Effect of oral supplementation of l-arginine on sexual function in men with type 2 diabetes: a double-blind clinical trial

Background: Sexual dysfunction is an important health problem which prevalence in patients with type 2 diabetes [T2D] is higher than other people. The aim of this study was to evaluate the effect of L-arginine oral supplementation on sexual function in men with T2D and mild-to-moderate erectile dysfunction [ED]

Methods: Eighty men with T2D, suffering from mild-to-moderate erectile dysfunction participated in this double-blind clinical trial. They were randomly assigned in to two groups; receiving 5 g/day L-arginine [AG] or placebo group [PG] for 4 weeks. Sexual functions were recorded with international index of erectile function questionnaire at the beginning and end of the intervention. Total testosterone concentrations were measured too

Results: The total mean score of sexual function parameters significantly increased only in AG than PG [43.2 +/- 6.2 vs. 39.4 +/- 4.0, P = 0.003]. Against PG, the mean of all parameters significantly improved in AG after intervention. Only the mean score of erectile function in AG had a significant increase compared to PG. Mean of other sexual activity scores between the two groups had no significant differences. The mean of testosterone concentration had a significant increase in both groups after the intervention, but the mean of changes was significantly higher in AG than in PG [1.91 microg/L vs. 0.53 microg/L, P = 0.004]

Conclusions: The present trial showed that daily consumption of 5 g L-arginine for four weeks in T2D men with mild-to-moderate sexual dysfunction improved various parameters such as erectile function, sexual satisfaction, sexual desire, pleasure from sexual intercourse, and testosterone level

Evaluation of sexual function in men with diabetes mellitus type 2- yazd diabetes research center

Sexual dysfunction is considered as an important health problems. Chronic diseases such as diabetes can have negative effect on sexual function. This study aims to determine the level of sexual dysfunction in male patients with diabetes mellitus type 2 in Yazd Diabetics Research Center. This descriptive study involved 69 male patients with type 2 diabetes mellitus in Yazd Diabetes Research Center- 2014. The Questionnaire consisted of two parts: demographic characteristics of patients and the IIEF questionnaire [the International Index of sexual function]. Data analysis was performed by using SPSS software version 21, and by using descriptive statistics, mean, standard deviation and statistical tests of Fisher' exact and T-test. The mean of age, height and weight of participants were 51.44 year, 171.14 cm, 77.55 kg, respectively. Through 15 items surveyed, lowest mean is related to the question attempted to intercourse [1.20+0.40] and the highest average related to the question marriage satisfaction [3.50 +/- 0.50]. According to the results, most of the participants were in trouble in making erection and frequency of intercourse. Informing the patient as the first and most effective ways of prevention and treatment is essential

Risk of postoperative hypocalcemia in patients underwent total thyroidectomy, subtotal thyroidectomy and lobectomy surgeries

The main objective of this study was to identify the incidence of post-thyroidectomy hypocalcemia in patients underwent lobectomy, subtotal thyroidectomy or total thyroidectomy. This randomized trial study was performed from May 2010 to July 2011 among 108 consecutive patients undergoing thyroidectomy. Patients were allocated into 3 groups based on the 3 common type of thyroidectomy. Pre and postoperative serum calcium levels were determined by using standard protocol for all patients. All patients' preoperative serum calcium levels were normal. Post-thyroidectomy hypoglycemia occurred in 0%, 8.3% and 8.3% of patients who underwent total hypocalcemia, subtotal thyroidectomy and lobectomy, respectively, which represents 5.6% of all patients who shown hypocalcemia [P=0.58]. Serum calcium levels were fall in 93% patients, however within several days were returned to normal ranges. We did not find a significant relation between the hypocalcemia and thyroidectomy types. We recommended determination other alternative factors as a more effective prediction for postoperative hypocalcemia

