Iranian Diabetic Patients Research Articles

The mediating effect of self-efficacy on the relationship between social support and medication adherence in adults with type 2 diabetes.

To evaluate the status of medication adherence in diabetic patients and its effective factors. A cross-sectional descriptive study was conducted with 170 diabetic patients in Iran. Participants were assessed for medication adherence, self-efficacy, and social support. Descriptive statistics, bivariate analyses, and multiple stepwise regression were conducted to explore predictors for medication adherence. Regression analysis showed that 48% of medication adherence changes stemmed from the four variables including social support, self-efficacy, income, and education levels, (R2adj = 0.480, F = 39.943, p < 0.001). According to the model, the highest effects were related to income level (β = 0.332, t = 5.493, p ⩽ 0.001) and self-efficacy (β = 0.330, t = 4.789, p ⩽ 0.001), respectively. Based on the final model, only the social support variable showed no significant relationship with adherence (β = 0.002, t = 0.032, p = 0.947). Social support and self-efficacy were related to medication adherence in diabetic patients, and social support can improve medication adherence in patients with diabetes by affecting self-efficacy. Healthcare workers who interact with individuals with diabetes should take into account the factors mentioned above when designing health promotion interventions to address the needs of these individuals.

Prevalence of Complementary and Alternative Medicine Use and Its Associated Factors among Iranian Diabetic Patients: A Cross-Sectional Study

ObjectiveThis cross-sectional study aimed to assess the prevalence of complementary and alternative medicine (CAM) use and its associated factors among diabetic patients in Fasa, a city in southern Iran. MethodsData were collected from diabetic patients who visited the endocrinology clinics at Fasa University of Medical Sciences. A structured questionnaire was administered to gather information on CAM use, including the types of CAM modalities used, and reasons for use. The patient's demographic and clinical characteristics, such as age, gender, duration of diabetes, glycosylated hemoglobin (HbA1c) levels, and quality of life (QoL) were also recorded. Descriptive statistics were used to determine the prevalence of CAM use, while logistic regression analysis was employed to identify factors associated with CAM use. ResultsA total of 376 diabetic patients participated in the study, with more than 89% reporting CAM use within the past year. Herbal preparations were the most commonly used type of CAM, with a prevalence rate of 99.4%. Factors associated with CAM use included patients’ psychological health, attitude towards the safety of CAM, belief in the synergistic effects of combining routine medications with CAM, and previous positive experiences with CAM. ConclusionThe high prevalence of CAM use highlights the importance of considering it in diabetes management and the need for healthcare professionals’ engagement in open discussions with patients about their CAM practices. Understanding the factors influencing CAM use can inform healthcare providers and policymakers in developing appropriate strategies for integrating CAM approaches into conventional diabetes care.

Factors affecting Hemoglobin A1c in the longitudinal study of the Iranian population using mixed quantile regression

Diabetes, a major non-communicable disease, presents challenges for healthcare systems worldwide. Traditional regression models focus on mean effects, but factors can impact the entire distribution of responses over time. Linear mixed quantile regression models (LQMMs) address this issue. A study involving 2791 diabetic patients in Iran explored the relationship between Hemoglobin A1c (HbA1c) levels and factors such as age, sex, body mass index (BMI), disease duration, cholesterol, triglycerides, ischemic heart disease, and treatments (insulin, oral anti-diabetic drugs, and combination). LQMM analysis examined the association between HbA1c and the explanatory variables. Associations between cholesterol, triglycerides, ischemic heart disease (IHD), insulin, oral anti-diabetic drugs (OADs), a combination of OADs and insulin, and HbA1c levels exhibited varying degrees of correlation across all quantiles (p < 0.05), demonstrating a positive effect. While BMI did not display significant effects in the lower quantiles (p > 0.05), it was found to be significant in the higher quantiles (p < 0.05). The impact of disease duration differed between the low and high quantiles (specifically at the quantiles of 5, 50, and 75; p < 0.05). Age was discovered to have an association with HbA1c in the higher quantiles (specifically at the quantiles of 50, 75, and 95; p < 0.05). The findings reveal important associations and shed light on how these relationships may vary across different quantiles and over time. These insights can serve as guidance for devising effective strategies to manage and monitor HbA1c levels.

