Comparison of Diabetic Ketoacidosis Characteristics During- and Before the COVID-19 Pandemic.

Background: Despite evidence about the relationship between diabetic ketoacidosis (DKA) and infectious diseases, our knowledge of DKA during the coronavirus disease 2019 (COVID-19) pandemic remains unclear. Objectives: This study aimed to compare the DKA situation among individuals with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) during the COVID-19 pandemic compared to pre-pandemic. Methods: This retrospective-longitudinal study included individuals with T1DM and T2DM hospitalized with newly diagnosed DKA before (March to August 2018 and 2019) and during (March to August 2020 and 2021) the COVID-19 pandemic. Demographics, the frequency of new-onset diabetes mellitus (DM) and new-onset DKA, days of hospitalization, DKA severity, laboratory tests, and mortality were assessed. Results: Of 162 patients with DKA, 139 patients were newly diagnosed. The frequency of individuals with new-onset DM had increased during the pandemic compared to pre-pandemic (P = 0.047). Moreover, new-onset DKA was higher in 2020 and 2021 versus 2019 and 2018 (P = 0.002). Significantly, there were no T2DM patients with DKA in pre-pandemic, but DKA admissions in people with T2DM increased in 2021 (P < 0.001). The severity of new-onset DKA had increased during the pandemic compared to pre-pandemic (P = 0.000). However, there was no significant difference between pre-and the pandemic regarding mortality (P = 0.981). Additionally, hospitalization length (P = 0.043) and mortality (P = 0.038) were higher in patients with T2DM compared to T1DM. Conclusions: During the COVID-19 pandemic, the frequency of DKA and its severity was higher than in pre-pandemic, and COVID-19 can be more life-threatening in patients with T2DM. Therefore, healthcare providers should be alert to DKA, especially in patients with T2DM.

Evaluation of the Risk Factors for Type 2 Diabetes Using the Generalized Structure Equation Modeling in Iranian Adults based on Shahedieh Cohort Study.

Objective: Diabetes mellitus (DM) is an important global health risk factor in the twenty-first century and one of the 10 major causes of mortality world wide. The generalized structural equation model (GSEM) is a family of statistical techniques in the analysis of multivariate data, classified and sequential, which measures the hidden variables and the relationships between them. Finding risk factors for type 2 diabetes and providing a model for lifestyle changes is the aim of the study.. Methods: This exploratory, cross-sectional study was performed to evaluate the risk factors in a cohort of Iranian diabetic patients aged over 35 years (N = 9975). Among 9975 people over 35 years old participating in the first phase of the Yazd cohort study, 1736 people (17.95%) with diabetes and people who were unaware of their diabetes status and pregnant women were excluded and finally we selected 7431 non-diabetics who had FBG test. By presenting the model of initial generalized structural equations using stata software (version 15), we investigated the risk factors affecting type 2 diabetes. Results: The risk factors of BMI (Impact coefficients0.010), triglyceride (0.005), hypertension (0.086), and high cholesterol level (0.005) directly affected the DM status (P < 0.001). Meanwhile, BMI and triglyceride played a mediating role in this regard, and the factors of high-density lipoprotein cholesterol, physical activity (-0.23), and diet (0.001) indirectly affected the DM status. Conclusion: Using a large sample, this study provides a clear and direct model of the risk factors for diabetes. The main finding is that the risk factors for diabetes 2 that directly affect Iranians in this study are high blood pressure, BMI, triglycerides and cholesterol.

Effect of Nanoalumina on Sex Hormones and Fetuses in Pregnant Rats.

OBJECTIVE: This study aimed at investigating the effect of nanoalumina on sex hormones, and fetuses in pregnant rats. METHODS: In this study, sixty-four pregnant rats were divided into eight groups. The control and the injection-control group received normal food and water, and 0.5 ml of distilled water, respectively. Treatment groups were treated with 25, 50, 100, 250, 500, and 1000µg/ml concentrations of Nanoalumina from the 7th day until the 18th day of pregnancy. On the 18th day, the rats were investigated in terms of their hormone levels. We evaluated the number of healthy and aborted offspring, as well as fetus size. RESULTS: Nanoalumina caused an increase in progesterone hormones at the concentrations of 250, and 500µg/ml, and a significant reduction in estrogen hormone and aborted fetuses at the concentrations of 250 and 500µg/ml (p<0.05). The largest and smallest size of fetuses were observed in 500µg/ml and 1000µg/ml, respectively. The highest number of aborted fetuses was observed in the group treated with the 500µg/ml concentration. There was no aborted fetuses with 25, 50,100, control, and injection-control groups. CONCLUSIONS: Due to nanoalumina toxicity, it must be used with caution.