Influence of physiological factors on thyroid size detemined by ultrasound

According to its superficial anatomical location, the thyroid gland is easily accessible by sonography. Sonography allows an exact documentation of the size and thyroid volume. The relationship between thyroid volume and anthropometric characteristics is a matter of controversy. The aim of this study was to investigate thyroid volume and its determinants in healthy adult. A cross-sectional study was performed from June 2003 until April 2005 in 314 healthy adults aged over 18 years old in Yazd, Iran. Data were collected on age, sex, and weight and thyroid size by sonoraphy. Mean of thyroid volume in male and female was 9.08 +/- 2.49 and 7.93 +/- 3.2 milliliter which the differences was significant [P<0.003]. Differences between thyroid volume and weight was significant [P=0.001]. Mean of female weight and proportion of thyroid volume to their weight was 61.83 +/- 12.09kg and 0.130 +/- 0.33. Mean of male weight and proportion of thyroid volume to their weight was 71.41 +/- 9.05kg and 0.126 +/- 0.028 [P<0.003]. Results of study is similar to other studies. Mean of thyroid volume in Yazd citizens is not differ from other Iranian but is different from other countries. This difference could be related to food intake habit, geographical region and daily oral iodine consumption

Evaluation of thyroid autoantibodies in type 2 diabetes

Diabetes mellitus and thyroid disease are the two common endocrinopathies seen in adult population. Studies to evaluate thyroid disorders in patients with type 2 diabetes are lacking. The aim of this study was to compare prevalence of thyroid dysfunction and autoimmunity in type 2 diabetic patients with age and sex matched non-diabetic control group. Among patients referred to Yazd Diabetes Research Center, 2792 type 2 diabetic patients were recruited. Clinical examination were carried out and samples for thyroid function test were obtained including thyroxin [T4], triiodothyronine [T3], Thyroid Stimulating Hormone [TSH], T3 Resin Uptake [T3RU], thyroid peroxidase antibodies [TPO-Ab] and thyroglobulin antibodies [TG-Ab]. They were compared with 4844 non-diabetic, age and sex matched control subjects. Our findings showed that the levels of thyroid hormone were not significantly different from levels in non-diabetic controls [P<0.05]. Positive TPO antibody was found in 1032 type 2 diabetic patients [36.9%] versus 1802 [37.2%] in control group [P=0.8]. Positive both thyroid antibodies, TPO antibody and TG antibody were found in 314 diabetic patients; [11.2%] versus 516 [10.8%] in controls [P=0.54]. Our findings indicate that the frequency of thyroid autoimmunity is not significantly higher in type 2 diabetic patients than in non-diabetic control group

Comparing effects of continuous insulin infusion with or without subcutaneous glargine insulin on glycemic control in diabetic patients undergoing coronary artery bypass graft [CABG]

Hyperglycemia is associated with increased morbidity and mortality in diabetic patients following coronary artery bypass grafting. Tight glycemic control in perioperative period can reduce these events. The goal of this study was to determine whether combination of continuous infusion and subcutaneous glargine as a basal insulin could improve glycemic control. Diabetic patients who were candidate for CABG were randomized to receive continuous insulin infusion with or without subcutaneous Glargine insulin for at least 72 hours which started 24 hours before surgery and continued for 48 hours after surgery. A total 84 subjects were required. In group A [n=45] continuous insulin infusion was used for glycemic control and in group B [n=39] we used continuous infusion with subcutaneous glargine insulin. Blood glucose level was significantly better in desirable range in group B in comparison to group A. Total mean blood glucose level in group A was 186.1 mg/dl and in group B was 174.3 mg/dl [P=0.008]. Frequency of hypoglycemia [blood glucose <70 mg/dl] was 0.66% in group A and 0.5% in group B that was similar [P=0.530]. The mean length of stay in the hospital was not different between two groups [P=0.288]. We found out that a combination of continuous insulin infusion and glargine insulin as main basal insulin can improve glycemic control in diabetic patients undergoing coronary artery bypass grafting

Effect of vitamin E on blood glucose, lipid profile and blood pressure in type 2 diabetic patients

Type 2 diabetes is associated with elevated oxidative stress and decline in antioxidant defense. Vitamin E supplementation reduces oxidative stress level in diabetic patients. Purpose of this study was to evaluate the effect of vitamin E supplementation on glycemic control and lipid profile in type 2 diabetic patients. In this study 31 type 2 diabetic patients with Fasting blood Sugar [FBS]:140-200 mg/dl, Triglyceride [TG]: 200-400 mg/dl, Cholesterol [TC]: 200-300 mg/dl and mild hypertension were selected. Subjects received vitamin E 800 IU/day for 3 months. At the baseline and end of the study FBS, TC, TG, LDL, HDL, Glycated hemoglobin and fasting insulin level were measured. In this study 31 type 2 diabetic patients [19 female, 12 male] with mean age 53.03 +/- 8.87 years were studied. Vitamin E supplementation for 3 months had no positive effect on type 2 diabetic patients. As FBS, TG and fasting insulin decreased but this decline was not significant. Also total Cholesterol, systolic and diastolic blood pressure changes were not remarkable. Results of this study showed that 800 IU vitamin E administration for 3 months could not improve blood glucose, lipids, HbA1c, fasting insulin, systolic and diastolic BP in type 2 diabetic patients

