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هدفت الدراسة الحالية إلى إيضاح دور كل من إدارة الرعاية الذاتية، والضيق الانفعالي وفعالية الذات في التنبؤ بجودة الحياة المرتبطة بالصحة. على عينة قوامها (323) مشاركا من مرضى السكري من النوع الثاني، تراوحت أعمار العينة ما بين 23: 70 عاما بمتوسط عمري بلغ (52.6) عام وانحراف معياري قدره (11.3) طبق عليهم مقاييس -الإدارة الذاتية لمرضى السكري (DSM)، -قائمة الضيق الانفعالي لمرضى السكري (DDS)، -مقياس فعالية الذات في إدارة مرض السكري، -مقياس جودة الحياة لمرضى السكري (QOLID). أشارت النتائج إلى وجود علاقة إيجابية بين جودة الحياة وكل من متغيرات الإدارة الذاتية لمرضى السكر والكفاءة الذاتية، بينما كانت العلاقة سلبية مع الضيق الانفعالي، كذلك لم تتوصل الدراسة إلى وجود فروق بين الجنسين في المتغيرات باستثناء اثنين من الدرجات الفرعية على مقياسي الإدارة الذاتية، الكفاءة الذاتية. وأخيرا استطاعت متغيرات الإدارة الذاتية، الضيق الانفعالي، فعالية الذات أن تتنبأ بجودة الحياة الصحية بنسب إسهام بلغت 32%، 29%، 17% على التوالي من التباين الكلي.

Background : Lower vitamin D status has been reported in diabetic patients. Serum 25-hydroxyvitamin D and adiponectin were inversely associated with type 2 diabetes and insulin resistance. Vitamin D may involve in regulation of the adiponectin levels, which is directly related to insulin sensitivity. Objectives : The aim of this study was to investigate the effect of therapeutic dose of vitamin D on serum adiponectin and insulin resistance in vitamin D-insufficient or deficient type 2 diabetic patients. Materials and Methods : This double-blind, randomized, clinical trial was conducted on 81 type 2 diabetic patients with vitamin D level of 10-30 ng/mL. Intervention was 50000 IU vitamin D or placebo once a week for 8 weeks. At the beginning and end of the study, blood samples were collected after 12 hours of fasting and serum glucose, insulin, 25-hydroxyvitamin D, and adiponectin were measured. Insulin resistance was calculated by homeostasis model assessment (HOMA-IR). Results : After 8-week intervention, serum 25-hydroxyvitamin D significantly increased and reached the normal levels in patients receiving vitamin D (P < 0.001) and the levels of fasting serum glucose, insulin, and HOMA-IR were significantly decreased (P = 0.04, 0.02 and 0.007, respectively). No significant changes were observed in these levels in the placebo group. Significant differences were observed in mean changes in the above-mentioned variables between the two groups (P = 0.01, 0.04 and 0.006, respectively). No significant changes were found in serum adiponectin in the vitamin D and placebo groups (P = 0.83). Conclusions : Therapeutic dose of vitamin D can improve vitamin D status and glycemic indicators. But it seems that an 8-week intervention period was not sufficient to reveal the possible effects of vitamin D on serum adiponectin levels.

Objectives: This study aimed to determine the prevalence of vitamin B12 deficiency amongst diabetic patients on metformin therapy. Methods: This cross-sectional study was conducted at general clinics at the University Health Center and diabetes outpatient clinics at Sultan Qaboos University Hospital, Muscat, Oman, between January and December 2017. All Omani adults who were diagnosed with type 2 diabetes mellitus and took metformin were invited to participate in the study. The variables included in this study were age, gender, duration of diabetes, dose and duration of metformin therapy, haemoglobin and glycosylated haemoglobin level. Results: A total of 248 subjects were included (response rate = 95.4%) of which 26 (10.5%) were vitamin B12 deficient and 53 (21.4%) were borderline deficient. The mean daily dose of metformin was highest among vitamin B12 deficient group (1,981 ± 222 mg; P = 0.004). Conclusion: The prevalence of vitamin B12 deficiency is considerable among diabetic patients on metformin therapy. Further research is needed to confirm the need for routine screening and monitoring

