Iranian Journal of Diabetes and Obesity

en The Relationship between Particulate Matter and Parameters of the Electrocardiogram and Blood Pressure in People with Type 2 Diabetes تخصصي Special پژوهشي Research Objective: This study aimed to investigate the relationship between particulate matter (PM) and electrocardiogram, blood pressure, and fasting blood sugar in people with type 2 diabetes mellitus. Materials and Methods: In this study, we collected laboratory and clinical information from 270 patients with type 2 diabetes (T2DM) who were hospitalized at educational hospitals affiliated with Abadan University of Medical Sciences from March 21, 2023, to March 19, 2024. Information related to the concentrations of PM10 and PM2.5 was received from the Khuzestan Environmental Organization. To explore the relationship between PM2.5 and PM10 with clinical and laboratory factors, the Pearson Correlation Coefficient was utilized. Results: The study showed that 53.3% of the patients were male, and the mean age was 60.32 (± 12.16) years. No significant relationship was observed between PM10 and PM2.5 with fasting blood sugar (P= 0.291), (P= 0.516), random blood sugar (P= 0.804), (P= 0.829), P-R interval (P= 0.289), (P= 0.163), S-T segment (P= 0.700), (P= 0.517), QRS voltage (P= 0.956), (P= 0.505), systolic blood pressure (P= 0.587), (P= 0.478) and diastolic blood pressure (P= 0.229), (P= 0.347). However, a significant relationship was observed between PM 10 and PM 2.5 with the Q-T interval (P= 0.042) and (P= 0.010). Conclusion: Based on the results of the present study, no significant relationship was observed between PM with Clinical and laboratory parameters in people with type 2 diabetes, and only the relationship between PM and Q-T interval, which is one of the electrocardiographic parameters, was significant.   Diabetes, Blood sugar, Particulate matter 1 8 http://ijdo.ssu.ac.ir/browse.php?a_code=A-10-30-467&slc_lang=en&sid=1 Abbas Salehi 0009-0007-1454-725X No Student Research Committee, Abadan University of Medical Sciences, Abadan, Iran. Naser Kamyari 0000-0001-6245-5447 No Department of Public Health, School of Health, Abadan University of Medical Sciences, Abadan, Iran. Maryam Ban 0000-0001-6702-5411 No Department of Nursing, School of Nursing, Abadan University of Medical Sciences, Abadan, Iran Iran. Gholamreza Goudarzi 0000-0001-5387-0761 No Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Esmat Radmanesh 0000-0003-1369-6580 Yes Department of Medical Physiology, School of Medicine, Abadan University of Medical Sciences, Abadan, Iran. Research Center for Environmental Contaminants (RCEC), Abadan University of Medical Sciences, Abadan, Iran. Clinical Research Development Unit, Taleghani Educational Hospital, Abadan University of Medical Sciences, Abadan, Iran.