Percentage of free to total leptin in diabetic patients and its correlation to blood insulin, glucose and lipids

Leptin is a hormone resulting from the obesity gene which could be important in the pathogenesis of the insulin. Only limited data concerning the interaction of insulin, glucose tolerance and free leptin are available and no data exist on the potential influence of free vs. bound circulating leptin. We, therefore, studied percentage of free to total leptin in diabetic patients. Thirty non-insulin dependent diabetic obese patients [age:50 +/- 20 years, BMI>30 kg/m[2]] and 30 non-insulin dependent diabetic non-obese patients [age:50 +/- 20 years, BMI<25 kg/m[2]] were studied. Free leptin was purified by Gel filtration chromatography and the fractions were collected and then their free leptin was measured by a high sensitive ELISA method. Circulation total leptin and insulin was measured by ELISA. Circulation total leptin was significantly correlated to insulin [P<0.005]. Percentage of free leptin to total in obese subjects was more than non-obese subjects [27% +/- %1 vs.%3 +/- %4, [p<0.001]]. Percentage of free to total leptin showed a positive correlation with insulin [r=0.58 [P<0.001]], insulin resistance [r=31 [P<0.015]] and BMI [r=0.86 [P<0.001]]. The majority of leptin which circulates in obese individuals was free form. Presumably it is bioactive protein of hormone and thus obese subjects are resistant to free leptin

Comparison of the effects of sodium metavanadate and zinc sulfate supplementation on lipid and glucose in patients with type 2 diabetes

Type 2 diabetes mellitus is a chronic illness causing considerable morbidity and mortality. Enormous advances have been made in medical care but more people are still having tendency to use herbal or alternative remedies. This study is a randomized, controlled trial on type 2 diabetic patients. The subject consisted of 60 patients divided randomly into three groups and supplemented daily with 100 mg sodium metavanadate and 660 mg zinc sulfate or placebo for six weeks. The following were checked at baseline of the study and after six weeks: Body Mass Index [BMI], Blood Pressure [BP], Fasting Blood Sugar [FBS], 2-h postprandial glucose [2hpp], Glycated hemoglobin [HbA1c], Triglyceride [TG], Total Cholesterol [TC], Low-Density Lipoproteins, and High-Density Lipoproteins. Also HbA1c, BMI and BP were measured after 12 weeks to evaluate the long-term effects of drugs. Statistical analysis was performed using SPSS 11.5. Data of continuous variables are expressed as means +/- standard deviation. Differences between groups were assessed by the paired T-test. Comparison between three groups was done by Post Hoc Tests. Mean age of patients was 51.39 +/- 8.60 years. The results of this study show a significant decrease in TG [P=0.01] and BMI [P=0.03]. After 12 weeks, there was a significant decrease in BMI [P=0.01] in Sodium metavanadate group. Due to zinc sulfate administration, significant decrease was seen in TG [P=0.005], TC [P=0.02], LDL [P=0.01] and systolic blood pressure [P=0.02]. After 12 weeks, there was a significant decrease in HbA1c [P=0.04] with zinc sulfate consumption. Consumption of zinc sulfate in type 2 diabetic patients could be effective in lipid profile. It is recommended to use another vanadium compound to achieve better results

Prevalence of sensory neuropathy in type 2 diabetic patients in Iranian population [Yazd province]

The aim of this study was to determine the prevalence and risk factors of the sensory neuropathy in type 2 diabetic patients referring to Yazd Diabetes Research Center. Neuropathy is one of the most common complications of both type 1 and type 2 diabetes mellitus. This is a cross-sectional study on 2350 diabetic patients [1071 male, 1279 female] referred to Yazd Diabetes Research Center [Iran] from June 2007 to February 2208. Data collection was carried out through a questionnaire including demographic subject, duration, body weight and length, lab test [HbA1c, 2hpp, FBS], Body Mass Index [BMI]. Blood Pressure was measured on the right arm after a five-min rest. Neuropathy was confirmed using a Semmes Weinstein 10g monofilament over 10 areas of the feet, ankle reflexes and vibration over the great toe and ankle. The prevalence of type 2 diabetes and diabetic sensory neuropathy in Yazd province in 14.5% and 51.7%, respectively. The prevalence of sensory neuropathy in male was 49.9% and 53.2% in female, that increased by age [P=0.001], duration of diabetes [P=0.001], HbA1c [P=0.001] and poor glycemic control [high FBS and 2hpp]. Age, duration of diabetes, HbA1c and poor glycemic control were considered to be the risk factors for sensory neuropathy