Background : diabetes is a metabolic disorder with a high worldwide prevalence. It has been reported that diabetic patients are more prone to depression and anxiety. Objectives : this study aimed to evaluate the prevalence of depression and anxiety among diabetic patients with regards to some factors such as age, gender, level of education and occupational status. Materials and Methods : One hundred and eighty four diabetic patients have participated in this study. To assess the severity of depression and anxiety Beck depression inventory and Beck anxiety inventory questionnaire were used respectively. Binary logistic regressions were used to analyze the data. Results : the results of the present study have shown that 70.7 % of the diabetic patients were suffered from depression. Besides, 69.6 % of them were diagnosed with anxiety. According to the result, diabetes related depression is affected by sex (OR : 2.767), age (OR : 2.222), level of education (OR : 4.145) and job status (OR : 3.901). It has been also resulted that gender (OR : 2.274), age (OR : 2.706) and Job Status (OR : 2.441) are the effective factors leading to anxiety. Conclusions : depression and anxiety have higher prevalence among diabetic patients and some sociological factors such as age, gender, job and education are related to these psychological disorders.

The 6th edition of International Diabetes Federation, 2014 shows an estimate of 387 million people with Type 2 diabetes mellitus (T2DM) worldwide, expected to rise to 592 million by 2035. T2DM is a metabolic disorder, one of the reasons being oxidative stress due to impairment in antioxidant enzymes. It leads to several complications such as micro and macrovascular diseases. Cyclooxygenase1 (COX1) enzyme is the rate limiting factor for the arachidonic pathway leading to vascular wall contraction with angiotensin II occurring in heart diseases resulting from T2DM. COX1 determines 6-Keto Prostaglandin F1α (6-k-PGF1α) level, plays a major role in vasodilation and restricts macrophage platelet aggregation. The aim of the present study was to compare the COX1 expression and level of reactive oxygen species (ROS) in T2DM patients and controls at different time periods in human macrophages in order to find a biomarker or drug target. The study subjects consisted of 100 individuals, 50 each from T2DM patients and healthy sex/age matched controls. Cell proliferation by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay and ROS measurement by 2′,7′-dichlorofluorescein diacetate (DCFDA) staining were performed at different time periods (24, 48, 72h). COX1 mRNA expression was checked by relative quantification method after real-time polymerase chain reaction (RT-PCR). The MTT assay showed that cell viability was significantly higher at 48h (P<0.05). ROS production was found to be lowest at 24h by DCFDA staining. ROS levels were raised in T2DM patients as compared to controls. The quantitative RT-PCR analysis showed that the COX1 expression was higher in T2DM patients as compared to healthy controls although not significant (P>0.05). Although COX1 is known to be a “housekeeping” gene, our study showed that its expression can be correlated with the disease condition and be used as a marker. However, further studies are required in more number of samples from other ethnic populations to confirm the findings.

Background: Continuous performing of diabetes self-care behaviors was shown to be an effective strategy to control diabetes and to prevent or reduce its- related complications. This study aimed to investigate predictors of self-care behavior based on the extended theory of reasoned action by self efficacy (ETRA) among women with type 2 diabetes in Iran. Methods: A sample of 352 women with type 2 diabetes, referring to a Diabetes Clinic in Khoy, Iran using the nonprobability sampling was enrolled. Appropriate instruments were designed to measure the variables of interest (diabetes knowledge, personal beliefs, subjective norm, self-efficacy and behavioral intention along with self- care behaviors). Reliability and validity of the instruments using Cronbach’s alpha coefficients (the values of them were more than 0.70) and a panel of experts were tested. Results: A statistical significant correlation existed between independent constructs of proposed model and modelrelated dependent constructs, as ETRA model along with its related external factors explained 41.5% of variance of intentions and 25.3% of variance of actual behavior. Among constructs of model, self-efficacy was the strongest predictor of intentions among women with type 2 diabetes, as it lonely explained 31.3% of variance of intentions and 11.4% of variance of self-care behavior. Conclusion: The high ability of the extended theory of reasoned action with self-efficacy in forecasting and explaining diabetes mellitus self management can be a base for educational intervention. So to improve diabetes self management behavior and to control the disease, use of educational interventions based on proposed model is suggested.