Utilization Trend of Parenteral Antidiabetic Drugs in Type 2 Diabetic Patients Covered by Iran Health Insurance Organization from 2011 to 2030.

Exploring and analyzing the cost of medicines is an important tool for their management and planning. This study aims to analyze the utilization and costs of parenteral anti-diabetic medications during the past decade and predict the future trend of these medications from 2021 to 2031 in people that are covered by Iran Health Insurance Organization (IHIO). This study was based on secondary analysis of data routinely reported to IHIO from 2011 to 2019. For each drug, the Defined Daily Dose (DDDs) and DDDs per 1000 inhabitants per day were calculated for the last 9 years according to the WHO protocol. Then a regression analysis was used to predict the utilization trend of each drug for the following 10 years. The overall utilization of injectable antidiabetic drugs has constantly increased during the last nine years. This increasing trend is estimated to continue during the next decade. In Iran, the increase in the diabetic population and better access in the future will be the main reasons for the increase in the utilization of various insulins. The increasing trend of utilizing injectable anti-diabetic drugs in Iran might be partly due to new patients and partly because of improvement in patient access to new treatments. This also suggests that, compared to the average in the commonwealth countries, Iranian diabetic patients has faced lack of drug utilization in the past decade that is gradually reducing.

Evaluation of bone mineral density and trabecular bone score for diagnosis of osteoporosis in Iranian diabetic patients

Introduction: Type 2 diabetes mellitus (T2DM) increases the risk of bone fractures. Objectives: This study aimed to examine the use of trabecular bone score (TBS) and BMD to select the best diagnostic tool for osteoporosis caused by type 2 diabetes. Patients and Methods: One hundred and four patients (52 individuals with type 2 diabetes and 52 ones without diabetes) aged at most 50 years were enrolled in a cross-sectional study that was conducted with dual-energy X-ray absorptiometry (DXA) images of patients referred to Khorshid and Al-Zahra hospitals, Isfahan, Iran. Results: Lumbosacral bone mineral density (BMD) was significantly lower in the diabetic group than in the control group (0.76 versus 0.82, P=0.041). The mean lumbosacral TBS was significantly lower in the diabetic group than in the controls (1.24 versus 1.36, P=0.001). Therefore, the lumbosacral TBS provided a more reliable indicator than lumbosacral BMD to discriminate between controls and women with T2DM. Conclusion: The TBS is recommended for early diagnosis of osteoporosis in diabetic patients because of its independence from BMD-related parameters. The TBS can capture a larger portion of the bone deterioration in women with T2DM that cannot be detected using methods based solely on BMD.

The Role of Personality Factors in Predicting Resilience and Coping Styles of Patients with Type 2 Diabetes: A Cross-sectional Study

Introduction: Diabetes is a serious, progressive, and costly disease that creates many limitations for its patient. Diabetes disrupts a person’s psychological and social adjustment and coping strategies, resulting in psychological complications for the patients. Objective: This study aims to determine the role of personality traits in predicting resilience and coping strategies of patients with type 2 diabetes living in Bushehr City, Iran. Materials and Methods: This cross-sectional study was performed on 120 patients with diabetes who were referred to healthcare centers in Bushehr. They were selected through the convenience sampling method. The study data were collected using the Connor-Davidson Resilience Scale, 60-item Neuroticism-Extraversion-Openness Personality Inventory, and Coping Strategies Questionnaire. In addition, descriptive statistics and linear regression tests were employed to interpret the data. Results: About 60.8% of the participants were female, and more than 90% were married and lived in urban areas. Based on the study’s results, there is a significant positive association between neuroticism and emotion-oriented (B=2.68, 95% CI; -0.666 to 4.701, P=0.01) and avoidance (B=2.60, 95% CI; -0.961 to 4.248, P=0.002) coping strategies. The results illustrated that neuroticism predicted resilience in patients with type 2 diabetes (B=-6.186, 95% CI; -11.632 to -0.741, P=0.026;), and the model predicted 9% of resilience (Adjusted R2=0.096). Conclusion: According to the results of the present study, most patients with type 2 diabetes had neuroticism, which could decrease their resilience. Therefore, due to the increasing trend of diabetic patients in Iran, and considering the etiological factors, it is necessary to pay attention to the psychological and personality components of these patients to know and adapt more to their physical and mental conditions.

