Journal of Diabetes & Metabolic Disorders

This study was designed to assess the prevalence of metabolic syndrome and its correlated factors in an urban population in Ahvaz.

This descriptive analytical study performed with random cluster sampling method in 6 health centers in Ahvaz. In each selected center, 55 households were randomly selected. A questionnaire included: age, sex, marital status, ethnicity, education level, family history of diabetes (DM), Hypertension (HTN) and obesity, smoking and parity and previous history of gestational diabetes Mellitus in women were filled for each person.

Blood pressure, weight, height, body mass index (BMI), abdominal and waist circumference were measured in each participant. Fasting blood glucose (FBS), serum total cholesterol, triglyceride and high density lipoprotein (HDL) level were measured in fasting blood sample.

The mean age of all participants was 42.27 ± 14 years (44.2 ± 14.26 years in men and 40.5 ± 13.5 in women). From total 912 participant, 434(47.2%) were men and 478(52.8%) women. Prevalence of metabolic syndrome based on ATPIII criteria (update2005) was 22.8% (15.9% in men and 29.1% in women) that showed significant difference (P = 0.0001). Prevalence of each component of MS in studied population was: 29.4% for abdominal obesity, 40.7% for high TG level, 40.2% for low HDL, 15.4% for hypertension and 37.8% for abnormal FBS. Among these factor, age of patients, BMI, sex had significant differences between persons with or without Ms (P = 0.0001). Ethnicity (Arab or Persian), cigarette smoking and family history of diabetes mellitus, hypertension and obesity, marital statues, education level, parity and previous history of GDM in women showed no significant differences between persons with MS and without MS.

Metabolic syndrome has high prevalence in our population and its prevalence increases with increasing age and BMI. Women are at higher risk for metabolic syndrome than men.

Diabetic ketoacidosis (DKA) is a potentially life-threatening acute complication of type 1 diabetes mellitus (T1DM). Although the frequency of DKA as first manifestation of T1DM is higher in developing compared developed countries, there is paucity of information on its characteristics in developing countries.

This retrospective study determined the frequency of ketoacidosis at diagnosis of new-onset type 1 diabetes and described the clinical characteristics of the patients seen between 1996 and 2011 by auditing the hospital records of all cases. The diagnosis of diabetic ketoacidosis (DKA) was based on the presence of hyperglycaemia (blood glucose > 11 mmol/L), acidosis (serum bicarbonate < 15 mmol/L) and ketonuria (urine ketone ≥1+).

At diagnosis of new-onset type 1 diabetes mellitus, three-quarter (77.1%) of the children and adolescents presented with DKA. Comparing the frequency of DKA during the initial 8 years (1996–2003) with the later 8 years (2004–2011), it was 81.8% vs 73.1%; p > 005. The frequency has not shown any significant declined over a 16-year period. The frequency of re-admission in ketoacidosis was 24.3%.

Three-quarter of children and adolescents present with DKA as first manifestation of T1DM with no significant decline in frequency over a 16-year period in our hospital.

Garlic is one of the medicinal plants which has showed beneficial effects on atherosclerosis risk factors. The liver X receptor α (LXRα) is an important regulator of cholesterol, triglyceride and glucose homeostasis that belongs to the nuclear receptor superfamily. In this study we investigated the effect of garlic on lipid profile, glucose as well as LXRα expression in intestine and liver of mice.

Forty male N-Mary mice were randomly divided into 3 groups (n = 8): group1 received chow + 2% cholesterol + 0.5% cholic acid, group 2: chow + 4% (w/w) garlic extract + 2% cholesterol + 0.5% cholic acid, and group 3: chow only. After one month of treatment, mice were anesthetized, blood was collected from their heart, and the first 10 cm of the small intestine and liver were removed. Glucose was measured by a glucometer; other biochemical factors were measured by enzymatic methods. LXR expression was checked by RT-PCR and western blotting.

Compared with hypercholesterolemic mice, treatment with garlic extract significantly decreased total cholesterol, low-density lipoprotein cholesterol (LDL-C), triglycerides, very low density lipoprotein-cholesterol (VLDL-C), atherogenic index, alanine aminotranferease (ALT) and aspartate aminotransferase (AST) (all of them P < 0.05). Change in HDL-C levels was not significant in garlic-extract treated animals compared with hypercholesterolemic group. LXR protein and mRNA in the intestine were increased in garlic-extract treated group compared with chow group (P < 0.05), while in the liver, only mRNA of LXR was increased in hypercholesterolemic control mice (P < 0.05).

The present study demonstrated that garlic extract reduced LXRα expression in the liver and increased its expression in the intestine. These effects probably have an important role in reducing serum triglyceride and cholesterol.

The purpose of this study was to assess diabetes distress and its related factors among type 2 diabetic patients to better tailor intervention planning in Isfahan-Iran.

A cross-sectional study was conducted in 2011. Study population was patients with type 2 diabetes referring to Omolbanin, an outpatient diabetic center in Isfahan. 140 diabetic patients met the inclusion criteria and were all included in the study. Patient’s diabetes distress was measured by DDS. A 17-item self-report diabetes distress scale was used with subscales reflecting 5 domains: 1) Emotional burden (5 items), 2) Physician distress (4 items), 3) Regimen distress (5 items) and 4) Interpersonal distress (3 items). The responses to each item were rated between 1 and 6 (1 = not a problem, 2 = a slight problem, 3 = a moderate problem, 4 = somewhat serious problem, 5 = a serious problem, 6 = a very serious problem). The minimum and the maximum of score in the scale were 17 and 114 respectively. Collected data was analyzed by using SPSS software version 11.5.

Mean age of participants were 53.23 years (SD = 7.82). 54.3% was female, 97.1% was married, and 57.1% had education lower than diploma. The average score of total diabetes distress was 2.96 ± 0.83. The average score of each domain was (3.40 ± 1.18), (2.57 ± 0.88), (2.97 ± 0.90), (2.76 ± 0.91) respectively. ‘Emotional Burden’ was considered as the most important domain in measuring diabetes distress. Total diabetes distress had significant association with age (p = 0.02), duration of diabetes (p<0.001), marital status, comorbidity, complications (p<0.001), and history of diabetes (p = 0.01). Pearson correlation coefficient revealed that diabetes distress of type 2 diabetic patients has a linear and direct relation with HbA_lc (r = 0.63, p<0.001).

It seems some keywords have a main role in diabetes distress such as emotional support, communication with patient and physician, self-efficacy and social support. All of these points are achievable through empowerment approach in diabetes care plan.