Journal of Diabetes and Metabolic Disorders10Comparison of incidence of pregnancy Induced hypertension in gestational diabetes mellitus and healthy pregnant women272272Hossein-nezhadAMirzaeiKhAhmadiSMaghbooliZhKarimiF20151005Background: Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance occurring or detected for the first time during pregnancy also hypertension is one of the major complications of pregnancy. Hypertension occurring as a result of pregnancy is called pregnancy-induced hypertension (PIH), which is itself divided into two groups: gestational hypertension and pre-eclampsia. The aim of this study is to compare the incidence of hypertensive disorders in pregnant women with GDM and healthy group.Methods: In a cohort study, 615 pregnant women including 293 GDM patients as exposed group were recruited. Gestational diabetes mellitus was diagnosed based on Carpenter and Coustan criteria. On the other hand, 322 women with a normal glucose challenge test were chosen as un-exposed. Results: Mean age, BMI, and parity in GDM and control groups were 27.64±5.80 and 25.71±4.93 years, 26.98±5.38 and 25.63±5.08 kg/m2, and 1.34 ± 0.84 [1(3)] and 0.25±0.43 [1(1)] births, respectively. Women with GDM had a significant higher prevalence of PIH than matched controls [OR=3.18, (95% CI: 1.13-8.94), RR=1.03, (95% CI: 1.004-1.06), P=0.03]. The prevalence of pre-eclampsia and essential hypertension was also higher in women with GDM than matched controls but not significant.Conclusion: Our results show that hypertensive disorders are more common in women with GDM than in normoglycaemic controls of similar age, parity and BMI. It has been hypothesized that this association, at least in part, could be due to insulin resistance, which is a physiologic phenomenon and adaptation in normal pregnancy but that in the predisposed individual with other risk factors could lead to pathologic procedures for instance the development of PIH, GDM, or both. Correlation does not necessarily imply causation, but the development of possible preventive strategies and therapeutic interventions based on this data could be beneficialhttps://jdmd.tums.ac.ir/index.php/jdmd/article/view/272https://jdmd.tums.ac.ir/index.php/jdmd/article/download/272/42Journal of Diabetes and Metabolic Disorders10Genetic association analysis of the adiponectin polymorphisms in type 2 diabetes with and without complications273273Hasani RanjbarShMohammad AmoliMSajadiMABalaeiPAmiriPNamakchianMHeshmetRMirzaeeMRRezazadehETavakkoly BazzazJLarijaniB20151005Background: Adiponectin gene polymorphisms are associated with adiponectin plasma levels, BMI, insulin sensitivity and type2 diabetes. This study was carried out to examine the possible association of adiponectin gene polymorphisms at positions +45T/G and -11391G/A and type2 diabetes in an Iranian population. Methods: Type 2 diabetic patients (N=244) were recruited from diabetes clinic in Rafsanjan, South-east of Iran. Healthy control subjects (N=99) were recruited from the same area. DNA was extracted using salting out methodResults: No significant association was found between adiponectin gene polymorphisms +45T/G and -11391G/A and diabetes in our study. In addition, no significant association was found between these polymorphisms and diabetic retinopathy, nephropathy and neuropathy. Linkage disequilibrium (LD) analysis showed no significant LD between these two polymorphisms also no significant differences for LD was found between cases and controls. Conclusion: Our findings confirm previous data reporting the lack of association between +45T/G polymorphism in adiponectin gene and development of diabetic neuropathy, retinopathy and nephropathy. Moreover, our data showed no association between -11391 polymorphism and type 2 diabetes.https://jdmd.tums.ac.ir/index.php/jdmd/article/view/273https://jdmd.tums.ac.ir/index.php/jdmd/article/download/273/43Journal of Diabetes and Metabolic Disorders10Citral as a potential antihyperlipidemic medicine in diabetes: a study on streptozotocin-induced diabetic rats274274NajafianMEbrahim-HabibiAYaghmaeiPParivarKLarijaniB20151005Background: As potential anti-diabetic and anti-obesity agents, glycosidase inhibitors are the subject of numerous studies. Among these enzymes, alpha-amylases are of particular interest, and most of their reported inhibitors have so far been natural compounds. Citral is an isoprenoid compound of various essential oils, and based on its alpha-amylase inhibitory effect, was further studied here in an in vivo model of type 1 diabetes.Methods: In vitro effect of the compound was assessed on mammalian alpha-amylase activity with the use of the Bernfeld method. In vivo effect of the compound was studied on streptozotocin-induced diabetic rats (wistar). Non-diabetic and diabetic rats received citral at 2, 8, 16 or 32 mg/kg body weight; the compound was dissolved in grape seed oil. The control groups received