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Introduction: Type 1 diabetes is believed to be an autoimmune disease. Pancreatic islet cell destruction occurs by infiltration of T lymphocytes. BCG vaccine modulates the development of type 1 diabetes in animal models. Based upon the studies in animals and man a clinical trial using a single dose of BCG vaccine was carried out in newly diagnosed type 1 diabetic patients. Material and methods: Ten newly diagnosed type 1 diabetic patients 4-14 years of age, were enrolled in this study. All patients had been vaccinated with BCG at birth. PPD positive patients and those with other autoimmune diseases were excluded from this study. Single dose of BCG (0.1 ml of 1 mg/ml) was administered intracutaneously to all patients. Ten newly diagnosed type 1 diabetic patients matched for age and sex were also followed as the control group. All patients were followed with fasting blood sugar, HbA1c and the needed insulin per kg of body weight for nine months. Results: There was no significant difference in fasting sugar, insulin dose & HbA1c levels at any time between the BCG-vaccinated and control groups. Conclusion: Our study does not support the effect of BCG therapy in this group of diabetic patients.

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The aim of this study was to find out whether there is seasonality of month of birth in children with diabetes in Mashhad and if so whether it differs from that of general papulation. 161 children and adolescents (0-18 years) with type 1 diabetes born between 1983-2001 were included the study. The results were analyzed by student’s t test and chi-square test and a P value<0.05 was considered significant. The children and adolescents with diabetes had a statistically significant different seasonality of month of birth compared to that of the general population (P<0.01). More children with type 1 diabetes were born in spring (P<0.05). The observations made are in accordance with observation made in other countries and support the hypothesis that a virus infection transmitted by the mother to the fetus during the annual viral epidemic may induce the autoimmune process in the pancreatic β-cells in genetically susceptible individuals who may subsequently develop clinical diabetes during childhood.

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Introduction: Hyperalgesia is one of the symptoms of diabetic neuropathy and is considered as a major clinical complaint in these patients which could affect the quality of their life. Since attenuation of hyperalgesia is very important, in the present study the possible analgesic effect of aqueous extract of coriander was investigated in male rats with streptozotocin-induced diabetes using standard formalin test in both early (acute) and late (chronic) phases. Materials and Methods: Male albino Wistar rats (250-350 g) were used. They were randomly divided into three groups, i.e. control, diabetic and extract-treated diabetic. For induction of diabetes, streptozotocin (60 mg/Kg) was administered i.p. After one month, formalin test was conducted. Results: Pain sensation of diabetic rats in the second interval (5-10 min) of the acute phase of the formalin test is higher (P<0.001) in comparison with control group, while a less significant difference was found between control and extract-treated diabetic group (P<0.05). On the other hand, there was no significant difference between control and extract-treated diabetic groups regarding acute and chronic phases of the formalin test. Conclusion: It is concluded that i.p. administration of aqueous leaf extract of coriander at a dose of 100 mg/kg does not produce a significant analgesic effect using formalin test.

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Aims: Type 1 diabetes mellitus is an autoimmune disorder which is associated with different organ specific autontibodies including anticardiolipin antibody (ACLA). The association of ACLA with diabetes has not been widely reported. The aim of this study was to determine the prevalence of ACLA IgG and IgM and evaluation of their possible association with other auto-antibodies, duration of disease and status of control of blood glucose in type 1 diabetes patients. Materials and Methods: In a cross sectional study, 48 patients with type 1 diabetes in Bandar Abbas were compared with 41 age & sex matched healthy persons for the presence of ACLA (IgG and IgM), Rheumatoid Factor (RF) and Anti Nuclear Antibody. Results: The mean age of diabetic patients was 20/5 ± 10 years. High titers of ACLA (IgG and/or IgM) were more common in type 1 diabetic patients than in healthy controls (18% vs. 0%, p<0.01) with no significant difference between males and females (4 and 12% respectively). Unlike ACLA IgG, the mean value of serum ACLA IgM was significantly higher in type 1 diabetic patients than in controls (6.8±2.8 vs. 4.5±2.4 GPLU/ml). Among type 1 diabetic patients, those with high titers of ACLA (ACLA+) were older and had higher age of onset of diabetes than those with normal titers, but there were no difference in duration of diabetes or level of HbA1c between them. No significant difference was observed in the prevalence of ACLA+ or the mean values of ACLA IgG and IgM between recently (< 1 years) and previously (> 1 years) diagnosed diabetic patients. ACLA+ patients were also more likely to show positive RF than the ACLA- group(25 vs. 0%). Conclusion: The relatively high prevalence of ACLA (+) in type 1 diabetic patients and its association with other autoantibodies may reflect an abnormal immunologic response in some stages of type 1 diabetes. ACLA might be added to the list of autoantibodies that should be measured in type 1 diabetes patients.

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Abstract

Introduction: According to some studies, sufficient breastfeeding may prevent β-cell infection and type 1 diabetes mellitus. This case-control study was designed to assess the relation between type 1 diabetes mellitus and nutrition patterns in the first 2 years of life and some demographic factors. Materials and Methods: One hundred children, from the Iranian Diabetes Association with type 1 diabetes, and 200 non-diabetic children from primary and guidance school from district 3,4 and 7 of Tehran, were assessed according to the easy sampling method. The data required were gathered using a demographic and nutritional questionnaire completed by the childs' mother. For determining of the adjusted odds ratio, logistic regression was used. Results: The percent of children who were exclusively breastfed, for less than 4 months, were higher in cases than controls, statistically significant (OR=5.60, P=0.008). There were significantly more mothers, whose weight gain during pregnancy was lower than mean weight gain (10.75kg), in the control group, (OR=0.52, P=0.04). Similar numbers of children consumed cow’s milk before age 1, in both the diabetic and non diabetic groups. Conclusion: According to our findings, exclusively breastfeeding for at least 4 months and lower maternal weight gain during pregnancy prevent type 1 diabetes mellitus, whereas early introduction of weaning food, consumption of cow’s milk and higher birth weight play no role in the development of type 1 diabetes. 