en Assessing Medication Adherence and Quality of Life among Type 2 Diabetic Outpatients in Al-Hilla, Iraq 2023 تخصصي Special پژوهشي Research Objective: The rising occurrence of type 2 diabetes mellitus in Iraq, impacted by changes in lifestyle and strain on the healthcare system, is worsened by the significant issue of inadequate treatment adherence. As a result, this scenario leads to inadequate glycemic control and an increased risk of severe disease complications. The objective of this research was to assess medication adherence and quality of life (QOL) in indivduals with type 2 diabetes at the Al-Hilla Diabetic Center in 2023. Materials and Methods: A cross-sectional study was carried out at diabetic centers and outpatient clinics in Marjan Hospital and Imam Al-Sadiq Hospital in Al-Hilla City, Babylon Province, Iraq. A total of 355 patients with T2DM who were attending diabetic centers and hospitals in Al-Hilla, Babylon were included in the study using a convenience sampling method. Regression linear tests were utilized to explore the factors that may influence adherence. Results: The data analysis showed that the QOL was relatively good (47.32± 22.13) and medication adherence was 4.64± 1.42. This study indicated that age significantly influences the QOL of patients with T2DM (P≤ 0.001). Additionally, medication adherence was found to be significantly associated with age, work, educational level, income, and living condition (P≤ 0.001), while there was no statistical significance observed with marital status and gender (P≥ 0.001). Conclusion: Diabetes Nurse Specialists need to consider factors that impact QOL and develop strategies to enhance both QOL and medication adherence.   Diabetes mellitus, Insulin resistance, Quality of life, Medication adherence 9 17 http://ijdo.ssu.ac.ir/browse.php?a_code=A-10-30-468&slc_lang=en&sid=1 Alice Khachian 0000-0002-7875-4166 No Professor, Nursing and Midwifery Care Research Centre, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran. Tahereh Alsadat Khoubbin Khoshnazar 0000-0001-7872-1025 Yes Assistant Professor, Nursing and Midwifery Care Research Centre, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran. Shima Haghani 0000-0002-1334-975X No MSc in Biostatistics, Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran. Duaa Sabah Najem 0009-0004-7584-4117 No MSc, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran. Kosar zeighami 0000-0003-0136-7886 No MS in Rehabilitation Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran. Elham Akhlaghi 0000-0003-3552-1685 No Assistant Professor, Nursing and Midwifery Care Research Centre, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.

en The Relationship between Sleep Quality and Obesity in Elementary School Children تخصصي Special پژوهشي Research Objective: Obesity and sleep disorders are major health concerns in children, with long-term consequences for physical and mental health. Numerous studies have shown a correlation between poor sleep quality and obesity, highlighting the importance of a deeper investigation into this matter. This study aims to examine the association between sleep quality and obesity in elementary school children in Kerman in 2023. Materials and Methods: This cross-sectional study was conducted on 384 children aged 7-13 years. Demographic data and sleep quality were gathered using the Pittsburgh Sleep Quality Index (PSQI). Weight status was assessed by appropriate anthropometric measurements. Data were analyzed with SPSS software version 29, using T-tests and ANOVA. Results: Sleep quality in obese children was significantly lower than in children with normal or overweight status (P< 0.001). Additionally, sleep quality decreased with age (P< 0.001). Gender (P= 0.222), family income (P= 0.625), and chronic illness (P= 0.664) had no significant effect on sleep quality. Conclusion: While obesity and age were significant indications of poor sleep quality, gender, income level, and health history were not. These results highlight the importance of obesity management and awareness among parents and educators regarding the importance of sleep quality in children's academic performance and mental health.   Obesity, Sleep quality, Body mass index, Children, Sleep disorders 18 29 http://ijdo.ssu.ac.ir/browse.php?a_code=A-10-30-469&slc_lang=en&sid=1 Mostafa Yazdani 0000-0002-5544-2370 No Department of Psychiatry, School of Medicine Shahid Beheshti Hospital Kerman University of Medical Sciences, Kerman, Iran. Reihaneh Mohammadi Jorjafki 0000-0001-5355-3010 No Department of Psychiatry, School of Medicine Shahid Beheshti Hospital Kerman University of Medical Sciences, Kerman, Iran. Farzaneh Raaii 0000-0002-9634-6895 No Department of Psychiatry, School of Medicine Shahid Beheshti Hospital Kerman University of Medical Sciences, Kerman, Iran. Ladan Shahba 0009-0009-4340-0171 No Department of Psychiatry, School of Medicine Shahid Beheshti Hospital Kerman University of Medical Sciences, Kerman, Iran. Farzaneh Jahanbakhsh 0000-0002-3469-4026 Yes Department of Psychiatry, School of Medicine Shahid Beheshti Hospital Kerman University of Medical Sciences, Kerman, Iran.