grape seed oil alone. Treatment was done for 24 days, after what the animals were sacrificed under light ether anesthesia. Measured parameters included: food and water ingestion and urine volume (daily), blood glucose levels (every two days), cholesterol, triacylglycerol, concentrations, and alpha-amylase levels after 24 days. Results: Citral was found to be a moderate inhibitor of mammalian alpha-amylase, with an IC50 of 120 μM, and caused also a decrease of alpha-amylase levels in vivo. Moderate lowering of postprandial glucose, alongside with normalization of blood lipid profile was observed in diabetic rats upon treatment with the compound. Citral was also found to be able to promote weight loss and to decrease food intake.Conclusion: Citral could be proposed as a possible antihyperlipidemic agent in diabetes and potential therapeutic in obesity, although further studies are needed to establish its complete profile as potential medication.https://jdmd.tums.ac.ir/index.php/jdmd/article/view/274https://jdmd.tums.ac.ir/index.php/jdmd/article/download/274/44Journal of Diabetes and Metabolic Disorders10Status of diabetes care in elderly diabetic patients of a developing country275275Tabatabaei-MalazyOPeimaniMHeshmatRPajouhiM20151005Background: Diabetes is the most common metabolic disease that its prevalence increases with age. The prevalence of diabetes amongst elderly population of Iran is estimated 14%, yet precious little is known about status of their care. This study was designed to evaluate this issue. Methods: This cross-sectional study sought to evaluate the diabetes care status of elderly diabetics who referred to a Diabetes Clinic of Tehran/Iran between 2007 and 2009. Data on the demographic, blood pressure, lipid profile, blood sugar, glycosylated hemoglobin (HbA1c), and treatment regimen used to control hyperglycemia and diabetes' complications were extracted from their medical records. Descriptive statistical methods were used. Results: In total, 200 cases enrolled to the study that 130 were female. Oral hypoglycemic agents, medications for hypertension, dyslipidaemia or neuropathy were used by 72.5%, 81.5%, 72%, and 73% of patients, respectively. There was uncontrolled status in blood pressure, blood glucose, and lipid profile in over 50% of participants. Conclusion: The status of diabetes care in our country is far from satisfactory. Given the rising prevalence of diabetes and also aging population, it is prudent that status of diabetes care in the elderly should be promoted because of the complexity of the process of diabetes care in this age group.https://jdmd.tums.ac.ir/index.php/jdmd/article/view/275https://jdmd.tums.ac.ir/index.php/jdmd/article/download/275/45Journal of Diabetes and Metabolic Disorders10Trace element analysis of hair, nail, serum and urine of diabetes mellitus patients by inductively coupled plasma atomic emission spectroscopy276276Nasli-EsfahaniEFaridbodFLarijaniBGanjaliMRNorouziP20151005Background: Trace elements play important roles in carbohydrates and lipids metabolism. According to some studies, trace elements concentrations are different in serum and urine of diabetic and healthy population. In this work, for the first time six trace elements (Zn, Cu, Mg, Mn, Cr, Se) concentration of scalp hair, nail, urine and serum of diabetes mellitus patients and control group were analyzed at the same time. Due to the very low concentration of some trace elements (e.g. Cr, Se), measurements were carried out by Inductively Coupled Plasma Atomic Emission Spectroscopy (ICP-AES). Methods: In this study diabetic patients (n=150) and healthy control (n=151) were enrolled in Tehran University of Medical Sciences Hospital. Their biological samples (scalp hair, nail, urine and serum) were analyzed by ICP-AES.Results: In serum samples zinc (Zn), magnesium (Mg), copper (Cu) and chromium (Cr) concentration of diabetic patients and control group were significant (p<0.05). In urine Zn, Mg, Se, and Mn had significant difference (p<0.05). In hair difference between amount of Zn, Mn and Cr in diabetic patients and control group were significant (p<0.05). The difference in Zn, Se and Cr content of nail were significant (p<0.05).Conclusion: The obtained results showed that scalp hair and nail samples are the best biological samples for trace element analysis especially in case of Cr, Se, and Mn due to the high accumulation of these elements in hair and nail which causes a better detection.https://jdmd.tums.ac.ir/index.php/jdmd/article/view/276https://jdmd.tums.ac.ir/index.php/jdmd/article/download/276/46Journal of Diabetes and Metabolic Disorders10Study of serum cystatin C as a reliable marker for metabolic syndrome277277AmirrasouliHAsefyZKazerouniFTaghikhaniM20151005Background: Serum concentration of cystatin C, a marker of glomerular filtration, has been associated with cardiovascular disease (CVD). The aim of this study was to elucidate