 

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Introduction: Quality of life, considered an indication of quality of health care, is an essential part of health care programs for controlling disease. Although the evaluation of quality of life in Iran dates back to 40 years ago, it is yet in its infancy as there is limited data available in this field. The present research deals with the effects of diabetes on the quality of life of adolescents in different areas including the rate of life satisfaction and concern about the future. Materials and Methods: In this descriptive-analytic research, 100 diabetic adolescents referred to the Zahedan diabetes centre were studied. A 52 item DQOLY questionnaire was used to collect data, which was analyzed using the independent T-test and variance analysis. Results: Results revealed lower scores in adolescents’ responses, their main problem being parent control and the effects of diabetes on their activities. The maximum average score was for adolescents’ satisfaction of life quality (52.6 ± 14.58). The 10-12 year age group was more affected by disease in their personal activities, a difference that was statiscally significant (P=0.004). Statistical tests also showed a significant difference for the average score of the diabetic adolescents in terms of the effect of parents’ education on adolescents’ satisfaction of life quality and parent control (P=0.0001). Conclusion: Results indicated that diabetic children and adolescents have difficulty in their social activities, and they are influenced by parent control, a finding more prominent in 10-12 year olds. It is hence suggested that this age group, especially in the groups with low economic status, must be provided with special care through training, counseling and intervention.

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Abstract

Introduction: Cardiovascular complications are considered as the main cause of morbidity and mortality in patients with diabetes mellitus. The role of increased serum concentrations of inflammatory markers, particularly C Reactive Protein (CRP), in the prediction and the pathogenesis of cardiovascular complications of type 1 diabetes has been established. The aim of the present study was to evaluate the effect of 10 weeks of L-carnitine supplementation and aerobic exercise training on serum levels of CRP in streptozotocin-induced diabetic rats. Materials and Methods: Male wistar rats (n=36), weighing 230±10 (grams) were randomly divided into 6 groups (n=6 each), including the healthy group, and the remaining (after the induction of diabetes mellitus by injection of streptozotocin), into the diabetic pre-test, diabetic control, diabetic aerobic training, diabetic oral L-carnitine treatment, and the diabetic aerobic training plus oral L-carnitine treatment groups. At the end of the interventions, blood samples were collected to determine serum levels of CRP. Data were analyzed with one-way ANOVA and Tukey's post hoc test using SPSS version 20; P values<0.05 were considered significant. Results: Althought L-carnitine supplem­entation in diabetic oral L-carnitine treatment group did not significantly reduce serum levels of CRP, compared with the diabetic control group (p=0.078), it however reduced the rate of its progressive increase. Also significant reductions in CRP levels in both the aerobic training (p=0) and the aerobic training plus L-carnitine supplementation groups (p=0) were observed. However, the percentage changes of CRP level in the latter group was higher. Conclusion: Results of the current study show that, aerobic training can reduce serum CRP levels in streptozotocin-induced diabetic rats, and the simultaneous use of L-carnitine supplementation, can lead to more beneficial effects.

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Introduction: Adolescents with type 1 diabetes show poorer adherence to self-care behaviors, compared with other patients. The purpose of this study was to determine the perceptions, enablers, and nurturers related to self-care behaviors in adolescents with type 1 diabetes. Materials and Methods: This cross-sectional study was conducted in 2016, on 120 adolescent participants with type 1 diabetes who had been referred to the Iranian Diabetes Association. Data collection tools were a questionnaire based on the PEN-3 Model and information extracted during interviews and focus group discussions. The questionnaire consisted of four parts (Demographic variables, Perceptions, Enablers, and Nurturers); the validity and reliability of the questionnaire had been approved. Data were analyzed using SPSS version 22 software and descriptive statistics tests. Results: Over 44% of adolescents with type 1 diabetes reported moderate compliance with self-care behaviors. Insupportable self-care behaviors, denial of disease, expensive blood glucose (blood sugar) test strips, lack of public and private education, lack of attention to spirituality and the spiritual needs of patients in therapeutic programs, conflict with parents and poor communication with other type 1 diabetes patients were the most important perceptions, enablers and nurturers. Conclusions: Focusing more attention on the design of the general education programs, via mass media and dedicated training, increasing government support and health insurance for patients, along with addressing and spiritual needs of patients can help overcome these obstacles.

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Introduction: The term stigma indicates characteristic labeling, in a way, that the individual becomes an outcast in his /her living environment for physical or psychological reason and in the case of patching it becomes ill fated. The objective of this study was to determine the perceived social stigma and its relationship with the demographic and clinical characteristics of patients with type 1 diabetes. Methods and Materials: In this analytical descriptive study, conducted in 2018, 135 patients with type 1 diabetes in Tabriz health centers, who met the inclusion criteria, were assessed using the purposeful sampling method. Data were collected on demographics also using social stigma questionnaires. Data were analyzed by SPSS software version 16 using independent t-test and one way ANOVA. Results: The majority of participants were women, with an average age of 26.02±7.27 years. Total mean for social stigma of the participants was 51.43±12.16, considered a moderate level. There was a significant relationship between social stigma and age, marital status, place of residence, educational level, duration of diabetes, diabetic family history and different levels of hemoglobin glycosylation. Conclusion: Based on the research results, the comprehensive effort and support of the treatment team, viz nurses is more effective educating diabetes patients and is vital for improving their knowledge about diabetes, to facilate coping with the psychological and emotional complications of diabetes and its social stigma.

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