[Association between health-related quality of life and glycemic control in type 2 diabetics]

Although several studies indicate that the quality of life of diabetic individuals decreases compared with non-diabetics, fewer studies have evaluated the association between quality of life and glycemic control in these people. The present study was conducted to assess the association between health-related quality of life and glycemic control in people with type 2 diabetes. This cross-sectional study was conducted on 125 type 2 diabetic individuals. Indices of glycemic control [serum concentrations of glucose, fructosamine and insulin, insulin resistance and HbA1c percent] were measured after 12-14 hours of fasting. Health-related quality of life was examined by a 36-item short-form health survey questionnaire [SF-36]. Using logistic regression and considering the confounding variables, the relationship between quality of life scales and glycemic control were evaluated.An inverse significant relationship between fructosamine concentration [p=0.04] and glucose concentration [p=0.04] with the general health scale score was observed. There was also a reverse significant relationship between serum glucose concentration and role limitations due to the physical problems scale score [p=0.02] and between insulin concentration and the physical functioning scale score [p=0.04]. There was a significant relationship between some quality of life scales and glycemic indices, indicating that better glycemic control in diabetic individuals enhances their quality of life

[Effects of daily consumption of Iranian yogurt drink doogh fortified with vitamin D or vitamin D plus calcium on the anthropometric and glycemic indices in type-2 diabetes patients]

Poor vitamin D status has been associated with impaired glucose tolerance and diabetes. The purpose of this study was to compare the effects of daily intakes of Iranian yogurt drink doogh fortified with vitamin D or vitamin D + calcium on anthropometric and glycemic status in type-2 diabetes patients. Ninety patients with type-2 diabetes were randomly allocated to one of three groups as follows: group1: plain doogh; group 2: vitamin D-fortified doogh [fortified with 500 IU vitamin D3 and 150 mg Ca/250 mL]; group 3: vitamin D + calcium-fortified doogh [fortified with 500 IU vitamin D3 and 250 mg Ca/250 mL]. The subjects took their respective doughs twice per day for 12 weeks. Anthropometric markers [weight, body mass index, and waist circumference], fasting serum glucose [FSG], glycated hemoglobin [HbA1c], and homeostasis model of insulin resistance [HOMA-IR] were measured before and after the intervention. In both groups 2 and group 3, the mean serum 25[OH]D3 level increased significantly [P>0.001]. As compared to group 1, in groups 2 and 3 the decreases in FSG [-12.9 +/- 33.7 mg/dL [P = 0.015] and -9.6 +/- 46.9 mg/dL [P = 0.035], respectively], Hb A1c [-0.4 +/- 1.2% [P<0.001] and -0.4 +/- 1.9% [P, 0.001], respectively], HOMA-IR [-0.6 +/- 1.4 [P = 0.001] and -0.6 +/- 3.2 [P, 0.001], respectively], and waist circumference [WC; -3.6 +/- 2.7 and -2.9 +/- 3.3, respectively; P<0.001 for both] were significantly higher. An inverse correlation was observed between changes in serum 25[OH]D3 and FSG [r = 20.208, P = 0.049] and HOMA-IR [r = 20.219, P = 0.005]. Daily consumption of vitamin D-fortified doogh with or without added calcium, improves anthropometric and glycemic status in diabetic patients

Blood pressure lowering effects of micronutrients in type 2 diabetic patients

The main objective of this study was to investigate the effects of magnesium, zinc, vitamins C and E, and a combination of these micronutrients with vitamin B groups [B1, B2, B6, B12, folic acid and biotin] on blood pressure in type 2 diabetic patients. In a randomized, double-blind, placebo controlled clinical trial, 67 type 2 diabetic patients, 36-69 years old, stratified for sex and were randomly divided into three groups. Each subject received two capsules per day for a period of 4 months, each capsule containing one of the following preparations: Group 1 received 250 mg magnesium and 20 mg zinc, 200 mg vitamin C and 100 mg vitamin E, 10 mg vitamin B1, 10 mg vitamin B2, 10 mg vitamin B6, 10 ug vitamin B12 and 1 mg folic acid [n=22]. Group 2: 250 mg magnesium and 20 mg zinc, 200 mg vitamin C and 100 mg vitamin E, [n=23], and group P: placebo [n=22]. Blood pressure and biochemical analysis were determined at the beginning and after 2 and 4 months. Fasting blood glucose and HbA1c were determined by glucose oxidase and chromatography methods, respectively. Plasma vitamin C and serum magnesium and zinc were determined by the colorimetric method and serum a-tocopherol using HPLC. Serum malondialdehyde [MDA] was determined by a colorimetric method. Treatment effects were analyzed by general linear modelling. Results indicate that after 2 and 4 months of supplementation levels of plasma vitamin C increased in group 1 [p<0.0001] and group 2 [p=0.029 and p<0.0001, respectively]. Serum vitamin E increased in group 1 and 2 [p<0.0001] and serum folic acid increased in group 1, after 2 and 4 months supplementation [p<0.0001]. Serum magnesium increased in group 1 after 2 months supplementation [p=0.001] but not after 4 months. After 2 or 4 months supplementation, there were no significant changes in fasting blood glucose or HbA1c in the 3 intervention groups. Levels of systolic blood pressure decreased significantly in group 2 after 4 months supplementation [p=0.012]. After 2 and 4 months supplementation, diastolic blood pressure decreased significantly in group 1 [p=0.003 and p=0.012, respectively] and in group 2 [p<0.0001 and p=0.002, respectively] and mean arterial blood pressure decreased in group 1 [p=0.018 and p=0.025, respectively] and in group 2 [p=0.002]. Also serum malondialdehyde decreased significantly in groups 1 and 2 [p=0.009 and p=0.041, respectively] after 4 months. The results of the present study indicate that in type 2 diabetic patients, combination of vitamins and minerals might decrease blood pressure

[Determinants of fruit and vegetable consumption in type 2 diabetics in Tehran]

The world is facing a dramatic rise in the prevalence of diabetes, most of which is occurring in the low-and middle-income countries. This is having a major impact on the quality of life of hundreds of millions of people and their families. Furthermore, nutrition, especially intakes of fruit and vegetable have important effects on glycemic control and prevention of diabetic complications. The present study was designed to assess the fruit and vegetable consumption in type 2 diabetic patients and their relationship with socio-demographic factors in Tehran. A cross-sectional study was conducted on 367 type 2 diabetic patients. Fruit and vegetable consumption was determined, using 169-item food frequency questionnaire. Information on demography and socio-economic factors was obtained from related questionnaires. Results: Vegetable consumption was significantly lower in retired or jobless patients [p=0.04], and higher in patients who had children [p=0.003]. Also, fruit consumption was significantly higher in patients with 3 or less children. No significant association was observed between fruit or vegetable consumption and education levels, parents' job levels, household size, ethnicity, family income, food expense and duration of living in Tehran. Based on logistic regression, employment was significantly related to the consumption of vegetable [p=0.012]

Effects of dietary omeg-3 fatty acid supplementation on HbA1c, total antioxidant capacity and superoxide dismutase and catalase activities in type-2 diabetic patients: a randomized clinical trial

Essential fatty acid deficiency has been found in diabetic patients. Omega-3 fatty acid supplementation could be beneficial in alleviating diabetes complications and glycemic control. However, it may increase oxidative stress. In this study the effects of omega-3 fatty acid supplements on glycemic control, total antioxidant capacity and antioxidant enzymes [superoxide dismutase and catalase] activities were investigated. In a double-blind, randomized, controlled clinical trial, 81 type-2 diabetic patients were divided into 2 groups. The experimental group took 2714 mg/day omega-3 fatty acids [1548 mg EPA, 828 mg DHA, and 338 mg other omega-3 fatty acids], and the control group took sunflower oil as a placebo, for 8 weeks. Dietary intakes were assessed by a 24h dietary recall, before and after intervention, and analyzed using food processor II. In addition, fasting blood samples were collected for analysis and height and weight were measured, initially and at the end of the trial. At the start of the study there were no statistically significant differences between the two groups with regard to mean weight, height, body mass index [BMI], daily intakes of energy, carbohydrate, protein, total fat, polyunsaturated fatty acids, fiber, vitamins A, B, C, E, folate, cobalamine, zinc, or biochemical parameters. Neither were there any difference in weight, BMI and dietary intakes before and after intervention in either group. The supplementation brought about a significant decrease [P < 0.00] in HbA1c% in the experimental group, while in the control group the HbA1c level actually increased [p < 0.02]. Furthermore, the magnitudes of HbA1c changes were significantly deferent between the two groups [P < 0.00]. Changes in the fasting blood sugar [163.88 +/- 10 vs. 165.6 +/- 7.9 mg/dl], total antioxidant capacity [3.79 +/- 0.07 vs. 3.62 +/- 0.7 mg/dl], and activities of super oxide dismutase [449.22 +/- 14.14 vs. 417.16 +/- 11.9 U/gHb] and catalase [150.72 +/- 9.6 vs. 151.86 +/- 12.6 k/gHb] were not statistically significant. Omega-3 fatty acid supplementation may be helpful in glycemic control in type-2 diabetes, but it has no significant effect on the antioxidant enzyme activities

[Effects of vitamin and mineral supplements on microalbuminuria and N-acetyl-beta-D- glucosaminidase activity [-betaNAG] in type 2 diabetic patients]

The present study was designed to assess the effect of Mg, Zn, vitamin C and E supplements on microalbuminuria and urinary albumin excretion and N-acetyl-beta-D-glucosaminidase activity [betaNAG] in type 2 diabetic patients. In a randomized, double-blind, placebo controlled clinical trial, 69 type 2 diabetic patients were randomly divided into four groups and received one of the following daily supplement for 3 months; group M: 200 mg Mg and 30 mg Zn [n=16], group V: 200 mg vitamin C and 100 IU vitamin E [n=18], group MV: minerals plus vitamins [n=17], group P: placebo [n=18]. Serum malondialdehyde concentration as well as urine microalbumin concentration and betaNAG activity and blood pressure were measured at the baseline and following the intervention. Results have revealed that following the intervention urinary albumin decreased in V and MV groups. Urinary betaNAG activity and protein concentration did not change significantly; however, malondialdehyde concentration was significantly decreased in M and MV groups. Finally, systolic, diastolic and mean blood pressure decreased significantly in the MV group. Our findings indicate that a combination of vitamin and mineral could decrease urinary concentration of microalbumin in type 2 diabetic patients. Thus, these supplements could be prescribed to improve renal function in type 2 diabetic patients