the association of serum C with metabolic syndrome as a constellation of cardiovascular risk factors. Methods: The study population consisted of 56 subjects with metabolic syndrome and 22 subjects free of metabolic syndrome (control group). Cholesterol, HDL-C, LDL-C, blood urea, triglycerides, glucose, HbA1c, serum cystatin C and serum creatinine were measured in both groups. GFR was calculated in both groups using Cockroft-Gault equation. Results: Metabolic syndrome group presented significantly higher cystatin C levels than the control group (1.38 ±0.57 vs. 0.954 ±0 .40; P=0.006). The sensitivity and specificity of cystatin C were 78.57% and 77.67%, respectively. Subjects with metabolic syndrome exhibited significantly higher blood glucose,triglyceride, cholesterol and HbA1c levels. Conclusion: Our results suggest that cystatin C may be a marker for metabolic syndrome and may identify a certain degree of renal dysfunction even when serum creatinine does not exceed normal level.https://jdmd.tums.ac.ir/index.php/jdmd/article/view/277https://jdmd.tums.ac.ir/index.php/jdmd/article/download/277/47Journal of Diabetes and Metabolic Disorders10Insulin-like growth factor-1 levels in children and adolescents with type1 diabetes mellitus and its relationship with serum zinc278278EstakhriMJalaliMDjazayeryAMajdzadehREshraghianMRKaramizadehZArvintanSPeyrovi MilaniM20151005Background: Some studies have indicated impaired metabolism of Insulin-like growth factor-1 (IGF-1) and zinc in type-1 diabetic patients. However, no results have been reported to date on the relationship between IGF-1 and serum zinc levels in children and adolescents with type-1 diabetes mellitus. Therefore, the objectives of this cross-sectional study were to compare IGF-1 levels in type-1 diabetic children and adolescents with that of healthy controls, and also to determine whether there is a relationship between IGF-1 and serum zinc levels. Methods: Thirty children and adolescents with type-1 diabetes mellitus and 30 age- and sex-matched healthy controls participated in the study. Serum IGF-1, serum zinc, fasting blood sugar, hemoglobin A1C (HbA1C) were measured by enzyme-linked immunosorbent assay, flame atomic absorption spectrophotometry, enzymatic colorimetry and ion-exchange chromatography methods, respectively. Results: The mean level of serum IGF-1 (ng/l) in the diabetics was significantly lower than in the controls (208.2 ± 15.7 and 317.0 ± 33.2, respectively; p=0.001). No relationship was found between the IGF-1 levels and serum zinc or the amount of glycemic control.Conclusion: IGF-1 levels of the diabetic children and adolescents were significantly lower compared to those of healthy controls and were independent of serum zinc levels and the amount of glycemic control.https://jdmd.tums.ac.ir/index.php/jdmd/article/view/278https://jdmd.tums.ac.ir/index.php/jdmd/article/download/278/48Journal of Diabetes and Metabolic Disorders10Evaluation of psychometric properties of the third version of the Iranian Diabetes Attitude Scale (IR-DAS-3)279279MahjouriMYArzaghiSMQorbaniMNasli-EsfahaniELarijaniB20151005Background: The aim of this pilot study was to evaluate the psychometric properties of the third version of the Iranian Diabetes Attitude Scale (DAS-3).Methods: A sample of 100 patients with type2 diabetes, selected via a systematic random sampling method, completed the IR-DAS-3. The validity of the questionnaire was evaluated through concurrent and criterion validity, whereas its reliability was assessed by test re-test internal consistency and splitting method.Results: The internal consistency and test-retest reliability of IR-DAS-3 was acceptable (α= 0.78, α= 0.68). The IR-DAS-3 total score and its five subscales score were correlated with HbA1C levels (P<0.01); this supported the concurrent validity of the questionnaire.Conclusion: The psychometric properties of the IR-DAS-3 are acceptable and the scale is a good instrument for assessing the attitudes of the Iranian diabetic patients.https://jdmd.tums.ac.ir/index.php/jdmd/article/view/279https://jdmd.tums.ac.ir/index.php/jdmd/article/download/279/49Journal of Diabetes and Metabolic Disorders10Correlation between oxidized-LDL and interleukin-6 in type 2 diabetic patients280280Ghadiri-AnariABehjatiJEsteghamatiAEsfahanianFKhazaiipoorZNakhjavaniM20151005Background: Studies have suggested that oxidative stress is a common pathway of different leading mechanisms to diabetes complications. Oxidative stress play a crucial role in atherogenesis and cause oxidation of low density lipoprotein. Evidence has been shown that oxidized LDL in diabetic patients is higher than nondiabetic individuals. Regarding to known role of oxidative stress in developing of micro and macrovascular complications of diabetes and recent evidences about importance of IL-6 in initiating of inflammatory processes in atherosclerotic plaques formation and reports that shown