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  Background & Objectives: Diabetes mellitus is a metabolic disease characterized by hyperglycemia together with biochemical alterations of lipid profile, insulin resistance and inflammation . Considering the high prevalence of hypertension, dyslipidemia and inflammation in type 2 diabetic patients, the aim of the present study was to investigate the effects of inulin on lipid profile, inflammation and blood pressure in women with type 2 diabetes.

  Methods: In this controlled, randomized clinical trial, 49 women with type 2 diabetes (fiber intake<30 g/d, BMI=25-35 kg/m²) were assigned to one of two groups. Experimental group (n=24) received 10 g/d inulin and control group (n=25) received 10 g/d maltodextrin for 8 weeks. Dietary intakes, anthropometric measurements, blood pressure, serum lipids and hs-CRP concentrations were measured at the baseline and at the end of the study. Data were analyzed using SPSS software (verision11.5). Paired, independent t-tests and ANCOVA were used to compare quantitative variables.

  Results: At the end of study, there was a significant decrease in systolic blood pressure (from 135.7 ± 16.2 to 125.9 ± 7.9 mmHg), total cholesterol ( from 192.5 ± 42.8 to 171.0 ± 39.7 mg/dl), triglyceride ( from 223.3 ± 84.2 to 169.9 ± 65.6 mg/dl) and hs-CRP ( from 7.9 ± 3.0 to 5.3 ± 3.0 mg/l) in inulin group compared with the maltodextrin group (p > 0.04 ). Changes in diastolic blood pressures, LDL-c and HDL-c were not significant in inulin group compared with the maltodextrin group. A significant decrease in systolic, diastolic blood pressures, total cholesterol, triglyceride, LDL-c, hs-CRP and significant increase in HDL-c were observed in inulin group compared to baseline.

  Conclusions: Inulin supplementation may improve lipid profile, hs-CRP and blood pressure in women with type 2 diabetes.

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  Background and Objectives: Patient education has an important role in controlling the diabetes. Tele-education is impressive due to the elimination of­­ both space and time limitation and establishing an effective relationship with client care. This study was carried out to determine the impact of tele-education by telephone and short message service on laboratory parameters in patient with type 2 diabetes.

  Methods: This experimental study carried out on patients with type 2 diabetes members of Urmia Diabetes Association . A total of 66 samples selected and allocated randomly in two intervention and control groups. Data gathered with demographic questionnaire and lab work. For intervention group education and telephone follow up had given for 12 weeks. Data were analyzed using descriptive and inferential statistical testes.

    Results: Finding of the study showed decrease in fasting blood sugar (-29.82), glycosylated hemoglobin (-0.54), cholesterol (-13.88), triglyceride (33.88) and insulin level (-4.59) in intervention group after performance of education and telephone follow up.

  Conclusion: Telephone follow up and tele-education have a beneficial effect on controlling the laboratory parameters in patients with type 2 diabetes .

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 Background & objectives: Successful implementation of diabetes care can reduce acute and chronic complications of diabetes. This study was conducted to evaluate the quality of care according to a care scoring system among people with type 2 diabetes referring to the diabetes clinic in Ardabil.

 Methods: This cross sectional study was conducted in 2014 and a total of 300 people with type 2 diabetes in age range of 20-70 years old were included via convenience sampling. Data were collected by an interviewer using a structured questionnaire and checklist. Each patient was classified according to a quality of care scoring system into 3 categories: ≤10, 15-20, >20. Statistical analysis performed by SPSS v.20 software and descriptive analysis used to display data as frequency tables and graphs. Analytical tests such as ANOVA, Kruskal-Wallis, Chi squared, and fisher exact test were also used to analyze the data.

 Results: The mean age of patients was 54.13 ± 9.13 and the majority of them were women (72.3%). The mean of BMI and HbA1c was 29.58 ± 4.77 and 8.93± 2.13, respectively. The mean of FBS was 191.18 ± 84.23 and the average length of disease was 7.74±5.89 years. The mean of quality of care score among participants was 23.20±9.99. About one-third of patients (29.7%) had a quality care score ≤10, half of them (51%) had a score between 15-20, and only 19.35% had a score >20. There was an association between HbA1c, FBS, diastolic blood pressure, cholesterol and LDL with a quality of care score which was statistically significant (p<0.05).

 Conclusion: In this study there was a gap between the current quality of care of patients and recommended standards. Therefore in order to minimize the current barriers and problems it is recommended to implement an effective interventional program. In addition, using a quality care scoring system is a rapid, easy and valid method for evaluating diabetes quality of care.

