ABSTRACT
Objective: All the aforementioned data have stimulated interest in studying other potential therapies for T1DM including noninsulin pharmacological therapies. The present study attempts to investigate the effect of adjunctive therapy with metformin and acarbose in patients with Type-1 diabetes mellitus
Method: In a single-center, placebo-controlled study [IRCT201102165844N1] we compared the results of two clinical trials conducted in two different time periods on 40 patients with Type-1 diabetes mellitus. In the first section, metformin was given to the subjects. After six months, metformin was replaced with acarbose in the therapeutic regimen. In both studies, subjects were checked for their BMI, FBS, HbA1C, TGs, Cholesterol, LDL, HDL, 2hpp, unit of NPH and regular insulin variations
Results: Placebo-controlled evaluation of selected factors has shown a significant decrease in FBS and TG levels in the metformin group during follow up but acarbose group has shown substantial influence on two hour post prandial [2hpp] and regular insulin intake decline. Moreover, Comparison differences after intervention between two test groups has shown that metformin has had superior impact on FBS and HbA1C decline in patients. Nonetheless, acarbose treatment had noteworthy influence on 2hpp, TGs, Cholesterol, LDL, and regular insulin intake control
Conclusion: The results of this experiment demonstrate that the addition of acarbose or metformin to patients with Type-1 diabetes mellitus who are controlled with insulin is commonly well tolerated and help to improve metabolic control in patients
ABSTRACT
Introduction: patient safety culture is an important part of improvement in the safety of health care. Knowing its present status is required for development of safety culture. The present study aimed to evaluate the current status of Patient safety culture in hospitals of three central provinces of Iran
Method: the present cross-sectional study was performed in teaching hospitals of Tehran, Alborz, and Qazvin provinces. The standard HSOPSC questionnaire was used for evaluation of the patient safety culture from the viewpoint of 522[Qazvin: 200, Tehran: 312, Alborz: 40] individuals who were randomly selected as workers of the hospitals. The collected data were analyzed using Chi-square and ANOVA tests
Results: the mean positive response to 12 aspects of the patient safety was 62.9%. "Organizational learning" had the highest proportion of positive response [71.18%] and "Handoffs and Transitions" had the lowest [54.49%]. There was a statistically significant difference in scores of "Teamwork within Units"[p=0.006[,"Manager Expectations and actions promoting"[p=0.014],"organizational learning and continuous improvement"[p=0.001], "Management support"[p=0.007], "Feedback and communication"[p=0.012], and "Communication openness"[p=0.003] among the provinces, respectively
Conclusion: we performed a full assessment of the patient safety culture in the studied provinces. Organizational learning was satisfactory in the hospitals. The studied hospitals need arrangement of safety-based programs and supports of senior administrators to perform more sophisticated efforts and improve the patient safety culture
ABSTRACT
The homeostasis model assessment of insulin resistance [HOMA-IR] is a useful model for application at large epidemiologic studies. The aim of this study was to determine the HOMA cut off values to identify insulin resistance [IR] and metabolic syndrome [MS] in Qazvin, central Iran. Overall, 480 men and 502 women aged 20-72 yr attended in this cross sectional study from September 2010 to April 2011. The diagnostic criteria proposed by national cholesterol education program third adult treatment panel [ATPIII], International Diabetes Federation [IDF] and new Joint Interim Societies [JIS]; were applied to define MS. Lower limit of the top quintile of HOMA values in normal subjects was considered as the threshold of IR. The receiver operating characteristic [ROC] curves of HOMA for MS diagnosis were depicted. The optimal cut point to determine MS was assessed by maximum Youden index and the shortest distance from the point [0, 1] on the ROC curve. The threshold of HOMA for IR was 2.48. Fifty one percent of the subjects were insulin resistant. The cut point for diagnosis of JIS, IDF, ATP III and Persian IDF defined MS was 2.92, 2.91, 2.49 and 3.21, respectively. Sensitivity and specificity of ATP III defined MS to diagnose IR was 33.95% and 84.78%, of IDF defined MS was 39.13%, 81.29% and of JIS defined MS was 43.77% and 78.11% and of Persian IDF defined MS was 27.32% and 88.76%, in that order. The high prevalence of IR in the present study warns about the future burden of type 2 diabetes. Only the ATP III criteria introduced more specific cut point for putative manifestations of IR
ABSTRACT
Diabetes is a common metabolic disease in the world that has many adverse effects. Olibanum gum resin [from trees of the genus Boswellia] has traditionally been used in the treatment of various diseases such as diabetes. The aim of this study was the comparison of Olibanum gum resin effect with placebo on the treatment of type 2 diabetes. Inclusion criteria was diabetic patients with fasting blood sugar [FBS] =140-200 mg/dL. This study has been designed as double-blined clinical trial on 71 patients with type 2 diabetes and the patients randomly were divided to interventional and placebo groups. The patients on standard anti-diabetic therapy [metformin] treated with Olibanum gum resin [400 mg caps] and placebo tow times per day for 12 weeks, respectively. At the end of 12 weeks the FBS, HbA1c, Insulin, total Cholesterol [Chol], LDL, Triglyceride [TG], HDL and other parameters were measured. The Olibanum gum resin lowered the FBS, HbA1c, Insulin, Chol, LDL and TG levels significantly [p<0.001, p<0.001, p<0.001, p=0.003, p 0.05] compared with the placebo at the endpoint. Moreover, this plant showed anti-oxidant effect and also no adverse effects were reported. The results suggest that Olibanum gum resin could be used as a safe anti-oxidant, anti-hyperglycemic and anti-hyperlipidemic agent for type 2 diabetic patients
ABSTRACT
Ezetimibe inhibits the resorption of dietary and biliary cholesterol in the small intestine and decreases insulin resistance in patients with nonalcoholic fatty liver disease [NAFLD]. Acarbose has been used in type 2 diabetes mellitus and metabolic syndrome. This study aims to compare the therapeutic effects of ezetimibe and acarbosein decreasing liver transaminase levels in patients with NAFLD. This was a single center, double-blind, parallel-group study conducted at Bu-Ali Sina Hospital, Qazvin, Iran. In this trial, we enrolled, by simple randomization, a total of 62 patients diagnosed with NASH. There were 29 patients treated with ezetimibe and 33 who were treated with acarbose over a ten-week period. Ezetimibe treatment significantly reduced ALT, AST, triglycerides, total cholesterol, low-density lipoprotein [LDL] cholesterol, high-sensitivity C-reactive protein [hsCRP], and serum insulin levels and the insulin resistance homeostasis model assessment [HOMA-IR] index compared to patients treated with acarbose [p<0.001]. Ezetimibe treatment decreased ALT [p=0.05], AST [p=0.01], total cholesterol [p=0.01], HDL cholesterol [p=0.03] and LDL cholesterol [p=0.03] levels to a significantly higher extent. Both ezetimibe and acarbose improved metabolic and biochemical abnormalities in patients with NASH, however these effects were more prominent with ezetimibe
Subject(s)
Humans , Male , Female , Azetidines , Acarbose , Double-Blind Method , Transaminases , Alanine Transaminase/drug effects , Aspartate Aminotransferases/drug effects , Cholesterol , Cholesterol, HDL , Cholesterol, LDLABSTRACT
This study was conducted to evaluate the effect of apple consumption on lipid profile and oxidative stress indices among hyperlipidemic men. We performed an experimental study on 46 hyperlipidemic men [Total Cholesterol [TC]=200-240 mg/dl, Triglyceride[TG]=150-350mg/dl] aged 30-50 years who were randomly divided into two [apple and control] groups. The apple group [23 subjects] received 300 gr of whole apple per day [Golden delicious] for 8 weeks. Control group [23 subjects] had the regular dietary pattern for the same period of time. Blood samples were collected at baseline and after intervention [after 8 weeks] and analyzed for serum TG, TC, LDL-C, HDL-C and plasma oxidative stress indices of Malondialdehyde [MDA] and Total Antioxidant Capacity [TAC] level. Before study, education level and family size were compared in both the groups. Before and after intervention, physical activity and dietary intake were compared between the two groups. Both total polyphenol and total fiber in the consumed apples were measured. Total polyphenol and total fiber were 485 mg/kg fresh apple and 4.03 gr/100 gr fresh apple, respectively. Chi square and t-tests with SPSS V.16 were used for data analysis. After 8 weeks, mean different TG concentrations increased significantly in apple group as compared to control group; however, no significant differences were observed in regards to TC, LDL-C, HDL-C, MDA and TAC level between the two groups. Consumption of Golden delicious apple may increase serum TG concentration in hyperlipidemic men. However, we need more studies to study the effect of Golden delicious apple on serum TC, LDL-C, HDL-C concentrations and plasma MDA and TAC indices