the effects of Ox-LDL upon IL-6 release, in this study evaluation of serum levels of IL-6 and correlation of these two agents in diabetic patients in comparison with healthy persons was performed.Methods: This stratified cross-sectional study was conducted in diabetic clinic of Imam khomeini Hospital, Tehran University of Medical Sciences during 2009-2010, recruiting 40 type2 diabetic (T2DM) patients as cases and 40 healthy subjects as controls. FBS, lipid profile, HbA1c, oxidized-LDL and IL-6 levels were measured for both patients and controls after 12 hours fasting state.Results: The mean of Ox-LDL/LDL ratio in T2DM group (0.65±0.14) were significantly higher than control group (0.5±0.15) (p<0.001). The mean level of IL-6 in T2DM group were 2.6±1.8 pg/ml that was higher than control group (1.9± 0.8pg/ml) (p=0.05). BMI, systolic and diastolic blood pressures revealed significant correlation with IL- 6 level in diabetic group. There was no correlation between diabetes duration and IL-6 level.Conclusion: We concluded that diabetes, as an independent factor, is responsible for increased IL-6 in T2DM.https://jdmd.tums.ac.ir/index.php/jdmd/article/view/280https://jdmd.tums.ac.ir/index.php/jdmd/article/download/280/50Journal of Diabetes and Metabolic Disorders10Relationships between serum zinc concentrations and inflammatory intermediate factors, blood glucose, and HbA1c in postmenopausal diabetic women281281TaghdirMDjazayeriASepandiMAshourpourMFatehiFDjalaliM20151005Background: Zinc (Zn( is one of the essential nutrients that its metabolism changes in diabetes. It has been shown that there is a relationship between Zn and both kinds of diabetes [non-insulin-dependent diabetes mellitus (NIDDM) and insulin-dependent diabetes mellitus (IDDM)]. TNF-α and IL-6 relate with BMI and insulin resistance. It seems that there are relationships between Zn and TNF-α, IL-6, blood glucose and HbA1c. The aim of present study was to investigate relationship between serum zinc concentration and inflammatory intermediate, blood glucose and HbA1c in postmenopausal diabetic women.Methods: We studied 45 diabetic women and 45 healthy women (controls) with BMI 25-30 kg/m2 and aged 45-60 years. Fasting blood sugar (FBS), HbA1c, serum zinc, TNF-α, and IL-6, were determined in the two groups. Results: There were non significant positive correlations between Zn, IL-6 (r=0.28) and TNF-α (r= 0.03) and a non significant negative correlation between Zn and FBS (r= -0.06) and HbA1c (r= -0.07) in diabetic group. Conclusion: There were not a significant relationship between serum Zn and inflammatory intermediates (TNF-α, IL-6), FBS, and HbA1c in postmenopausal diabetic women.https://jdmd.tums.ac.ir/index.php/jdmd/article/view/281https://jdmd.tums.ac.ir/index.php/jdmd/article/download/281/51Journal of Diabetes and Metabolic Disorders10Independency of acute regulation of IGF-1 system components to growth hormone and insulin in response to resistance exercise282282Soleymani FarEHasani-RanjbarShHeshmatRRajabiHKosariH20151005Background: The aim of this study was to determine
possible relationship between changes induced by exercise in serum
concentrations of growth hormone and insulin with IGF-1 system components over
time in trained and untrained individuals.Methods: Nineteen healthy men among physical
education students as trained group and 15 healthy men among non-physical
education students as untrained group voluntarily participated in this study. The
subjects randomly were divided into experimental (trained and untrained) and
control (trained and untrained) groups. Blood samples were obtained just before;
and at immediately, four and seven hours after the end of exercise. Serum
concentrations of GH, Insulin, total IGF-1, IGFBP1 and IGFBP3 were determined. Results: No significant difference was observed in
the pre-exercise concentrations of variables between the trained and untrained
individuals. However, a strong and positive correlation between areas under
curves of variations in IGF-1 and IGFBP3 was identified in the experimental
trained group (r=0.872 and p=0.001); and also, there was correlation between
areas under curves of variations in Insulin with IGF-1 (r=0.752 and p=0.05) and
in IGF-1 with IGFBP3 (r=0.922 and p=0.003) in the control untrained group, but
no statistically significant relationship was observed in the control trained
and experimental untrained groups.Conclusion: Overall, there was no relationship
between acute changes in levels of IGF-1 components with GH and insulin after
resistance exercise and the role of each component of the system in mutual
regulation of the other components may be more important than nonmember factors
