[Risk factors associated with depression in type 2 diabetics]

Depression is one of the most common psychological states in type 2 diabetes that contributes to adverse health outcomes. This study aimed to investigate the risk factors for the incidence of depression in type 2 diabetic patients. In this descriptive cross-sectional study, 254 type 2 diabetic patients were selected through convenience sampling among diabetes outpatient clinics of Tehran university of medical sciences and also Iranian diabetes society during 2010-11. Data were collected using demographic and disease characteristic questionnaire, patient health questionnaire, social support scale and diabetes self-management scale [DSMS] and then analyzed using Chi square, t-test and binary logistic regression. Increased pain and functional disability [OR=11.725], decreased social support [OR=3.086], decreased performance for diabetes self-care [OR=4.088], longer duration of diabetes [OR=1.328], diabetes complications [OR=2.324], the need for insulin therapy [OR=2.431], HbA1c>9% [OR=21.575], BMI>25kg/m2 [OR=2.251] and major life events [OR=14.043] were significantly different between the diabetic patients with and without depression [P=0.001]. There was no significant difference in age, sex and socio-economic status between the two groups. The regression model correctly was fitted in 95.3% of the cases. Pain and functional disability, poor social support, weaker diabetes self-care, longer duration of diabetes, diabetes complications, the need for insulin therapy, HbA1c>9%, BMI>25kg/m2 and the experience of major life events all together contribute to the incidence of depression in type 2 diabetic patients. The results of the study have implications for the prevention of depression in diabetic patients

Waist circumference, weight, and body mass index of Iranians based on national non-communicable disease risk factors surveillance

Obesity is an important and life-threatening disease, associated with different chronic conditions such as cardiovascular disease, diabetes, and dyslipidemia. We sought to address the paucity of information on the trends of anthropometric indices such as weight, waist circumference, and body mass index in the adult population of Iran. We drew upon data from the First Non-communicable Disease Survey in Iran in 2005. In total, 79,611 participants between 20 and 64 years old were selected via the random multistage cluster sampling. The Lambda Median Scale method was applied to construct normal curves for anthropometric indices. The mean of waist circumference in both genders increased with age and in all the age groups except those between 20 and 24 years old was higher in the women. The mean of body mass index was higher in all the age brackets in the women, but the means of weight and height were higher in the men. The association of theses indices with diabetes, hypertension, and dyslipidemia was stronger in men. The ranges of waist circumference and body mass index in Iranian population are different from those of other countries. The higher body mass index and waist circumference in females and the direct association between obesity and chronic diseases, is advisable that the effects of this phenomenon be fully investigated and due heed be paid to the importance of lifestyle modification

Report pf bilateral inferior petrosal sinus sampling in Iran

The differential diagnosis of ACTH-dependent Cushing syndrome is a challenging issue for clinical endocrinologists. MRI is commonly used to diagnose Cushing disease and remains the obvious technique to identify pituitary microadenomas in a noninvasive manner but it has proved to be problematic in some cases

[Evaluation and prevention of diabetic neuropathy]

Diabetic neuropathy is an incapacitating disease that afflicts almost 50 percent of patients with diabetes. A late finding in type 1 diabetes, diabetic neuropathy can be an early finding in non insulin-dependent diabetes. Diabetic neuropathies are divided primarily into two groups, sensorimotor and autonomic. Patients may acquire only one type of diabetic neuropathy or may present with combinations of neuropathies, such as autonomic neuropathy or distal symmetric polyneuropathy, the latter of which the most common form. Motor deficits, orthostatic hypotension, silent cardiac ischemia, hyperhidrosis, vasomotor instability, gastroparesis, bladder dysfunction, and sexual dysfunction can also result from diabetic neuropathy. Strict control of blood sugar, combined with proper daily foot care, is essential to avoid the complications of this disorder. With the potential to afflict any part of the nervous system, diabetic neuropathy should be suspected in all patients with type 2 diabetes as well as patients who have had type 1 diabetes for over five years. Although some patients with diabetic neuropathy notice few symptoms, upon physical examination mild to moderately severe sensory loss may be noted by the physician. Idiopathic neuropathy has been known to precede the onset of type 2 diabetes