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Background & objectives: Type 2 diabetes is a metabolic disorder considered as one of the most common chronic diseases in many countries, including Iran. One of the reducing factors in insulin sensitivity is increased serum levels of inflammatory factors like hsCRP and TNF-α. On the other hand, in recent years, Cuminum Cyminum is known as one of the potent herbs in the treatment of diabetes type 2 in animal studies. The aim of this study was to evaluate the effect of two doses of 50 and 100 mg of Cuminum Cyminum extract on glycemic indices and indicators of inflammation in human subjects with type 2 diabetes mellitus.

Methods: This study is a double blind randomized clinical trial performed in Urmia city on 2015. Samples were selected based on inclusion criteria and randomly divided into 3 groups: two groups receiving Cuminum Cyminum extract of 50 and 100 mg per day and the control (placebo) group. Before and 8 weeks after intervention, fasting blood sugar, serum insulin and inflammatory profile of hsCRP and TNF-α were measured. Data were analyzed by SPSS and the effect of supplementation was studied.

Results: The mean age of the all participants was 47.33±6.36. Results showed that the mean fasting blood sugar (FBS), glycosylated hemoglobin (HbA1c), and serum insulin reduced significantly in the both groups receiving Cuminum extract of  50 and 100 mg(p<0.01)., but increased in the placebo group. Average hsCRP and TNF-α levels have shown significant reduction at the beginning and end of the study in either group receiving 50 and 100 mg of supplementation (p<0.01).

Conclusion: This study indicates that short-term daily supplementation of Cuminum Cyminum extract at the doses of 50 or 100mg in patients with type 2 diabetes during 8 weeks may act to reduce the serum levels of insulin, blood glucose, glycosylated hemoglobin and hsCRP and TNF-α levels, and also may be fruitful for control of this disease.

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Background & objectives: Irisin is a novel myokine that encoded by FNDC5 gene and effects on obesity, metabolism and glucose homeostasis through browning of white adipose tissue and thermogenesis. The main purpose of this study was to investigate the changes of FNDC5 gene expression and Irisin protein level of visceral fat tissue after eight weeks of resistance training in type 2 diabetic rats.
Methods: Eighteen male Wistar rats (8 week old) were used for this study. Diabetes was induced using nicotinamide and streptozotocin . Five days after inducing diabetes, rats with fasting blood glucose levels between 127-600 mg / dl were selected as diabetic subjects. Rats were homogenized according to the body weight and assigned into two groups including control-diabetes (n=9) and resistance training-diabetes (n=9). Training group exercised resistance training for eight weeks (5 days a week). The resistance training protocol consisted of climbing   a one-meter- high ladder, with a weight attached to a tail sleeve. Quantitative Real time RT-PCR and ELISA Kit were used for assessment of expression level of FNDC5 gene and Irisin protein, respectively. Data were analyzed using independent t- test at p≤0.05.
Results: Resistance training significantly increased the expression level of FNDC5 gene and Irisin protein in visceral adipose tissue in type 2 diabetic rats.
Conclusion: It seems that FNDC5 gene and Irisin protein have an important role in metabolic diseases and can be affected by resistance training. Perhaps the changes in the levels of these metabolic indicators is a potential new target for the treatment of metabolic disorders, such as T2DM (type 2 diabetes).

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Background & objectives: Type 2 diabetes mellitus (DM) is a metabolic disorder that is common throughout the world. Meta-analysis is a statistical technique in which the results of two or more independent studies, with similar objectives, are mathematically combined in order to improve the reliability of the results. The aim of this study was to compare the efficacy of metformin and linagliptin in patients with type 2 diabetes.
Methods: To identify relevant studies, PubMed, ISI Web of Science, Embase, Cochran library, Scopus and Ovid databases were searched from January 2000 to August 2016. Mean difference (MD) with 95% confidence interval (CI) for efficacy were calculated and pooled analysis was performed using Stata V.12 and RevMan V.5.3 software.
Results: Four studies recruiting1260 patients with DM (682 patients in group linagliptin and 578 patients in metformin group) were included in this study. The MD of HbA1C outcome of 0.5 mg linagliptin was effective (0. 7295, % CI = 0. 69 - 0. 75). The MD of fasting blood sugar (FBS) test revealed that linagliptin was effective at 0.5mg (MD = 36.79, 95% CI = 35.20 - 38.38) and 5 mg (MD = 12.65, 95% CI = 2.68 to 22.63) doses.
Conclusion: Our results suggest that some doses of linagliptin versus metformin may be an effective treatment for DM2. However, the number of studies was limited, and further research is needed.
 