of the system during exercise and the following recovery period.https://jdmd.tums.ac.ir/index.php/jdmd/article/view/282https://jdmd.tums.ac.ir/index.php/jdmd/article/download/282/52Journal of Diabetes and Metabolic Disorders10Examining Diagnostic Value of the Fasting Plasma Glucose in Screening Gestational Diabetes283283MirfeiziMMehdizadeh ToorzaniZAsghari JafarabadiMShoghiMGholamiMJMoniri TekmehdashA20151005Background: Many different tests have been introduced for screening gestational diabetes mellitus (GDM). The Objectives of this study were to determine both the diagnostic value of fasting plasma glucose (FPG) and the suitable cut-off point of plasma glucose with the best sensitivity and specificity for diagnosing gestational diabetes mellitus (GDM).Methods: This cross-sectional study was done on 242 women in Karaj-Iran who had at least one risk factor for GDM. Having conducted 50 gram glucose challenge test (GCT), the diagnostic values of FPG were determined by receiver operating characteristic curve (ROC). Then the level of plasma glucose, with the highest sensitivity and specificity rate, were determined for the diagnosis of GDM. Results: Based on the results of ROC curve, FPG with cut-off point ≤91 mg/dl revealed 63.89% and 76.56% sensitivity and specificity for diagnosing GDM, respectively. Conclusion: It is recommended to use FPG as a suitable screening test for GDM with acceptable specificity and sensitivity.https://jdmd.tums.ac.ir/index.php/jdmd/article/view/283https://jdmd.tums.ac.ir/index.php/jdmd/article/download/283/53Journal of Diabetes and Metabolic Disorders10Glycated hemoglobin measurements from dried blood spots: reliability and relation to results obtained from whole blood samples284284Tabatabaei-MalazyOHeshmatROmidfarOPasalarPDelavariAKeshtkarALarijaniB20151005Background: Main objective was to measure glycated hemoglobin (HbA1c) in dried blood spots on paper filter and in whole blood samples in diabetic patients to evaluate relationship between two methods and their respective reliability.Methods: The 20×10 µl of venous blood samples of 33 diabetics were blotted onto the filter paper allowed to dry at room temperature and then stored at 25˚C and 4˚C. HbA1c was measured via the Turbidimetric Inhibition Immunoassay Technique. The relation was evaluated with correlation and linear regression tests using STATA software and SPSS. Agreement between the results obtained from the dried blood spots and others was evaluated using the Bland and Altman. The pitman's permutation test was also employed to compare the difference in variance.Results: A high positive correlation was detected between whole blood samples and dried blood spots stored at 4˚C (r2 =0.90) and at 25˚C (r2 = 0.95). The Bland and Altman graphs, as well as the Pitman tests, showed statistically significant differences in variability between the values obtained from whole blood samples and those derived from dried spots stored at 4˚C (p=0.05) or 25˚C (p=0.004).Conclusion: HbA1c measurements from dried blood spots on the filter paper yielded reliable results. That the Hitachi autoanalyzer is available in most countries renders this assay less costly than the High Performance Liquid Chromatography Method (HPLC). In addition, the filter paper method for Immuno-turbidimetric estimations of HbA1c at different temperatures is reliable and may be particularly useful in outpatient diabetes clinic.https://jdmd.tums.ac.ir/index.php/jdmd/article/view/284https://jdmd.tums.ac.ir/index.php/jdmd/article/download/284/54Journal of Diabetes and Metabolic Disorders10Comparison between the effects of type 1 and type 2 diabetes on hippocampal neuronal density in Wistar rats285285MomeniZBehnam-RasouliMFereidouniMRostamiS20151005Background: Diabetes is one of metabolic disorders characterized by hyperglycemia due to defects in insulin secretion, insulin function, or both. Diabetes induces neuronal death in different regions of the brain especially hippocampus. In this regard, the present study has been conducted to compare the effects of type I and type II diabetes on hippocampal neuronal density in Wistar rat. Methods: Male Wistar rats were divided into three groups including control, type 1 and type 2 diabetes. Type I diabetes was induced by a single subcutaneous injection of Alloxan (135 mg/kg body weight), and for type 2 diabetes, drinking water containing 10% fructose was administered for eight weeks. Two months after diabetes confirmation, hippocampal neuronal density was investigated using dissector technique. Results: Neuronal density in CA1 region showed significant decrease in both experimental groups compared to control, whereas CA3 neuronal density demonstrated a remarkable reduction only in type 1 diabetic group in comparison with control (P<0.05). Likewise, in the whole hippocampus, there was a statistically meaningful difference between control and type 1 diabetic group (P<0.05). Conclusion: Significant reduction in CA1 neuronal density may be possibly due to more vulnerability of this region to pathological conditions. In the whole hippocampus, decrement in neuronal density was also more significant in type 1 diabetes, while in type 2, neuronal density could be associated with age and diabetes duration.https://jdmd.tums.ac.ir/index.php/jdmd/article/view/285https://jdmd.tums.ac.ir/index.php/jdmd/article/download/285/55Journal of Diabetes and Metabolic Disorders10Stem cells: Paradigm and present concepts286286Eghbali-FatourechiGuiti ZLarijaniB20151005The ultimate goal of stem cell