en Predicting Psychological Distress based on Mindfulness and Resilience with the Mediation of Cognitive Flexibility in Diabetic Patients تخصصي Special پژوهشي Research Objective: The present study aimed to predict psychological distress based on mindfulness and resilience with the mediation of cognitive flexibility in diabetic patients. Materials and Methods: This study is descriptive-correlational in nature and was conducted using structural equation modeling. The statistical population consisted of all diabetic patients visiting hospitals in Mashhad city. Using purposive and volunteer sampling methods, 115 individuals were selected as the sample. Participants completed The Kessler Psychological Distress Scale (K10), The Five Facet Mindfulness Questionnaire (FFMQ), The Connor-Davidson Resilience Scale (CD-RISC), and Cognitive Flexibility Inventory (CFI). Inferential statistics were employed, utilizing structural equation modeling (SEM), while inferential analysis evaluated hypotheses and assessed the structural relationships using SPSS version 22 and LISREL version 3. Results: The descriptive results indicated the following scores for the study variables: psychological distress (M= 15.43± 10.81), mindfulness (M= 132.93± 36.30), resilience (M= 78.76± 15.95), and cognitive flexibility (M= 56.81± 20.91).The analyses confirmed significant relationships: resilience and mindfulness directly affect psychological distress and indirectly influence it through cognitive flexibility, with all effects being statistically significant (P< 0.05). Conclusion: In conclusion, fostering mindfulness and resilience, alongside enhancing cognitive flexibility, offers a promising approach for alleviating psychological distress in patients with diabetes. Future studies should explore targeted intervention strategies to effectively strengthen these psychological resources, ultimately contributing to better disease management and quality of life.   Psychological distress, Mindfulness, Resilience, Cognitive flexibility, Diabetic patients 30 40 http://ijdo.ssu.ac.ir/browse.php?a_code=A-10-30-470&slc_lang=en&sid=1 Nahid Azimi Ghahveh Moghadam 0009-0000-2073-1618 Yes MSC in Psychology, Department of Psychology, Torbat Jam Branch, Islamic Azad University, Torbat Jam, Iran. Reza Noori 0000-0003-3238-6262 No Assistant professor, Department of Psychiatry, School of Medicine, Zabol University of Medical Sciences, Zabol, Iran.

en Nurse-Led Multidisciplinary Care for Type 2 Diabetes: Protocol for a Feasibility Pilot Randomized Controlled Trial تخصصي Special پژوهشي Research Objective: To assess the feasibility of a nurse-led multidisciplinary intervention to improve self-management, psychological distress, and medication adherence in patients with type 2 diabetes (T2D) in Iran, informing a future definitive randomized controlled trial (RCT). Materials and Methods: This single-blind, parallel-group pilot RCT will recruit 60 adults with T2D (HbA1c> 6.5%) from the Yazd Diabetes Research Center, Iran. Participants will be randomized 1:1 to a 6‑month intervention or usual care. The intervention, grounded in self-efficacy theory and motivational interviewing, comprises 3 months of in-person/online counseling (three sessions targeting American Diabetes Association–endorsed self-care behaviors: diabetes knowledge, nutrition counseling, physical activity, glucose monitoring, medication adherence, and cardiovascular risk reduction) delivered by a nurse-led team (endocrinologist, dietitian, psychologist), followed by 3 months of biweekly telephone follow-ups. Feasibility outcomes include recruitment (>70%), retention (>80%), acceptability (Likert score >4/5), and data completeness (>90%). Exploratory outcomes include HbA1c, fasting blood sugar, low-density lipoprotein, blood pressure, anthropometric indices, dietary self-management assessed by the Diabetes Self-Management Questionnaire-Revised, diabetes-related distress measured by the Diabetes Distress Scale-17, and medication adherence evaluated by the Medication Adherence Report Scale-5, collected at baseline, 3 months, and 6 months. Data will be analyzed descriptively (proportions, means, 95% CIs) using SPSS v25. Results: It is merely a proposed research protocol that can be used in the future. Conclusion: This pilot will evaluate the feasibility of a culturally tailored, nurse-led multidisciplinary intervention for T2D management in Iran, providing data to refine a definitive RCT and inform care models in resource-constrained settings.   