The effect of L-carnitine supplementation on insulin resistance, sex hormone-binding globulin and lipid profile in overweight/obese women with polycystic ovary syndrome: a randomized clinical trial.

PURPOSE: Polycystic ovary syndrome (PCOS) is a common endocrine disorder among reproductive-age women. Insulin resistance and dyslipidemia are linked to PCOS. L-Carnitine supplementation as a management strategy for women with PCOS has been proposed. The effect of L-carnitine supplementation on insulin resistance, sex hormone-binding globulin (SHBG) and lipid profile in overweight/obese women with PCOS was investigated. METHODS: This randomized, double-blind, controlled clinical trial, was conducted on 62overweight/obese women with PCOS. Participants were randomly assigned into two groups to receive 1000 mg/day L-carnitine or placebo (1000 mg starch) for 12 weeks. RESULTS: L-Carnitine supplementation compared to the placebo showed a significant improvement in insulin [- 0.7 (- 7.3 to 4.0) vs. 0.7 (- 3.0 to 5.2); P = 0.001], homeostatic model assessment for insulin resistance [- 0.4 (- 1.7 to 1.1) vs. 0.0 (- 0.7 to 1.3); P = 0.002], quantitative insulin sensitivity check index (+ 0.01 ± 0.02 vs. - 0.01 ± 0.01; P = 0.02) and a non-significant change toward improvement in SHBG (+ 11.5 ± 40.2 vs. - 3.2 ± 40.2; P = 0.2). However, there was no significant differences between the two groups in serum levels of fasting plasma glucose, total cholesterol, triglyceride, low density lipoprotein-cholesterol and high density lipoprotein cholesterol (P > 0.05). CONCLUSION: 12-week L-carnitine supplementation in overweight or obese women with PCOS ameliorate insulin resistance, but has no effect on SHBG and lipid profile. Studies with higher dosages and duration of L-carnitine intake are required. The trial was registered on 30 December 2019 at Iranian Registry of Clinical Trials IRCT20191016045131N1. TRIAL REGISTRATION: Registered on 30th December 2019 at Iranian Registry of Clinical Trials (IRCT20191016045131N1).

Effect of l-carnitine supplementation on liver fat content and cardiometabolic indices in overweight/obese women with polycystic ovary syndrome: A randomized controlled trial.

BACKGROUND: Polycystic ovary syndrome (PCOS) is a common endocrine disorder among reproductive-age women, and is associated with cardiovascular diseases as well as non-alcoholic fatty liver disease. The recent evidence suggested the beneficial effects of l-carnitine in women with PCOS. OBJECTIVE: The present study aimed to investigate the effect of l-carnitine supplementation on liver fat content and cardiometabolic outcomes in overweight/obese women with PCOS. METHODS: The present study was designed as a 12-week double-blind, randomized controlled clinical trial. Sixty-two overweight/obese women with PCOS were assigned into the treatment (received 1000 mg/d l-carnitine capsule) and the control (received placebo capsule) groups. The outcomes included lipid accumulation product (LAP), atherogenic index of plasma (AIP), atherogenic coefficient (AC) and Castelli II indices. RESULTS: At the end of the trial, there was no significant difference between the treatment and the control groups in terms of LAP (-1.1 vs. -4.0; P = 0.45), AIP (0.0 vs. -0.09; P = 0.14), AC (-0.2 vs. -0.8; P = 0.06) and Castelli II index (-0.2 vs. -0.6; P = 0.07) after controlling the mean change of waist circumference. CONCLUSION: l-carnitine supplementation for 12 weeks has no beneficial effect on liver fat content and cardiometabolic outcomes in overweight or obese women with PCOS. TRIAL REGISTRATION: Registered on 30 December 2019 at Iranian Registry of Clinical Trials IRCT20191016045131N1.

Antimicrobial Peptides from Amphibian Innate Immune System as Potent Antidiabetic Agents: A Literature Review and Bioinformatics Analysis.

Antimicrobial peptides, as an important member of the innate immune system, have various biological activities in addition to antimicrobial activity. There are some AMPs with antidiabetic activity, especially those isolated from amphibians. These peptides can induce insulin release via different mechanisms based on peptide type. In this review study, we collected all reported AMPs with antidiabetic activity. We also analyze the sequence and structure of these peptides for evaluation of sequence and structure effect on their antidiabetic activity. Based on this review, the biggest peptide family with antidiabetic activity is temporins with nine antidiabetic peptides. Frogs are the most abundant source of antidiabetic peptides. Bioinformatics analysis showed that an increase of positive net charge and a decrease of hydrophobicity can improve the insulinotropic effect of peptides. Peptides with higher positive net charge and Boman index showed higher activity. Based on this review article, AMPs with antidiabetic activity, especially those isolated from amphibians, can be used as novel antidiabetic drug for type 2 diabetes disease. So, amphibians are potential sources for active peptides which merit further evaluation as novel insulin secretagogues. However, strategy for the increase of stability and positive activity as well as the decrease of negative side effects must be considered.

Evaluation of hyperprolactinemia risk factors in infertile women referred to Yazd Infertility Center: A cross-sectional study.

BACKGROUND: Hyperprolactinemia is one of the most common causes of infertility in women. The prevalence of pituitary tumors is 25-30% among infertile participants with hyperprolactinemia. OBJECTIVE: The aim of this study was to describe the causes of hyperprolactinemia in infertile women referred to Yazd Infertility Center. MATERIALS AND METHODS: This cross-sectional study was conducted with 182 infertile women with hyperprolactinemia who were referred to Yazd Infertility Center from February 2018 to October 2019. Serum prolactin was assessed by the human prolactin ELISA kit according to the Padtan Gostar Isar protocol. The age, duration of infertility, causes of hyperprolactinemia, and type of infertility treatment were noted. The MRI findings were added. RESULTS: The mean age of participants was 28.9 ± 0.36 yr and the prolactin level was 76 ± 8.97 ng/ml. The etiology of hyperprolactinemia among the study participants was 35 participants (19.2%) with pituitary adenoma, 47 participants (25.8%) with polycystic ovary syndrome, 14 participants (7.7%) with pituitary adenoma and polycystic ovary syndrome, and 86 participants (47.3%) with idiopathic hyperprolactinemia. The results of this study showed that there was no statistically significant difference between the mean prolactin levels in participants with different causes of hyperprolactinemia (p = 0.31). CONCLUSION: Idiopathic hyperprolactinemia and polycystic ovary syndrome are the most common reasons for hyperprolactinemia.

Effect of hypocaloric high-protein, low-carbohydrate diet supplemented with fennel on androgenic and anthropometric indices in overweight and obese women with polycystic ovary syndrome: A randomized placebo-controlled trial.

OBJECTIVE: The aim of this study was to evaluate the effect of hypocaloric high-protein, low-carbohydrate weight loss diet supplemented with fennel on anthropometric and androgen indices in overweight and obese women with polycystic ovary syndrome (PCOS). METHODS: A randomized controlled trial with a factorial design was performed on sixty-four overweight/obese women with PCOS. Participants were randomly allocated to four groups (n = 16 per group) as follows: 1) hypocaloric standardize diet + fennel (2 capsule/day) (HSDF), 2) hypocaloric high-protein diet + fennel (2 capsule/day) (HHPF), 3) hypocaloric standardize diet + placebo (HSDP), and 4) hypocaloric high-protein diet + placebo (HHPP). RESULTS: The mean (SD) age of the participants was 28.54 (6.80) years and body mass index was 32.24 (4.65) kg/m2. At the end of intervention, protein intake was 20.43 % in the groups that received a high-protein diet versus 16.37 % in the standard diet groups (P < 0.001). Combination of hypocaloric high-protein diet and fennel capsule did not significantly affect change in outcomes compared with groups not receiving them. There was a significant interaction between hypocaloric high-protein diet and fennel on weight (P = 0.019). CONCLUSION: A hypocaloric high-protein diet along with fennel supplementation could not provide additional improvements in anthropometric and androgen indices among PCOS women. Further studies are required to more precisely elucidate these findings.

Relationship between Self Care Management with Glycemic Control in Type 2 Diabetic Patients.

BACKGROUND: The purpose of this study was to investigate the relationship between self-care management and HbA1c level of the patients with type 2 diabetes in YAZD. METHODS: This study was a cross-sectional study. The number of 376 diabetic patients referred to the Diabetes Research Center in Yazd entered the study. The data collection tool was a summary of Diabetes Self Care Activity questionnaire (SDSCA), which was collected through interviews with patients. Data analysis was performed using SPSS software V 16 and kruskalwallis and independent sample t tests. RESULTS: The results showed that of 376 patients, 218 (%58) were women and 158 (%42) were male. The mean age of the participants in the study was 54.5 ± 10.9 years old and the mean duration of the disease was 9.53 ± 8.39 years. The mean HbA1C in the patients was 7.93% ± 1.38%. The mean of BMI was 28.93 ± 6 kg/ m2. The mean of self-care score in the patients under study was 30.53 ± 11.4. There was a significant relationship between the mean of self-care score, BMI, age and HbA1C (P value <0.05). CONCLUSIONS: According to the results of the study, it can be concluded that the level of self-care in patients with controlled diabetes mellitus (HbA1C <7%) is more than patients with uncontrolled diabetes mellitus (HbA1c ≥9%).

The role of androgens in COVID-19.

BACKGROUND AND AIM: The coronavirus disease 2019 (COVID-19) pandemic is a global health emergency. According to the findings, male patients with COVID-19 infection are at an increased risk for severe complications than females. The causes of this issue are unknown and are most probably multifactorial. Sexual hormones affect the immune system, so estrogen strengthens the immune system, and testosterone suppresses it. Due to the reports of the high prevalence of androgenic alopecia in hospitalized patients with COVID-19 and a higher risk of respiratory disease and increased use of allergy/asthma medications among patients with polycystic ovary syndrome (PCOS) as a hyperandrogenism condition compared with non-PCOS women, this review aimed to evaluate androgens role in COVID-19. METHODS: 42 related articles from 2008 to 2020 were reviewed with the keywords of androgens, hormonal factors, and hair loss in combination with COVID-19 in medical research databases. RESULTS: The evidence of transmembrane protease, serine 2 (TMPRSS2) expression in lung tissue, which is an androgen-regulated gene and expressed mainly in the adult prostate may interpret the increased susceptibility of the male gender to severe COVID-19 complications. Moreover, angiotensin-converting enzyme 2 (ACE-2) acts as a functional receptor for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and male hormones are effective in the ACE-2 passageway and simplify SARS-CoV-2 entry into host cells. CONCLUSION: Further studies on the severity of symptoms in patients with COVID-19 in other hyperandrogenism conditions compared to the control group are recommended.

COVID-19 and self-care strategies for women with gestational diabetes mellitus.

BACKGROUND AND AIM: The outbreak of the emerging coronavirus disease 2019 (COVID-19) is a global public health emergency. According to the findings, women with gestational diabetes mellitus (GDM) are at increased risk of this virus. Due to the need for quarantine and social distancing in the current disease situation and need to receive repeated medical care in GDM patients, this review study aimed to evaluate the self-care strategies for women with GDM during COVID-19 pandemic. METHODS: 25 related articles from 2011 to 2020 and 3 guidelines were reviewed with the keywords of gestational diabetes mellitus, diabetes, pregnancy and COVID-19 in combination with self-care and self-management in PubMed, Google Scholar, Scopus, Science Direct, Elsevier, Springer, Wiley Online Library and SID. RESULTS: According to the results of the studies, face-to-face visits should be limited and instead, telemedicine services recommended. Self-care throughout telemedicine services were improved maternal and neonatal outcomes in women with GDM. CONCLUSION: Although self-care program through telemedicine services is beneficial for women with GDM, performing clinical trials are recommended to assess maternal and neonatal outcomes in this condition.

The effectiveness of counseling based on acceptance and commitment therapy on body image and self-esteem in polycystic ovary syndrome: An RCT.

BACKGROUND: Polycystic ovary syndrome (PCOS) is one of the most common endocrine and metabolic disorders known with irregular menstruation, hirsutism, alopecia, obesity, infertility, and acne. These symptoms cause a negative effect on the satisfaction of body image, self-esteem, and quality of life in such patients. Recent studies emphasize the need to consider the psychological problems in these women and also the need for appropriate interventions. OBJECTIVE: The aim of this study was to determine the effectiveness of group counseling based on acceptance and commitment therapy (ACT) on body image and self-esteem in patients with PCOS. MATERIALS AND METHODS: In this randomized controlled trial, 52 women with PCOS were randomly allocated to intervention and control groups (n = 26/each) using the table of random numbers. Group counseling based on the ACT was held in eight sessions of 90 min once a week for the intervention group. The demographic questionnaire, Littleton development of the body image concern inventory and Rosenberg self-esteem scale were completed in both groups before, immediately after, and one month after the intervention. RESULTS: The mean scores of body image concern (p = 0.001) and self-esteem (p ≤ 0.001) in the intervention group after the intervention and follow-up were significantly different from the control group. CONCLUSION: Based on the findings of this study, use of cognitive-behavioral therapies in health care centers is recommended as a complementary method.

The effect of apple vinegar consumption on glycemic indices, blood pressure, oxidative stress, and homocysteine in patients with type 2 diabetes and dyslipidemia: A randomized controlled clinical trial.

BACKGROUND: Some foods and drinks contain special ingredients, causing impressive effects on human health. The aim of the current study was to assess the health effects of apple vinegar in patients with diabetes and dyslipidemia. METHOD: Seventy participants with type 2 diabetes and hyperlipidemia were randomly assigned into an intervention and control group in order to assess the effect of 20 ml apple vinegar per day using an 8-week parallel study. Fasting blood sugar (FBS), homeostasis model assessment for insulin resistance (HOMA-IR), homeostasis model assessment for b-cell function (HOMA-B), quantitative insulin sensitivity checks index (QUICKI), insulin, malondialdehyde (MDA), 2,20-Diphenyl-1- picrylhydrazyl (DPPH), homocysteine, systolic blood pressure (SBP), and diastolic blood pressure (DBP) were measured at the beginning and end of the study. RESULTS: The intervention with apple vinegar could significantly improve FBS (mean change: -10.16 ± 19.48 mg/dl, p = 0.006) and DPPH (mean change: 16.58 ± 11.56, p < 0.001) within intervention group and in comparison with control group (p < 0.001). Additionally, the significant increase of MDA in control group (p < 0.05) caused a considerable difference between two groups. Glycemic indices containing insulin, HOMA-IR, HOMA-B, and QUICKI decrease significantly in both groups (p < 0.05). No considerable effect was observed on blood pressure and homocysteine in intervention group as well as control group. CONCLUSION: This trial provided some evidences that apple vinegar consumption may cause beneficial effects on glycemic indices and oxidative stress in individuals with diabetes and dyslipidemia. This randomized clinical trial was registered in the Iranian Registry of Clinical Trials (https://www.irct.ir/) as 2013070710826N5.

The effect of vitamin D supplementation on the androgenic profile in men: A systematic review and meta-analysis of clinical trials.

The aim of this systematic review and meta-analysis was to evaluate the effect of vitamin D supplementation on total testosterone (TT) and sex hormone-binding globulin (SHBG) in men. We searched PubMed, Scopus and Web of Science for randomized, controlled trials of vitamin D supplementation in men ≥18 years old up to September 2018, without language restrictions. Meta-analysis was based on a random effects model. The systematic review was registered as CRD42018094498. We identified 3,402 articles, of which eight studies with 10 effect sizes met the inclusion criteria. Vitamin D daily dose equivalents ranged from 600 to 4,000 per day to 60,000 IU per week; duration was 6 weeks to 36 months. In general, vitamin D supplementation had no significant effect on TT (MD = 0.20, 95% CI: -0.20, 0.60, p = 0.336) and SHBG (MD = 1.56, 95% CI: -0.85, 3.97, p = 0.204). Subgroup analysis conducted with duration of prescription, type (daily or weekly), dosing frequency and baseline vitamin D and TT concentration showed that vitamin D did not significantly affect TT. The present study did not find any evidence to support beneficial effect of vitamin D supplementation on TT and SHBG in men. Thus, further large-scale randomised controlled trials are required to evaluate the effects of vitamin D supplementation on androgen in men.

Association between selected trace elements and body mass index and waist circumference: A cross sectional study.

BACKGROUND: The prevalence of obesity has increased worldwide. Abnormal plasma level of some trace elements may be associated with obesity. The present study was designed to compare the plasma level of zinc, phosphate, calcium and magnesium with the degree of body mass index and waist circumference. MATERIAL AND METHODS: In this cross sectional study 149 persons (20-60 years old) from March 2014 till April 2017 were included. Definition of central obesity was waist circumference (WC)≥ 102 cm and ≥88 cm in men and women, respectively. Also BMI categorized to: normal weight: 18.50-24.99, overweight: 25.00-29.99 and obese: ≥30 kg/m2 respectively. Mg, Ca, P and Zinc in plasma was checked after12 h fasting in each persons. Comparison between the level of Mg, P, Ca and Zinc by three categories of BMI or waist circumference performed. The data were analyzed by independent T-test and one-way ANOVA. Scheffe method was used to determine post-hoc pair-wise comparisons. The relationship between BMI and concentration of elements was detected by linear correlation and Cubic model. A p ≤ 0.05 were considered statistically significant. Statistical analyses were executed by SPSS version 20. RESULTS: In this study, 32.2% male and remainder female, mean age of 42.26 ±â€¯13.03 were participated. 40.9% were normal and 59.1% obese base on waist circumference. Also 24.8% normal,44.3% overweight and remainder was obese according to BMI. Obese subjects base on waist circumference had significantly lower serum Zinc(pvalue:0.002), Ca (pvalue:0.0001)and Mg(pvalue:0.042) concentration. Whereas, P concentration was significantly higher in obese cases in comparison with normal subjects(pvalue:0.012). Also normal cases had significantly higher serum Zinc (pvalue: 0.0001), Ca (pvalue:0.0001), and Mg(pvalue:0.006) concentration compared to overweight and obese subjects according to BMI categorizes. CONCLUSION: Inverse correlation present between plasma zinc, calcium and magnesium level and BMI and waist circumference, but positive correlation seen between P level and waist circumference. Further studies are needed to evaluate the effect of dietary or supplemental interventions on obesity and central obesity.

Prediabetes and gastrointestinal (GI) symptoms; a cross-sectional study.

AIMS: Prediabetes associate with known micro and macrovascular complications of diabetes. Also gastrointestinal symptoms are present in diabetics higher than general population. The aim of this study was evaluation of gastrointestinal symptoms in subjects with prediabetes. METHODS: This analytical cross-sectional study was conducted on 130 persons 30-65 years old, 65 pre-diabetic patients and 65 persons without glucose disorders from 2014 to 2015 in YAZD province. FBS and HbA1c used for diagnosis prediabetes. Demographic and medical history were collected. A questionnaire according to Rome III Criteria was used to collect digestive information (diarrhea, abdominal pain, constipation, abdominal bloating, heartburn, increased gas passing, nausea, intermittent diarrhea and constipation in the last 6 months ago). Frequency of GI symptoms in subjects with and without glucose disorders were compared. Data were analyzed by SPSS software Version 20. Data were reported as mean ±â€¯standard deviation or frequency and T-test, Chi Square and Spearman correlation coefficient tests were used. P-value less than 0.05 were considered statistically significant. RESULTS: Higher frequency of bloating, early satiety, nausea, heartburn, gas passing and constipation are seen in the pre-diabetes group than in the control group; (p-value 0.0001, 0.0001, 0.0001, 0.0001, 0.001 and 0.0001 respectively). 96.9% in prediabetics had at least one gastrointestinal symptom, while in the normal groups 50% had at least one GI symptom (p-value: 0.0001). CONCLUSIONS: Gastrointestinal symptoms were seen in prediabetics higher than healthy persons. So, prediabetes can not be considered an entirely benign and asymptomatic condition. Lifestyle interventions maybe necessary at this state.

Dose vitamin D supplementations improve peripheral diabetic neuropathy? A before-after clinical trial.

OBJECTIVE: Peripheral neuropathy is a common complication of diabetes mellitus. This study was set to assess the effect of vitamin D supplementation on peripheral neuropathy in patients with type 2 diabetes (T2DM). MATERIALS AND METHODS: This study was a quasi-experimental trial in Yazd diabetic research center. Sixty T2DM subjects (30-65 years old) with painful diabetic neuropathy enrolled in this study from March 2017 till April 2018. Patients received weekly 50000 IU of vitamin D3 for 12 weeks orally. Evaluation of diabetic neuropathy was performed by using Michigan Neuropathy Screening Instrument (MNSI) before and after trial. Also fasting plasma glucose, HbA1c, calcium and vitamin D checked before and after the trial. SPSS version 20 software was used for statistical analysis. P ≤ 0.05 was considered to be statistically significant. RESULTS: Among 60 T2DM patients, 58 completed the study. Most of them (53.4%) were male. At the end of study, HbA1c, vitamin D, MNSI (both questionnaire and physical examination) improved that is statistically significant (p-value: <0.001). CONCLUSION: Oral supplementation of vitamin D 3 (50,000 IU) once weekly for 12 weeks was associated with improvement in the serum level of vitamin D and significant decrease in the symptoms and sign of diabetic neuropathy. So serum vitamin D level should be checked in persons with diabetic neuropathy and low levels of it should be corrected in order to reducing neuropathy severity.

Relationship Between Vitamin D Deficiency and Markers of Metabolic Syndrome Among Overweight and Obese Adults.

In recent years, metabolic syndrome, obesity, diabetes and cardiovascular disease has had a tremendous elevation growth. Many studies have demonstrated negative correlation between vitamin D deficiency and indexes of metabolic syndrome in obese patients. This study was designed to find the relation between vitamin D deficiency and markers of metabolic syndrome among overweight and obese adults referred to obesity center of Shahid Sadoughi hospital in 2014. Eighty-nine overweight and obese adults (79 women and 10 men), who 13 subjects were overweight and 76 subjects were obese were recruited in this cross-sectional study. Total cholesterol, high-density lipoprotein cholesterol, triglyceride, plasma glucose and vitamin D were measured. IDF criteria were used for identifying subjects with metabolic syndrome. Demographic questionnaire was completed. Statistical analysis was performed using SPSS version 16.0. Fisher exact test, logistic regression, and Spearman correlation coefficient were used. The frequency of vitamin D deficiency was 93.2%. According to IDF criteria, the frequency of metabolic syndrome was 36%. There was no significant relationship between vitamin D deficiency and metabolic syndrome. Among metabolic syndrome indicators, there was a significant direct relationship between vitamin D level with FBS (P=0.013) and SBP (P=0.023). There was no significant relationship between vitamin D deficiency and metabolic syndrome. Due to the lack of relationship between vitamin D deficiency and metabolic syndrome, small number of participants in this study and very low case of normal vitamin D level, further studies are needed.

Effect of Ziziphus jujube Fruit Infusion on Lipid Profiles, Glycaemic Index and Antioxidant Status in Type 2 Diabetic Patients: A Randomized Controlled Clinical Trial.

This study was designed to assess the effects of Ziziphus jujube fruit (ZJF) infusion on lipid profiles, glycaemic control and antioxidant status in patients with type 2 diabetes mellitus (T2DM). In this randomized controlled clinical trial, 116 participants with T2DM (older than 30 years) were assigned to consume a balanced diet or diet plus ZJF infusion (10 g/100 mL boiling water) three times/day before main meals for 12 weeks. Diet was designed to be energy restricted (500 kcal/day deficit from estimated energy requirements), and macronutrient content was similar in both groups (55% carbohydrate, 15% protein and 30% fat). The consumption of ZJF infusion compared with the control group was associated with significant improvement in glycosylated haemoglobin (-0.68 ± 0.65 vs. -0.44 ± 0.55%; p = 0.03), total cholesterol (-24.29 ± 28.89 vs. -11.21 ± 29.98 mg/dL; p = 0.02), triglycerides (-43.3 ± 39.26 vs. -27.16 ± 46.84 mg/dL; p = 0.05), low-density lipoprotein cholesterol (-19.85 ± 27.62 vs. -6.55 ± 27.82 mg/dL; p = 0.01), low-density lipoprotein cholesterol/high-density lipoprotein cholesterol (-0.56 ± 0.80 vs. -0.2 ± 0.72; p = 0.01) and total cholesterol to high-density lipoprotein cholesterol ratios (-0.73 ± 0.94 vs. -0.35 ± 0.77; p = 0.02). ZJF had beneficial effects on glycosylated haemoglobin and lipid profile in T2DM patients. Further research is needed to identify the mechanism of ZJF action on glucose and lipid metabolism. Copyright © 2017 John Wiley & Sons, Ltd.