Objective To evaluate the role of soluble Fas (sFas) and soluble Fas ligand (sFasL) in the pathogenesis of distal symmetrical polyneuropathy (DSPN) in patients with type 2 diabetes mellitus, and to analyze the relationship between these apoptotic markers with clinical parameters and electrophysiologic profile of DSPN, as well as with different diabetic factors among those patients. Patients and methods The study included 60 Egyptians with type 2 diabetes mellitus. All patients were evaluated clinically for DSPN by using Michigan Neuropathy Screening Instrument. Electrophysiological diagnosis of DSPN was based on the criteria suggested by the European Standardized Telematic tool to Evaluate Electrodiagnostic Methods group. Diabetic patients were divided into two groups according to the electrophysiological findings: group A included patients with DSPN (N=42), and group B included patients without DSPN (N=18). The severity of DSPN among group A patients was assessed clinically using Toronto Clinical Neuropathy Score and electrophysiologically by the severity score proposed by Hidasi and colleagues. The study also included 30 healthy volunteers as a control group. Serum levels of sFas and sFasL were assessed in all the studied groups. Results Serum level of sFas was significantly elevated in diabetic patients with DSPN compared with diabetics without DSPN and nondiabetic control (P=0.029 and 0.000). Receiver operating characteristic (ROC) curve analysis detected that sFas was statistically significant in discriminating between diabetic patients with DSPN from those patients without DSPN with an accuracy of 66%. The cutoff point that has the highest sensitivity (61%) and specificity (62%) was 33.3 ng/ml. Serum level of sFas showed a positive significant correlation with the electrophysiological severity of DSPN (P=0.020). Serum level of sFasL did not show statistically significant difference between all the studied groups. Conclusion Fas-mediated apoptosis has an important role in the development of diabetic DSPN and is correlated with its electrophysiological severity.

Type 2 diabetes mellitus is a multifactorial and heterogenic disease with a complex etiology. In recent decades the association of a large number of genes has been shown with T2DM. CAPN10 gene was the first T2DM candidate gene identified through genome-wide screening and positional cloning, and among all identified genes until now, TCF7L2 gene has shown most association with T2DM. The aim of this study was to investigate the association between TCF7L2 rs11196205(C/G) and CAPN10 rs3792267 (G/A) with T2DM in a subset of Iranian population from Khuzestan province. It should be noted that this is the first report of TCF7L2 polymorphism rs11196205with T2DM in Iran. A case-control association study was performed using 150 T2DM patients and 150 controls. Genotyping for TCF7L2 rs11196205 was done by Tetra-Primer ARMS-PCR and for CAPN10 rs3792267 was done by PCR-RFLP Technique. Statistical analyses were carried out using SPSS version 16. In examining TCF7L2 rs11196205 based on the genotype GG, results for CG genotype were, 95%CI = (0.5–1.7), OR = 0.92, P-value = 0.79 and for genotype CC were, 95%CI = (0.94–3.92), OR = 1.92, P-value = 0.07. in examining CAPN10 rs3792267 based on the genotype AA, results for GG genotype were, 95%CI = (0.55–6.8), OR = 1.93, P-value = 0.31 and for genotype GA were, 95%CI = (0.43–5.64), OR = 1.55, P-value = 0.5. So, in both polymorphisms, none of the alleles or genotypes had significant statistical differences between case and control groups (P > 0.05). Our results showed that TCF7L2 rs11196205 and CAPN10 rs3792267 (SNP- 43) polymorphisms are not associated with the risk of T2DM in the studied population.