Diabetes mellitus, Nurses, Multidisciplinary, Medication adherence, Self-management 41 52 http://ijdo.ssu.ac.ir/browse.php?a_code=A-10-30-471&slc_lang=en&sid=1 Fatemeh Bakhshi 0000-0002-9238-0340 No Assistant Professor, Ph.D. In Nursing Education. Research Center for Nursing and Midwifery Care, Comprehensive Research Institute for Maternal and Child Health, Department of Nursing, School of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Reyhaneh Azizi 0000-0002-0996-045X No Assistant Professor, Diabetes Research Center, Non-Communicable Diseases Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Mahdieh Hossienzadeh 0000-0001-7482-2494 No Associate Professor, Research Center for Food Hygiene and Safety, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.Diabetes Research Center, Non-Communicable Diseases Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Shakiba Sadat Tabatabaee 0000-0001-8216-0881 No PhD Candidate in Psychology, Kish International Campus, University of Tehran, Tehran, Iran. Zahra Ramezani 0009-0004-7618-9791 Yes MSc Student of Medical Surgical Nursing, Department of Nursing, School of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

en Compassion-Focused Therapy for Bulimia Nervosa in Women: Effects on Rumination and Early Maladaptive Schemas تخصصي Special پژوهشي Research Objective: Bulimia nervosa is frequently associated with elevated rumination and early maladaptive schemas. The aim of this study was to investigate the effectiveness of compassion-focused therapy (CFT) in reducing rumination and early maladaptive schemas among women with bulimia nervosa. Materials and Methods: This quasi-experimental study utilized a pretest-posttest control group design. Fifty women with a confirmed DSM-5 diagnosis of bulimia nervosa were recruited via convenience sampling from the Ahvaz Eating Disorders Association and randomly assigned to either an experimental group (n= 25) receiving compassion-focused therapy (8 sessions, 90 minutes each) or a no-intervention control group (n= 25). Rumination was assessed using the Rumination Response Scale (RRS), and early maladaptive schemas were measured with the 75-item Early Maladaptive Schema Questionnaire-Short Form. Data were analyzed using analysis of covariance (ANCOVA) in SPSS-25. Results: After controlling for pretest scores, women who received CFT showed significantly greater reductions in both rumination (P< 0.001) and early maladaptive schemas (P< 0.001) compared to the control group. Large effect sizes were observed for both outcomes (η²> 0.70). Conclusion: CFT is an effective intervention for reducing rumination and early maladaptive schemas in women with bulimia nervosa. These findings support the clinical utility of CFT in targeting core cognitive-emotional maintenance factors in this population and suggest that it may be a valuable treatment option for bulimia nervosa.   Self-compassion, Rumination, Bulimia nervosa, Women 53 67 http://ijdo.ssu.ac.ir/browse.php?a_code=A-10-30-472&slc_lang=en&sid=1 Fatemeh Momeni 0009-0006-5857-800X No Department of Psychology, Ahv.C., Islamic Azad University, Ahvaz, Iran. Sasan Bavi 0000-0001-8929-4719 Yes Department of Psychology, Ahv.C., Islamic Azad University, Ahvaz, Iran. Karim Sevari 0000-0003-2971-2434 No Department of Psychology, Payame Noor University, Tehran, Iran. Zahra Eftekhar Saadi 0000-0002-6744-8577 No Department of Psychology, Ahv.C., Islamic Azad University, Ahvaz, Iran. Ali Khalafi 0000-0001-7743-8201 No Department of Psychology, Shad.C., Islamic Azad University, Shadegan, Iran.