Prevalence of type 2 diabetic complications and their contributin factors in Yazd province

Type 2 diabetes is a common disorder recognized as a major health problem in Iran. Diabetes is a major source of morbidity, mortality and economic cost to society. Diabetic patients are at risk of experiencing macrovascular and microvascular complications of diabetes. The aim of this study was to assess the prevalence of type 2 diabetes complications and their contributing factors. This cross-sectional study was carried out on 1000 the type 2 diabetic patients referred to Yazd Diabetes Research Center. All diabetic patients underwent the specific tests for retinopathy, nephropathy, neuropathy, peripheral vascular diseases [PVD] and cardiovascular diseases [CAD]. Logistic regression analysis was used to find out strength of association of risk factors with a specific complication. In this stud y1000 type 2 diabetic patients [457 male, 543 female] were studied. Nephropathy was diagnosed in 285 [28.5%], retinopathy in 519 [51.9%], CAD in 251 [25.1%], PVD in 143 [14.3%], CVA in 109 [10.9%] and foot ulcer in 84 patients [8.4%]. In this study the most important contributing factors in diabetic complications were age, duration of diabetes, systolic and diastolic blood pressure, glycated hemoglobin and Body Mass Index [BMI]. So glycemic and blood pressure control can prevent diabetic complications or at least delay them

Effect of Sodium Metavanadate Supplementation on Lipid and Glucose Metabolism Biomarkers in Type 2 Diabetic Patients

Type 2 diabetes mellitus is a chronic, progressive illness that causes considerable morbidity and premature mortality. Vanadium is a trace mineral that has been claimed to be effective in controlling blood glucose levels in diabetic patients. A randomised placebo-controlled study was conducted to evaluate the effect of sodium metavanadate on selected biochemical markers in type 2 diabetic patients. Forty patients were enrolled and half of them received 100 mg sodium metavanadate daily for 6 weeks while the other half were placebo subjects. The mean age of the patients was 53.1 ± 8.5 years. Body mass index (BMI), blood pressure(BP), fasting blood sugar (FBS), 2-h postprandial glucose, glycated hemoglobin (HbA1C), triglyceride(TG), total cholesterol (TC), low-density lipoproteins (LDL), high-density lipoproteins (HDL) were determined before the start and at the end of the study. Levels of FBS, HbA1C, TC and LDL in the diabetic subjects decreased after six weeks on sodium metavanadate, but the differences were not statistically significant on comparing between pre- and posttrial levels. Based on the results, this study did not find sodium metavanadate of beneficial use as a form of vanadium supplementation among patients with type 2 diabetes.

Relationship between anti-thyroid peroxidase antibody and thyroid function test

Anti-thyroid peroxidase antibody [anti-TPO antibody] is a member of thyroid autoantibodies which are important in inducing and also diagnosing autoimmune thyroid diseases. Thyroid autoimmunity can cause several forms of thyroiditis and abnormal thyroid functions, ranging from hypothyroidism to hyperthyroidism. To evaluate the relationship between serum levels of anti-TPO antibody and thyroid function test parameters [T3, T4, and TSH] in patients with thyroid disease. In 2425 subjects suspected of having thyroid disease referred to Yazd central medical laboratory by physicians during a 2 year period, the concentrations of serum anti-TPO antibody [ELISA] and T3, T4, and TSH [RIA] were measured. 53.53% of the patients were 20 to 39 years old. 2135 patients [88.04%] were female and 290 [11.96%] were male. The levels of T3, T4, and TSH in individuals with normal and raised anti-TPO antibody titers was significantly different [P<0.0001]. A correlation between TSH and T4 levels and abnormal anti-TPO antibody was detected [P=0.002]. Our results confirm the correlation between thyroid function test and anti-TPO antibody values, indicating the clinical significance of this antibody and suggesting a through clinical examination and follow up of individuals with high anti-TPO antibody titer