Practical Focus on American Diabetes Association/European Association for the Study of Diabetes Consensus Algorithm in Patients with Type 2 Diabetes Mellitus: Timely Insulin Initiation and Titration (Iran-AFECT)

BACKGROUND: The aim of this study was to evaluate the safety and effectiveness of insulin glargine in a large population from a variety of clinical care in Iranian people with type 2 diabetes mellitus (T2DM) and to measure the percentage of patients achieving glycosylated hemoglobin (HbA1c) <7% by the end of 24 weeks of treatment in routine clinical practice. METHODS: This study was a 24 week, observational study of patients with T2DM, for whom the physician had decided to initiate or to switch to insulin glargine. The safety and efficacy of glargine were assessed at baseline and at week 24. RESULTS: Seven hundred and twenty-five people with T2DM (63% female) including both insulin naïve and prior insulin users were recruited in this study. The mean age of the participants was 54.2±11.2 years, and the mean HbA1c level was 8.88%±0.93% at baseline. By the end of the study, 27% of the entire participants reached to HbA1c target of less than 7% and 52% had HbA1c ≤7.5%. No serious adverse event was reported in this study. Furthermore, overall hypoglycemia did not increase in prior insulin users and the entire cohort. In addition, body weight did not change in participants while lipid profile improved significantly. CONCLUSION: Treatment with insulin glargine could improve glycemic control without increasing the risk of hypoglycemic events in people with T2DM. In addition, a significant clinical improvement was observed in lipid profile.

[ frequency of metabolic syndrome among female patients admitted in psyciatry ward]

In recent years the metabolic syndrome has been highly common among psychiatric patients. Since many factors including genetic factors contribute to the prevalence of this syndrome, it seems necessary to look for metabolic syndrome among Iranian psychiatric patients. This cross-sectional study was performed on 130 female patients admitted to psychiatric ward of Mashhad 22 Bahman hospital since March 2009 until December 2009 to find whether they had metabolic syndrome. Questionnaires were completed for patients. Pregnant women and those who had had a delivery during the last 6 months were excluded. Data were analyzed through statistical tests such as t-test and chi square and SPSS software 17. P-value less than 0.05 was regarded as meaningful result. In this study the prevalence of metabolic syndrome was, according to criteria of NCEP [ATP III], 39.8%, which is deemed as significantly more than expectable range for healthy Iranian population. Older age, higher waist circumference, BMI and weight, persistence of diabetes mellitus and hypertension, low educational level and marriage status were proven to be associated with increased risk of metabolic syndrome [p-value <0.05]. There were no meaningful relation between metabolic syndrome, duration of administration and type of drugs, and mental disorder. [p-value>0.05]. In the present study, the prevalence of metabolic syndrome was examined. And it was proved that the rate of the prevalence of metabolic syndrome is more than what is typically found in similar studies among Iranian psychiatric population. No relationship was detected between metabolic syndrome and any specific drug, however, more extensive studies are suggested