Design and Psychometrics of Diabetes Knowledge Questionnaire

Background: Due to the important role played by knowledge in controlling and managing diabetes in most educational interventions, the assessment of the individuals’ levels of knowledge is regarded as a key variable when planning the given interventions. Objectives: This study aimed to design and evaluate the psychometric properties of the Diabetic Knowledge Questionnaire for Iranian diabetic patients. Methods: This cross-sectional study was conducted from March 2020 to May 2021 in Yazd, to examine 400 type 2 diabetes mellitus (T2DM) by adopting the simple random sampling method. Exploratory factor analysis was carried out to evaluate the validity, and 2 methods of test-retest and internal consistency were used to evaluate the reliability. Data were analyzed using SPSS 20 and Amos 21 software. Results: The questionnaire’s items were classified into 6 factors based on factor analysis method; that is, a total of 27 questions with the dimensions of general, hypoglycemia, complications, nutrition, physical activity, and insulin were included. Questions 1 to 24 were allocated to patients with oral therapy, and questions 25 to 27 were allocated to patients under insulin therapy. These factors altogether accounted for 78% of the total variance. The internal correlation coefficient (ICC) for the knowledge questionnaire as a whole was 0.85, which demonstrated an acceptable level of reliability. Also, Pearson correlation coefficient of reliability between test times (test-retest) was found to be 0.92. Conclusions: The instrument was a valid scale designed to assess the awareness of patients with T2DM about various aspects of the disease. However, it was suggested that further studies should be conducted to investigated the patients with type 1 diabetes mellitus (T1DM) as well as patients with different age groups and education levels.

Psychometric evaluation of Persian version of Diabetes Acceptance Scale (DAS)

BackgroundAcceptance of diabetes is a psychological adaptation to the potential limitations of the disease. Poor acceptance of diabetes impairs effective self-management of diabetes, leading to worsening metabolic control. This study aimed at determining the psychometric properties of the Persian version of the Diabetes Acceptance Scale.MethodsThis cross-sectional methodological study was performed on diabetic patients in Iran in 2021. The questionnaire consisted of two parts: demographic characteristics and Diabetes Acceptance Scale. The questionnaire was translated into Persian through the forward–backward translation method. The face validity and content validity were performed qualitatively and quantitatively. Exploratory (n = 200) and confirmatory (n = 200) factor analysis were performed to evaluate the validity of the structure. Internal consistency and temporal stability were estimated to determine reliability.ResultsExploratory factor analysis on the polychoric correlation matrix obtained three factors: Rational dealing, Resentment and Avoidance, which explained 68.8% of the total DAS variance. Confirmatory factor analysis showed that the 3-fractor model had a good fit to a second independent data set. Finally, Ordinal Cronbach's alpha coefficient was 0.96, 0.94 and 0.93, respectively for the Rational dealing, Resentment, and Avoidance factor. Also, using intraclass correlation coefficient, the stability of the instrument was 0.97.ConclusionBased on the findings of this study, the Persian version of DAS has sufficient validity and reliability to measure the admission of Iranian diabetic patients.

Factors Associated With Adherence to Treatment Regimen in Patients With Type 2 Diabetes in Sari, Iran

Background &amp; Aims: As a chronic disease with many complications, diabetes requires adherence to treatment regimen. Despite the importance of adherence, it is not done completely in these patients. Non-adherence to treatment has many personal and social consequences. Adherence in diabetic patients can lead to mortality reduction and success in the treatment of diabetes. Considering that adherence to the treatment regimen is challenging among diabetic patients and less attention has been paid to it in Iran, the present study aims to identify the factors related to adherence to treatment regimen among diabetic patients in Sari, Iran. Materials &amp; Methods: This descriptive cross-sectional study was conducted in 2021 on 226 adults with Type 2 diabetes referred to Baghban clinic affiliated to Mazandaran University of Medical Sciences in Sari, Iran who were selected using a continuous sampling method. Data were collected using a demographic form and the diabetes activities questionnaire. Questionnaires were prepared online using Google Forms. Data analysis was performed in SPSS software, version 26. Results: The mean age of participants was 53.06±10.81 years. Most of them were female (61.9%) and married (85.8%) with a high school diploma (26.5%) and moderate economic status (69%). Economic status, age, and BMI had a significant relationship with adherence to treatment regimen (P&lt;0.05); Economic status and age had a positive significant relationship while BMI had a negative significant relationship with adherence to treatment regimen. Diabetic patients with better economic status, higher age, and lower BMI had better adherence. Conclusion: This study provides a basis for expanding knowledge of adherence to treatment regimens in diabetic patients in Iran. It is necessary for healthcare providers, especially nurses, to pay attention to the factors related to adherence to treatment in diabetic patients in providing care and education to them to have better treatment.

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

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.. This exploratory, cross-sectional study was performed to evaluate the risk factors in a cohort of Iranian diabetic patients aged over 35years (N = 9975). Among 9975 people over 35years 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. 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. 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.

Comparison of Canola and Soybean Oils on Serum Lipid and Glucose Profiles and Anthropometric Parameters in overweight and Obese Type 2 Diabetes Mellitus Patients: A Randomized Clinical Trial

No earlier human study compared influences of canola and soybean oils on patients with type 2 diabetes (T2D). Current study aimed to investigate effects of canola and soya oils on blood and anthropometric parameters in overweight and obese Iranian diabetic (II) patients. A total of sixty-six T2D subjects were randomly allocated to three groups. Canola oil (CO; n 23, received 30g canola oil); Soya oil (SO; n 19, received 30g soya oil) and control group (n 24, their usual intake of dietary oils) for 8 weeks. Lipid and glycemic profiles as well as anthropometric indicators were evaluated before and after the intervention. Repeated-measures ANOVA was used to evaluate time×group interactions for the outcome variables followed by a t test (significance level, p < 0.05). After 8 weeks, serum total cholesterol (-21.3 and -36.4v. -2.2 mg/dl; P=0·007), low density lipoprotein (-6.6 and -15.9v. +3.0 mg/dl; P=0·013), fasting blood sugar (-39.6 and -30.5v. +11.7 mg/dl; P<0.001) significantly decreased and high density lipoprotein (+3.0 and +3.5v. +2.4 mg/dl; P=0.038) significantly increased in CO and SO groups compared with controls. Changes in lipid profiles were more considerable in the soybean oil group than the canola oil group. The mean changes of waist circumference (WC; −4.1 v. -1.4 and -1.3 cm; P=0·031) and weight (−3.1 v. -0.3 and +0.5 kg; P=0·048) significantly decreased in canola group comparing to the two other groups. Current study showed that daily consumption of canola and soybean oil for 8 weeks improved serum levels of fasting blood sugar, total cholesterol, low density lipoprotein and high density lipoprotein in T2D patients. Changes were more considerable in those consumed soybean oil. Canola oil decreased central obesity indices (waist circumference and weight) in T2D patients. Further studies are needed to shed light on this issue.

COVID-19 in patients with diabetes: factors associated with worse outcomes.

PurposeDiabetes is one of the major comorbidities associated with COVID-19. We aimed to determine the clinical and epidemiological factors associated with the mortality of COVID-19 in diabetic patients in Iran, and also the impact of prescribed antiviral and antibiotics on patients’ status.MethodsIn this study, we used the national registry of hospitalized patients with Severe Acute Respiratory Syndrome (SARS) Symptoms with diabetes from February 18, 2020, to December 22, 2020. Demographic, clinical features, treatments, concurrent comorbidities, and their associations with mortality and severity outcomes were assessed using logistic regression.Results78,554 diabetic in-patients with SARS symptoms were included from 31 provinces of whom 37,338 were PCR positive for COVID-19. Older age and male gender are associated with COVID-19 mortality in diabetic patients. CVD is the most frequent comorbidity (42%). CVD, kidney disease, liver disease, and COPD are associated comorbidities which increased the risk of mortality. The mortality rate is higher in diabetic patients comparing to patients with no comorbidities, particularly in younger age groups. The frequency of antiviral, and antibiotics in COVID-19 positive patients was 34%, and 31%, respectively. Antibiotic treatment has no association with mortality in COVID-19 patients.ConclusionsDiabetic patients indicate higher mortality comparing to patients without any underlying comorbidities. Restrict strategies on increasing effective health care utilization must be considered in diabetic patients, especially in those with parallel underlying comorbidities. Regarding the antibiotic resistance issue and the noticeable use of antibiotics in diabetic patients, it is recommended to prioritize an antibiotic guideline prescription in COVID-19 patients for better stewardship by countries.

Interactions of dietary insulin index and dietary insulin load with brain-derived neurotrophic factor (BDNF) Val66Met polymorphism in relation to cardiometabolic markers in Iranian diabetic patients: a cross-sectional study.

The progression of cardiometabolic diseases is determined by both genetic and environmental factors. Gene-diet interactions may therefore be important in modulating the risks of developing metabolic diseases. The objectives were to investigate the effect of the interaction between brain-derived neurotrophic factor (BDNF) Val66Met polymorphisms and dietary insulin index (DII) and dietary insulin load (DIL) on cardiometabolic markers among diabetic patients. In this cross-sectional study, blood samples were collected from 667 patients. DIL and DII were defined using a validated FFQ. Genotyping the BDNF Val66Met polymorphism was conducted by the PCR-Restriction fragment length polymorphism(RFLP) method. Interactions between dietary indices and gene variants were evaluated using a generalised linear model. PGF2a concentrations were significantly higher among Val homozygotes than Met-allele carrier. This study revealed that, compared with individuals with the Val/Val genotype, those with the Met/Val or Met/Met genotype had lower BMI (Pinteraction = 0·04), TAG (Pinteraction = 0·04), leptin (Pinteraction = 0·01), LDL (Pinteraction = 0·04) and total cholesterol (Pinteraction = 0·01) when they consumed diets higher on the DIL index. Moreover, the highest quartile of the DIL, compared with the lowest, showed increase in waist circumference (Pinteraction = 0·02) and LDL/HDL (Pinteraction = 0·04) for Val/Val homozygotes compared with Met-allele carriers. BDNF Val66Met variants may interact with DIL and DII, thus be involved in the development of cardiometabolic risk factors. If diabetic patients with Met alleles regulate dietary intakes, they have a protective opportunity to regulate their cardiometabolic markers.

Associated factors of poor glycemic control in Iranian diabetic patients

Associated factors of poor glycemic control in Iranian diabetic patients

Candida albicans skin infection in patients with type 2 diabetes: a systematic review and meta-analysis.

Fungal infections including Candida albicans is one of the most important health concerns among type 2 diabetic patients. Therefore, this study aimed to determine the prevalence of C. albicans skin infection in patients with type 2 diabetes in a systematic review and meta-analysis. In this review study, data were extracted from national and international databases of SID, MagIran, IranMedex, IranDoc, Google Scholar, Cochrane, Embase, ScienceDirect, Scopus, PubMed, and Web of Science (WoS) with no time limit until January 2021. The random effects model was used for doing analysis and the I2 index was used for assessing the heterogeneity of studies. Data were analyzed using Comprehensive Meta-Analysis (Version 2). The prevalence of C. albicans skin infection in patients with type 2 diabetes was 11.4% (95% CI: 8.9%-14.4%) in 13 reviewed articles with a sample size of 1348. Regarding the heterogeneity based on meta-regression, there was a significant difference between the effect of sample size (P < 0.05) and the prevalence of C. albicans skin infection in patients with type 2 diabetes. The results of this study showed that C. albicans skin infection was high in type 2 diabetic patients in Iran. Therefore, to improve the aforementioned situation and to troubleshoot and monitor at all levels, appropriate policies should be adopted.

The relationship between personality disorder, depression and eating disorder with treatment adherence in patients with type 2 diabetes; a cross-sectional study in diabetic patients in Iran

Adherence to treatment is of great importance in patients with diabetes mellitus due to its necessity and benefits. The purpose of this study was to evaluate the relationship between personality disorder, depression and eating disorder with appropriate treatment acceptance and follow-up in patients with type 2 diabetes. This cross-sectional study was performed in Imam Ali Medical Education Center in Karaj city of Alborz province of Iran. A total of 1320 patients were evaluated and were screened according to the inclusion criteria, including type 2 diabetes and those over 18years of age. Finally, considering the exclusion criteria, 600 patients with type 2 diabetes were included in the study. Patients were divided into 4 groups. 150 patients with type 2 diabetes in the control group, 150 patients with type 2 diabetes with major depressive disorder, 150 patients with type 2 diabetes with personality disorder and 150 patients with type 2 diabetes and eating disorder were studied. Questionnaires used in the study included Hamilton Depression Rating Scale(HAM-D) for depression, Minnesota Multiphasic Personality Inventory II (MMPI II) questionnaire for personality disorders and Eating Disorder Diagnostic Scale(EDDS) for eating disorder. The Murisky questionnaire also assessed adherence to treatment in patients, which included 8 questions. Scores measure the degree of adherence to treatment. 600 patients with type 2 diabetes were studied. Patients were divided into 4 groups (each group consisting of 150 patients) of control, depression, personality disorder and eating disorder. Mean age, sex, marital status and duration of diabetes were not significantly different in the study groups (P > 0.05). The mean Murisky score in patients with depression and personality disorder was significantly lower than the control group (P < 0.05) but the mean Murisky score in patients with eating disorder was not significantly different (P > 0.05). Patients with depression, paranoid, schizotypal, antisocial, borderline, avoidant and dependent personality disorder had less adherent to treatment than the control group. Early psychiatric evaluation of patients with diabetes and identification of possible disorders can help improve diabetes control.

Systematic Review and Meta-Analysis on Quality of Life in Diabetic Patients in Iran.

Background:Diabetes is the fifth leading cause of death in the world, which reduces the patients' quality of life (QOL) and is considered as an important subject especially in medicine and medical community. The present study aimed at investigating the QOL of diabetic patients in Iran through meta-analysis.Methods:The search was conducted using relevant keywords in national and international databases including Iranmedex, SID, Magiran, IranDoc, Medlib, Science Direct, PubMed, Scopus, Cochrane, Embase, Web of Science. Questionnaires WHOQOL, SF-36, SF-20, DQOL, QOL, PedsQL, ADDQOL, D-39, DQOL-BCI, SWED-QUAL, IRDQOL, PHG-2, EQ-5D, and IDQOL-BCI were used to assess the QOL. Heterogeneity of studies was assessed using I2 index. Data were analyzed using STATA version 11.Results:In 96 studies of 17,994 people, the mean score of QOL in diabetic patients was based on the questionnaires WHOQOL [66.55 (95% CI: 45.83, 87.26)], D-39 [129.43 (95%CI: 88.77, 170.10)], SF-36 [65.64 (95% CI: 59.82, 71.46)], SF-20 [46.50 (95% CI: 37.19, 55.81], DQOL [61.19 (95% CI: 35.73, 86.66)], QOL [117.91 (95% CI: -62.97, 298.79)], PedsQL [34.36 (95% CI: -31.49, 100.22)], ADDQOL [41.76 (95% CI: 12.01-71.50)], SWED-QUAL [59.19 (95% CI: 21.15, 97.23)], IRDQOL [105.92 (95% CI: 102.73, 109.10)], PHG-2 [61.00 (95%CI: 59.63, 62.37)], EQ-5D [0.62 (95% CI: 0.61, 0.64)], DQOL-BCI [3.40 (95% CI: 3.31, 3.49)], and IDQOL-BCI [22.63 (95% CI: -2.38, 47.64)].Conclusions:The QOL of diabetic patients was evaluated according to different types of questionnaires and the QOL of diabetic patients was found to be lower than normal population.