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 Background & objectives: Ultrasonography as a non-invasive, inexpensive and generally available method has been used to measure of the intima-media thickness (IMT) of carotid arteries changes and finding its relationship with cardiovascular risk factors and vascular diseases. The aim of this study was to investigate the carotid arterial wall thickness (IMT) changes based on clinical and para-clinical indexes in patients with type 2 diabetes mellitus (DM).
Methods: In this descriptive-analytical study, 100 patients with type 2 DM were randomly selected from all patients admitted to diabetes clinics and were considered in terms of clinical and paraclinical indexes of systemic atherosclerosis. Both types of IMT (TA and TB) were measured by ultrasonography in six locations of the carotid system. The intensity of these two values was calculated compared with the normal IMT and also, its relationship with clinical and para clinical indexes were determined. The results were statistically analyzed using SPSS software version 19. 
Results: In this study, more than 80% of patients had IMT upper than normal. There was a significant difference between the severe increase of IMT and effective variables such as sex, smoking, physical inactivity, dyslipidemia and poor blood glucose control.
Conclusions: This study showed that the DM and factors such as sex, smoking, physical inactivity had a significant effect on the increasing IMT compared to the normal range.

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Background & objectives: Type 2 diabetes mellitus is characterized by metabolic disorders and elevated blood glucose. It is one of the most common diseases in developed countries. Thyme is one of the herbs which have been used in some drug content due to its high antioxidant properties. Thyme can increase the activity of mitochondrial oxidative enzymes and affect metabolic and hematological indices due to its phenolic compounds.
So, the aim of this study was to determine the effect of Thymus migricus extract supplementation on the metabolic, hematological indices and oxidative stress in type 2 diabetic rats.
Methods: For this purpose, 24 Wistar rats (220-240g) were divided randomly into three groups; group1: healthy control group (NC, n=8), group2: diabetic control group (D, n=8) that took fat diet for 2 weeks then were injected with streptozotocin (37 mg/kg), and group3: diabetic+Thyme group (Th+D,n=8). Thyme hydro-alcoholic extract dissolved in distilled water to the desired concentration (400 mg/kg) according to their daily water consumption (30 ml). Then glycemic, blood and lipid indices were measured in the peripheral blood of the rats.
Results: The results revealed that thyme supplementation significantly decreased the fasting blood glucose level (356.35±40 mg/dl to 261.61±35 mg/dl) and HOMA-IR index (3.52±0.30 mg/dl to 2.2±0.33 mg/dl). Also significantly decreased the lipid profile level of the Th+D group compared to those of the D group (p<0.05), but the hematological parameters of the Th+D group compared to those of D group were not significantly changed. FRAP in Th+D group was not significantly different in comparison with the other two groups, but MDA was significantly increased in diabetic groups (p<0.05).
Conclusion: Based on the results, thyme supplementation by decreasing insulin resistance and fasting blood glucose can improve lipid parameters, but does not affect blood parameters and antioxidant indices.
 

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Background & objectives: Foxo1 is a transcription factor in insulin signaling in the liver. The function of Foxo1 is important in the ability of insulin to regulate hepatic glucose production and glucose homeostasis. The aim of this study was to determine the effect of resistance training program on Foxo1 expression in liver cells as well as glucose and insulin serum levels in male Wistar rats with type 2 diabetes.
Methods: The statistical population of this experimental study was 10-weeks old, male Wistar rats weighing 220±20 g (n=14). The studied rats were subjected to 6 weeks of high-fat diet and STZ injection for type 2 diabetes induction and then rats were randomly divided into two groups (control and resistance). The training group participated in a resistance training course for 6 weeks, 5 sessions per week, in the form of 4 sets and 5 repetitions per set, climbing a 26-step ladder to a height of one meter with a vertical slope of 80%. Finally, 48 hours after the last training session, fasting blood  glucose and insulin levels as well as Foxo1 expression level  in liver cells of both groups were measured and compared by independent t-test (a=%5).
Results: The resistance training improved fasting blood glucose compared to control subjects (p>0.001). the serum insulin levels were significantly increased (p=0.042) and Foxo1 expression significantly decreased in resistance group when compared with control subjects (p=0.023).
Conclusion: Based on these data, the decrease in glucose concentration in the exercise group can probably be attributed to the decreased expression of Foxo1 in hepatocyte cells in response to resistance training.