Amir Bahrami

Effectiveness of Insulin Glargine on Recovery of Patients with Diabetic Ketoacidosis: A Randomized Controlled Trial.

BACKGROUND Diabetic Ketoacidosis (DKA) is a major hyperglycemic emergency in diabetes mellitus (DM). The basic treatment is injection of Regular insulin (RI). This study was aimed to investigate the effects of insulin Glargine (GI) on recovery of patients with DKA. MATERIALS AND METHODS A randomized clinical trial conducted on 40 patients (twenty patients in each group) with DKA. Both groups received standard treatment for DKA. Experimental group was given 0.4U/kg of GI within three hours of initiation of IV insulin infusion. RESULTS The mean duration of acidosis correction time and recovery from DKA was 13.77±6.10 and 16.91±6.49 h in the intervention and control groups respectively (p=0.123). The mean dosage of RI until recovery from DKA was 84.8±45.6 in the intervention and 116.5±91.6 units in control groups (p=0.17). Hypokalemia occurred in three patients in intervention and four patients in control groups. In 35% of samples in intervention group and 51% in controls blood sugar was more than 10 mmol/l for 24 h after discontinuation of the insulin infusion (p=0.046). The mean duration of hospitalization was 5.1±1.88 in intervention and 5.9±2.19 d in control group (p=0.225). CONCLUSION Adding GI to the standard treatment of DKA reduced average time of recovery from DKA, without incurring episodes of hypoglycemia and hypokalemia. This also reduced in the time of recovery from DKA, amount of required insulin and the duration of hospitalization. It seems that the non-significant difference in the time of recovery from DKA be related to the small sample size and study design. Further studies are recommended.

Effect of extract of Urtica dioica on insulin and C-peptide secretion from rats (RIN5F) pancreatic beta cells

Plants are being used in the treatment of diabetes in traditional system of medicine. Urtica dioica (UD) has a variety of uses in traditional medicine. There are few reports about hypoglycemic mechanisms of U. dioica . The present study was designed to determine the possible mechanisms of hypoglycemic effects of UD on RIN5F rat pancreatic beta cells in vitro models. Beta cells were prepared in multiple flasks containing culture medium. Alcoholic extract of UD at concentrations of 50, 100 and 200 µg/ml was added to flasks. Insulin and C-peptide level were measured at 0, 60, 120 and 80 min. Insulin level in pancreatic cells media before and after addition of UD extract at different concentrations and in different times did not changed significantly (p > 0.2). Also, C-peptide (µg/ml) levels in these media with dose of 50, 100 and 200 µg/ml UD, did not change significantly. The results of the present study demonstrated that alcoholic extract of UD was unable to increase insulin and C-peptide secretion from RIN5F pancreatic beta cells. Hence, the hypoglycemic effects of UD are not based on enhancement of insulin secretion and needs more study. Key words: Urtica dioica , insulin secretion, hypoglycemic activity. INTRODUCTION Diabetes is a chronic disorder in metabolism of carbohydrates, proteins, and fat, due to absolute or relative deficiency of insulin secretion or varying degree of insulin resistance (American Diabetes Association, 2011; Farmer and Fox, 2011). The number of adults with diabetes in the world is anticipated to rise from 285 million in 2010 to 439 million in the year 2030 (Shaw et al., 2010). Patients with diabetes experience significant morbidity and mortality from microvascular (retinopathy, neuropathy and nephropathy) and macrovascular complications (heart attack, stroke and peripheral vascular disease).

Rhinocerebral mucormycosis, risk factors and the type of oral manifestations in patients referred to a University Hospital in Tabriz, Iran 2007-2017

Inadequate data are available on the global epidemiology of mucormycosis, mainly derived from the evaluation of specific population groups. Rhinocerebral mucormycosis is an invading and fatal mycosis, particularly among diabetic patients. In the present study, patients hospitalised in Imam Reza Hospital in Tabriz, from 2007 to 2017, were evaluated. The hospital information system (HIS) was used to collect the records of the patients. A total of 42 patients with a diagnosis of mucormycosis were included in the study, 40 cases (95%) of which had a diagnosis of the rhinocerebral form. Of these 40 patients, 21 (52.5%) and 19 (47.5%) were male and female, respectively. Seven cases (17.5%) of rhinocerebral mucormycosis were due to dental procedures. The most predisposing factor in the patients was diabetes with 36 (90%) cases. In our study, the role of tooth extraction in patients with uncontrolled diabetes was identified as an important factor. It may show the important role of dentists in preventing of the disease in diabetic patients.