technology is to generate and expand cells that can be used in human diseases
and regenerative medicine. Diseases that might benefit from cell therapy
include but are not limited to the juvenile diabetes, Parkinson's disease,
myocardial necrosis, spinal cord injury, and nonunion fractures. Two major
sources for human cell therapy have been adult stem (AS) cells and embryonic
stem (ES) cells. Major achievement was made to generate pluripotent stem cells by
inducing pluripotency in cells obtained from patients, and treat patients with patient
reprogrammed cells. In this review we discuss sources and recent
techniques for inducing pluripotency in cells for using in clinic and we will
review concerns regarding potential undesired consequences of cell therapy with
reprogrammed cells.https://jdmd.tums.ac.ir/index.php/jdmd/article/view/286https://jdmd.tums.ac.ir/index.php/jdmd/article/download/286/56Journal of Diabetes and Metabolic Disorders10Psychometric properties of the Iranian version of the Problem Areas in Diabetes scale (IR-PAID-20)287287ArzaghiSMMahjouriMYHeshmatRKhashayarPLarijaniB20151005Background: This study was conducted to determine the psychometric properties of the Iranian version of the Problem Area in Diabetes scale (IR-PAID-20).Methods: After translation, back-translation and obtaining the confirmation of the experts in the field of diabetes, the Iranian version of PAID was developed. Thereafter, 100 patients with type 2 diabetes who were selected via systematic random sampling method completed the IR-PAID-20. The validity of the scale was evaluated through construct, concurrent and criterion validity and the reliability evaluated by test-retest internal consistency and splitting method.Results: Internal consistency and test-retest reliability of the IR-PAID-20 was high (Cronbach's alpha 0.94 and 0.88, respectively). Factor analysis resulted in three subdimensions: "Psychological distress in relation to diabetes management", "Depression- related problems" and "Treatment barriers". The results indicated that the correlation between HbA1C levels and PAID total score and its subscales was not significant; whereas, there was a significant association between the duration of diabetes and the PAID total score, "Psychological distress in relation to diabetes management", and "Depression-related problems" subscales. Findings also supported the concurrent validity of the instrument.Conclusion: The IR-PAID-20 is a reliable and valid scale to evaluate diabetes-related emotional distress among Iranian population suffering from type2 diabetes; so, it can be applied as an appropriate measure in research and clinical fields.https://jdmd.tums.ac.ir/index.php/jdmd/article/view/287https://jdmd.tums.ac.ir/index.php/jdmd/article/download/287/57Journal of Diabetes and Metabolic Disorders10Previous History of Gestational Diabetes Mellitus and the Risk of Early Onset Subclinical Atherosclerosis288288FakhrzadehHAlatabSSharifiFGhanaatiHMirarefinMBadamchizadehZMostashfiAHosein-nezhadALarijaniB20151005Background: Women with history of gestational diabetes mellitus (GDM) are at higher risk for developing type 2 diabetes mellitus and metabolic syndrome. The aim of the present study was to investigate whether this population of women also are at increased risk for early subclinical atherosclerosis. Methods: Twenty women with previous history of GDM and 20 unaffected women were recruited in the study. Two groups were matched based on their age, BMI and parity. The maximum duration from affected pregnancy was set at 5 years. The carotid intimal-medial thickness (CIMT), multiple cardiovascular risk factors along with fasting blood levels of glucose, insulin, total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides, vitamin B12 and folic acid were measured in two groups.Results: The mean fasting blood glucose (p=0.03) and insulin (p=0.03) levels were significantly higher in women with pGDM compared to the control group. Women with pGDM were presented with significantly higher levels of CIMT than control group (0.510 mm vs. 0.478 mm, p=0.037). CIMT positively correlated with fasting insulin (r=0.376, p=0.02).Conclusion: Women with pGDM are at increased risk for premature atherosclerosis. This might be due to the persistence of disturbance in glucose homeostasis after delivery in this group of women.https://jdmd.tums.ac.ir/index.php/jdmd/article/view/288https://jdmd.tums.ac.ir/index.php/jdmd/article/download/288/58Journal of Diabetes and Metabolic Disorders10Development of a Valid and Reliable Diabetes Self-management Instrument: An Iranian Version289289TolAMohajeri TehraniMRMahmoodiGAlhaniFShojaeezadehDEslamiASharifiradG20151005Background: The aim of this study was to develop a valid and reliable instrument in order to measure self-management of type 2 diabetic patients. Methods: Validity and reliability of Iranian version of Diabetes Self-Management Instrument (DSMI) measured through a cross-sectional study. Content validity, reliability, and cultural equivalency of Iranian version of DSMI were evaluated through a qualitative and quantitative study by 350 type 2 diabetic patients.Results: Reliability and validity of the instrument and its 5 subscales, namely, "self-integration" (a=0.88), "self-regulation" (a=0.88), "interaction with health professionals and significant others" (a=0.79), "self-monitoring blood glucose" (a=0.92), and "adherence to recommended regimen" (a=0.87) were approved by a psychometric analysis. An intraclass correlation was satisfactory when a test-retest conducted among 150 patients by two weeks interval (p< 0.001). Criterion validity between total instrument and metabolic control Index (HbA1c) of type 2 diabetic patients was approved (p< 0.001).Conclusion: Study findings supported the reliability and validity of the Iranian version of DSMI for measuring self-management among Iranian people with type 2 diabetes in order to set appropriate interventions.https://jdmd.tums.ac.ir/index.php/jdmd/article/view/289https://jdmd.tums.ac.ir/index.php/jdmd/article/download/289/59Journal of Diabetes and Metabolic Disorders10Evaluation of novel “biopaper” for cell and organ printing application: an in vitro study290290ImaniRHojjati EmamiShSharifiAMRahnama MoshtaqPBaheiraeiNFakhrzadehF20151005Background: Recent advances in tissue engineering strategies have led to the development of the concept of tissue or organ printing-a biomedical application of rapid prototyping technology- that offers an interesting alternative to traditional solid scaffold-based tissue engineering. Biopaper is a bioprocessible biomimetic hydrogel that is specially designed for the bioprinting process. Methods: In the present work, four different weight percentage ratios (100:0, 75:25, 50:50, 25:75) of agarose- gelatin blend hydrogels have been studied for the construction of biopaper for bioprinting application. Prepared hydrogels were characterized in terms of gel point temperature, mechanical stability, morphological observation, glucose diffusion, amount of in vitro degradation and cell viability. Tissue fusion study was performed on ChineseHamster Ovary cell aggregates embedded into the hydrogel. Results: Based on obtained results, sol-gel transition point for samples with quite the same proportion of two components was in the physiological condition range (35-37°C). By adding gelatin content of hydrogels, the Young's modulus decreased about 4.5 times; furthermore, less dense network with larger pores resulted that provided glucose diffusion into hydrogels. Amount of degradation linearly decreased by enhancing agarose part of samples. Evaluation of tissue fusion process on sample of 50:50 demonstrated relative permissiveness of blend hydrogel with time scale of τcc = 60 h. Conclusion: Agarose-gelatin blend hydrogel with the same proportion of two components is capable to be used as a biopaper for bioprinting technology.https://jdmd.tums.ac.ir/index.php/jdmd/article/view/290https://jdmd.tums.ac.ir/index.php/jdmd/article/download/290/60Journal of Diabetes and Metabolic Disorders10PECAM-1 (CD31) gene polymorphisms in type 1 diabetes and its microangiopathic complications291291Tavakkoly BazzazJAmoliMMPravicaVLarijaniBHutchinsonIV20151005Background: Platelet-endothelial cell adhesion molecule 1 (PECAM-1) is a widely distributed adhesion molecule and is considered as a candidate molecule in vascular pathologies including diabetic microvascular complications. Endothelial cells have a crucial role in the pathogenesis of diabetic complications. PECAM-1 is expressed on both residential endothelial and circulatory blood cells.Methods: In the present study, at first the PECAM-1 gene promoter region was explored for detection of novel polymorphism using PCR-SSCP technique. Genotyping of polymorphisms was carried out using ARMS-PCR technique on type 1 diabetic patients (N=251) and normal controls (N=86). Subgroup analysis was performed on type 1 diabetic patients with various microvascular complications. In order to investigate the effect of novel polymorphism on PECAM-1 cell surface expression, functional or phenotypic value of novel polymorphism in quantitative level was assessed using flow cytometry of PBMC's carrying different genotype. Results: We found a novel polymorphism in PECAM-1 gene promoter (-265*C/T) (Genebank acc. No. AJ313330). Flow cytometry analysis showed that this polymorphism had no effect on PECAM-1 cell surface expression. However, flow cytometry analysis for another