en The Impact of Antidepressants on Blood Sugar and Lipid Profiles in Diabetic Patients: A Comprehensive Review تخصصي Special پژوهشي Research Diabetes prevalence and mortality are rising worldwide. Despite multiple treatments, optimal blood sugar control in type 2 diabetes remains challenging. This has prompted interest in whether antidepressants could influence glycemic management. However, studies examining their effects on blood glucose have reported inconsistent and sometimes conflicting results. This article will discuss the effects that different anti- depressants may have on blood sugar and lipid levels. We plan to focus chiefly on tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs) and serotonin/norepinephrine reuptake inhibitors (SNRIs). To achieve the aim of the present study, we searched PubMed using separate strategies that combined Title/Abstract keywords and MeSH terms related to type 2 diabetes and different classes of antidepressants (SSRIs, SNRIs, TCAs, agomelatine, and benzodiazepines) to ensure comprehensive coverage of relevant evidence. For type 2 diabetic patients, the principal achievement was that SSRIs of all types could reduce blood sugar, and they particularly had been shown to stimulate the body’s own insulin response. Patients lost weight and blood sugar control improved with fluoxetine. The purpose of this review is to describe the existing information and also point out shortcomings in previous studies, as well as providing directions for future research on how various antidepressants affect their patients' metabolic outcomes alongside potential mental status changes. These relationships are important to understand, not only for planning effective treatments for diabetes but also in order to manage the complicated metabolic-psychiatric continuum.   Anti-depressive agents, Blood glucose, Dyslipidemias, Diabetes mellitus 58 67 http://ijdo.ssu.ac.ir/browse.php?a_code=A-10-30-473&slc_lang=en&sid=1 Narjes Hazar 0000-0002-2623-7685 No Diabetes Research Center, Non-Communicable Diseases Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Sanaz Dastghaib 0000-0001-8553-9221 No Endocrinology and Metabolism Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. Reyhane Dehlavi 0000-0002-7678-7001 No Diabetes Research Center, Non-Communicable Diseases Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Fatemeh Samimi 0000-0001-5426-6785 No Diabetes Research Center, Non-Communicable Diseases Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Biochemistry Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. Mohammad Afkhami-Ardekani 0000-0001-9768-5904 Yes Diabetes Research Center, Non-Communicable Diseases Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

en Dipeptidyl peptidase-4 Inhibitors in Type 2 Diabetes Mellitus: Mechanisms and Efficacy in Clinical Practice تخصصي Special پژوهشي Research Type 2 diabetes mellitus (T2DM) is a long-term metabolic condition marked by reduced insulin release, decreased sensitivity to insulin, and hyperglucagonemia. In recent years, dipeptidyl peptidase-4 (DPP-4) inhibitors have become increasingly significant within the newer classes of antidiabetic medications, thanks to their distinct mechanism of action, advantageous safety profile, and the convenience of oral administration. In contrast to sulfonylureas, which have a significant risk of causing hypoglycemia, DPP-4 inhibitors offer insulin stimulation that depends on glucose levels, making them a safer choice for many patients. The aim of this study is to investigate the mechanisms and efficacy of DPP-4 inhibitors in clinical practice. The incretin effects of DPP-4 inhibitors are mediated by the hormone glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP). GLP-1 and GIP stimulates insulin secretion. Furthermore, DPP-4 inhibitors hinder apoptosis in cells. For example, suppressing apoptosis in cardiac, renal, and pancreatic beta cells may be advantageous for enhancing insulin secretion and minimizing complications related to diabetes. DPP-4 inhibitors reduce inflammatory cytokines and chemokines by inhibiting nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB). In addition, they mitigate inflammation through modulation of immune cell activity and upregulation of anti-inflammatory chemokines and adipokines. Also, DPP-4 inhibitors have antioxidant roles, such as improving antioxidant factors and downregulating oxidant agents. Considering that T2DM is characterized as an inflammatory disease, DPP-4 inhibitors elevate insulin secretion and sensitivity, improve glycemic indices, and mitigate diabetic complications through incretin, anti-inflammatory, and antioxidant effects.   T2DM, DPP-4, GLP-1, GIP, Insulin, NF-κB, Glycemic 68 76 http://ijdo.ssu.ac.ir/browse.php?a_code=A-10-30-474&slc_lang=en&sid=1 Ali Nosrati Andevari 0000-0002-8699-4688 Yes Department of Clinical Biochemistry, Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran.