the of Langerhans island, and improving insulin function.It has been shown Resveratrol increases the rate of glucose reabsorption, even in the absence of insulin, by increasing the expression of genes involved in glucose transporters in plasma membranes such as GLUT4, by various cells derived from diabetic rats (28). These results suggest that Resveratrol and exercise can strengthen the heart tissuechr('39')s antioxidant defense system against oxidative stress.

In general, the results of the present study showed that exercise by lowering blood glucose and increasing insulin levels in diabetic rats causes increasing of the levels of SOD and catalase, as antioxidant enzymes and decreasin of the levels of MDA in the heart tissue of diabetic rats as an oxidative enzyme. These positive changes, when it comes to Resveratrol consumption was higher.

Introduction:

 Diabetes is a metabolic disorder in the body that is impaired by the ability to produce insulin hormone. The main purpose of the present study is to discover the hidden knowledge in the data of diabetic patients, which can assist clinicians in clustering new patients and prescribing appropriate medication according to each cluster.

In this paper, we use MR-VDBSCAN algorithm. The implementation of this algorithm is based on the map-reduce framework of Hadoop. The main idea of the research is to use local density to find the density of each point. This strategy can prevent clusters from joining at different densities.

The algorithm is based on the selected dataset, tested and evaluated, and the results show high accuracy and efficiency. The results were compared with the results of k-Means clustering, The MR-VDBSCAN algorithm has a higher execution speed than that of the algorithm and has the ability to detect clusters with different density of superiority of this algorithm than the comparable algorithm. The results show that the MR-VDBSCAN algorithm can provide better performance than other algorithms. In particular, the similarity of the proposed algorithm is 97% for the diabetes set.

The results show that the MR-VDBSCAN algorithm performs better clustering than the K-means algorithm and can place patients into subgroups that assist physicians in prescribing.

Diabetes is one of the most prevalent diseases in the world with its side effects, for instance in reproductive system. Probiotics are beneficial microorganisms that have preventive and therapeutic effects. The present study aimed to evaluate the effect of probiotics Bifidobacterium lactis and Lactobacillus casei on sperm maturation in streptozotocin-induced diabetic rats.

In this experimental study, 35 male Wistar rats were divided into five groups: control, diabetic (type 1), diabetic rats treated with B.lactis and L.casei and a mixture of both probiotics. Diabetic groups were injected intraperitoneally with streptozotocin (60mg/kg). Probiotics were administered for 35 days. At the end of treatment, blood glucose levels, epididymal weight and sperm maturation were evaluated. The percentage of histone-protamine replacement was evaluated by aniline blue staining.

In the present study, blood glucose level in the diabetic group was significantly increased compared to the control group (P<0.001), however, the diabetic groups treated with Lactobacillus casei and Bifidobacterium lactis showed a significant decrease compared to the diabetic group (P<0.001).
The percentage of immature sperms was significantly increased in diabetic rats compared to the control group (P<0.001), and there was a significant increase in probiotic treatment groups compared with diabetic group (P<0.05).

Probiotics B. lactis and L. casei have a positive effect on lowering blood glucose and improving sperm maturation in diabetic rats.