polymorphism at codon +125*G/C has shown that it was correlated with the level of PECAM-1 cell surface expression in PBMCs. No significant association between these two polymorphisms and type1 diabetes or diabetes microvascular complications were found.Conclusion: The polymorphisms in PECAM-1 gene do not appear to be genetic risk factors for type 1 diabetes or diabetes microvascular complications. However this needs to be further confirmed.https://jdmd.tums.ac.ir/index.php/jdmd/article/view/291https://jdmd.tums.ac.ir/index.php/jdmd/article/download/291/61Journal of Diabetes and Metabolic Disorders10The Relationship between perceived social support from family and diabetes control among patients with diabetes type 1 and type 2292292TolABaghbanianARahimiAShojaeizadehDMohebbiBMajlessiF20151005Background: perceived social support has a key role in diabetes control. It seems that diabetes control has been related to adoption of self-management behaviors which can be supported by family. The aim of this study was to assess relation between perceived social support from family and diabetes control among type 1 and 2 diabetic patients.Methods: A cross-sectional study was performed in teaching hospitals affiliated to Tehran University of Medical Sciences during 6 months from May to October 2011. Study sample was 430 (113 type 1 and 317 type 2) diabetic patients who met the inclusion criteria through convenience sampling method. Patient's perceived social support from family was measured by Perceived Social Support from Family scale. Collected data was analyzed by using SPSS software version 11.5. Descriptive statistics were used for all variables. Non-parametric test (Mann-Whitney U and Kruskal-Wallis) was also used if variables had non-normal distributions.Results: The Mean ± SD score for perceived social support were 13.13± 1.8 and 12.89 ± 2.56 in both type 1 and 2 diabetic patient groups, respectively. Study findings revealed that perceived social support had not significant relation with HbA1C in type 1 diabetic patients (p>0.05), and had significant relation with HbA1C in type 2 diabetic patients (p<0.001). Gender, BMI and marital status variables had significant relation with perceived social support from family and HbA1C in both type 1 and type 2 diabetic patients (p<0.001). Also, variable age in type 2 diabetic patients had significant relation with perceived social support and HbA1C (p=0.05). However, variables of education had not significant relation with perceived social support and HbA1C among type 1 diabetic patients. Disease duration did not show any statistical relation with perceived social support and HbA1C among type1 and 2 diabetes patients.Conclusion: Perceived social support from family is an important psychosocial factor affecting glycemic control in patients with type 2 diabetes other than patients with type1 diabetes.https://jdmd.tums.ac.ir/index.php/jdmd/article/view/292https://jdmd.tums.ac.ir/index.php/jdmd/article/download/292/62Journal of Diabetes and Metabolic Disorders10Comparison study of semiquantitative test strips for detecting human serum albumin (HSA) in urine specimens293293Darziani AziziMMansouriMOmidfarKLarijaniB20151005Background: Microalbuminuria (MAU) is a powerful predictive marker of early diabetic nephropathy, progressive cardiovascular disease in diabetic and hypertensive patients as well as in the general population. Methods: This study was designed to compare the diagnostic performance of the two semi-quantitative immunostrip tests for rapid detection of urinary albumin based on monoclonal antibody (mAb) conjugated with colloidal gold particles (AuNPs) (test A) and MCM-41 mesoporous nanoparticles conjugated with HSA (test B). The measurements of the analyte were compared with the values obtained by immunoturbidimetry (IT) assay (test C). Results: 30 randomly chose urine samples were analyzed by tests A, B and C. Resemble to the gold standard, 10 patients were normoalbuminuric, 18 were microalbuminuric and 2 were macroal-buminuric by test B. By comparison with IT, the immunostrip tests had a sensitivity of 90% and 100% for test A and B, respectively. False-negative results were yielded in 6.6% of specimens in the normoalbuminuric group, by using test A. No false-negative results occurred in the group of macroalbuminuric and microalbuminuric patients by this test. The agreement degree of the test A and B was 86% which were classified as substantial with regard to Kappa index (κ=0.857).Conclusion: Our findings suggest that the immunostrip test with MCM-41 is a very reliable method for detecting urine albumin in the range of 0 to >200mg/L. This test with sensitivity of 100% is easy to perform, low-cost and rapid as compared to other sophisticated tests which are time-consuming and expensive to perform.https://jdmd.tums.ac.ir/index.php/jdmd/article/view/293https://jdmd.tums.ac.ir/index.php/jdmd/article/download/293/63