Sleep quality in diabetic patients in Iran: A review

Sleep quality in diabetic patients in Iran: A review

Health Literacy in the Population of Diabetic Patients in Iran: A Systematic Review and Meta-Analysis

The present systematic review and meta-analysis were conducted to find the degree by which the Iranian diabetic patients were informed about their disease in term of health literacy. The search was carried out in databases including the PubMed, MEDLINE (PubMed), Scopus, Embase, Cochrane Library, ProQuest, Web of Science, Science Direct and Wiley and also domestic databases including the Iranian Academic Center for Education Culture and Research (sid.ir), the Iranian Research Institute for Information Science and Technology (IranDoc.ac.ir), Barakat Knowledge Network System (barakatkns.com), the national publications database (magiran.com) and also Google Scholar and Elmnet search engines. All the original studies published by Oct 20, 2018, in Persian or English, to assess the health literacy of adults with diabetes were included in the study. Ultimately, 17 articles were included in the meta-analysis. The meta-analysis was carried out using the fixed-effects method using Stata-11.2. The pooled mean score of health literacy was 56.65 out of score of 100, and its 95% CI was estimated as 49.85 to 63.45. No significant heterogeneity could be reported for the articles included in the meta-analysis (I-squared=21.3%, P=0.177). The pooled mean scores with the CI of 95% by gender based on the study population in women and men were estimated as 47.97and 50.06 respectively. Health literacy is not high in Iranian diabetic patients and is rather inadequate in most of them in both genders. Diabetic women have somewhat lower health literacy compared to diabetic men.

Efficacy and Safety of a Traditional Herbal Combination in Patients with Type II Diabetes Mellitus: A Randomized Controlled Trial

Background Capparis spinosa, Rosa canina, Securidaca securigera, Silybum marianum, Urtica dioica, Trigonella foenum-graecum and Vaccinium arctostaphylos are used traditionally as an herbal combination for treatment of diabetic patients in Iran. Despite the clinical evidence supporting their use in solitary form, no controlled human study has determined the efficacy and safety of their combination in treatment of diabetic patients. Methods A total 150 type II diabetic patients of both sexes under the oral anti-hyperglycemic drugs treatment (maximum 10 mg glyburide and 1000 mg metformin daily) were randomly assigned to three groups. The patients in each group received either herbal combination or placebo or metformin capsule daily for three months, without any change in their previous oral anti-hyperglycemic drugs dosage. Herbal combination, placebo and metformin capsules matched by shape and color were prepared in the Institute of Medicinal Plants Karaj, Iran. To assess the efficacy and safety of the treatments, the patients fasting plasma glucose, HbA1c, lipid profile, liver enzymes and renal function were determined at the beginning of the study and after three months. Results Results showed that after three months, the fasting plasma glucose, HbA1c and cholesterol levels in herbal combination were decreased significantly as compared to placebo group (20% and 12% respectively) and also compared to base line (25% and 15% respectively). The herbal combination was as effective as metformin in reduction of FPG (p = 0.001, p = 0.001) and HbA1c (p = 0.028 and p = 0.050 respectively) compared to placebo. No notable hepatic, renal and gastrointestinal side effects were observed in the trial groups. Conclusion The results suggest that traditional herbal combination may safely improve glycemic control in type II diabetic patients with no significant adverse effect.