Maryam Rashidi

Maternal Vitamin D Status in Gestational Diabetes Mellitus

BACKGROUND Vitamin D deficiency has long been suspected as a risk factor for glucose intolerance. This study compared serum levels of 25-hydroxy vitamin D(3) in pregnant women with gestational diabetes mellitus (GDM), impaired glucose tolerance (IGT), and non-GDM control subjects. METHODS In this case-control study, 54 women with diagnosed GDM and 39 women with IGT (1 abnormal oral glucose tolerance test) were compared with 111 non-GDM control women in whom GDM were excluded by glucose challenge test. Controls were matched in gestational age, age, and body mass index with IGT and GDM groups. RESULTS Maternal serum 25-hydroxy vitamin D(3) concentration in GDM and IGT groups at 24-28 weeks of gestation were significantly lower than non-GDM controls (P = .001). A total of 83.3% of GDM compared with 71.2% of the control group had plasma 25-hydroxy vitamin D(3) concentrations consistent with a diagnosis of vitamin D deficiency (<20 ng/mL; P = .03). Women with GDM had a 2.66-fold increased risk of deficient status (25-hydroxy vitamin D(3) <15 ng/mL) compared with control group. CONCLUSIONS These results suggested that rates of vitamin D deficiency are higher among women with IGT/GDM, and the relationship between vitamin D status and glucose tolerance in pregnancy needs further study.

Prevalence of dry eye syndrome and diabetic retinopathy in type 2 diabetic patients

BackgroundThis study was performed to assess the prevalence of dry eye syndrome and diabetic retinopathy (DR) in type 2 diabetic patients and their contributing factors.Methods199 type 2 diabetic patients referred to Yazd Diabetes Research Center were consecutively selected. All Subjects were assessed by questionnaire about other diseases and drugs. Dry eye syndrome was assessed with Tear break up time tests and Schirmer. All the subjects underwent indirect ophthalmoscopy and retinal color photography. DR was graded according to early Treatment Diabetic Retinopathy (ETDRS) criteria.ResultsOf 199 subjects, 108 patients (54.3%) suffer from dry eye syndrome. Although dry eye syndrome was more common in older and female patients, this association was not significant. But there was significantly association between dry eye syndrome and duration of diabetes (P = 0.01). Dry eye syndrome was more frequent in diabetic patients with DR (P = 0.02). DR was found in 140 patients (70.35%), which included 34 patients (17.1%) with mild non proliferative DR (NPDR), 34 patients (17.1%) with moderate NPDR, 22 patients (11.1%) with severe NPDR and 25 patients (25.1%) with proliferative DR (PDR). There were significant relation between age, sex and duration of diabetes and DR.ConclusionIn this study the prevalence of dry eye syndrome was 54.3%. Diabetes and dry eyes appear to have a common association. Further studies need to be undertaken to establish an etiologic relationship. However, examination for dry eye should be an integral part of the assessment of diabetic eye disease.

Iron status in women with and without gestational diabetes mellitus

OBJECTIVE Gestational diabetes mellitus (GDM) affects approximately 7% of all pregnancies. Pregnancy, mostly because of the mitochondria-rich placenta, is a condition that favors oxidative stress. A transitional metal, especially iron, which is particularly abundant in the placenta, is important in the production of free radicals. Also, studies have shown that free radicals have a role in GDM. As there are little data about iron status in GDM, this study was performed to compare iron status in GDM and control group. RESEARCH DESIGN AND METHODS In this case-control study, 34 women with diagnosed GDM were compared with 34 non-GDM women in the control group at 24-28 weeks of pregnancy in terms of iron status, including ferritin, serum iron, total iron-binding capacity (TIBC), hemoglobin (Hb), mean corpuscular volume (MCV), and mean corpuscular hemoglobin (MCH). RESULTS In this study, concentration of serum ferritin, iron, transferrin saturation and hemoglobin, MCV, and MCH was significantly higher in the GDM group and TIBC was significantly lower in this group (P<.05). No significant association was observed with the other variables including familial history of diabetes and GDM. CONCLUSION Our findings indicate an association between increased iron status and GDM. The role of iron excess from iron supplementation in the pathogenesis of GDM needs to be examined.

Effect of Opium Addiction on Diabetes

Background: Type 2 diabetes is a common disorder that is recognized as a major health problem in Iran. Diabetes is a major cause of morbidity, mortality, and economic burden to the society. Some people believe that smoking opium can reduce serum glucose and lipids in diabetes mellitus. This study was designed to compare blood glucose and lipids in opium addicts with non-addicts among patients with type 2 diabetes. Methods: In this case, control study subjects were chosen from type 2 diabetic patients. Twenty-three males with type 2 diabetes and addicted to opium were selected as the case group, and 46 patients with no addiction to opioid drugs were chosen as control group. Blood Sugar (BS), glycated hemoglobin (HbA1C), lipids and microalbumin in urine were measured in two groups. Results: Our results showed that the mean FBS and 2-hour post prandial were significantly different between two groups. (P =. 04). No significant difference was observed in HbA1C, triglyceride, total cholesterol, LDL, and HDL between the two groups (P >. 05). Conclusions: Our finding showed that while opium might decrease blood glucose temporarily, it had no clear and long-lasting effects on blood glucose, as it had no significant effect on HbA1c.

Antigen-based vaccination and prevention of type 1 diabetes

Insulin-dependent or type 1 diabetes (T1D) is a paradigm for prevention of autoimmune disease: Pancreatic β-cell autoantigens are defined, at-risk individuals can be identified before the onset of symptoms, and autoimmune diabetes is preventable in rodent models. Intervention in asymptomatic individuals before or after the onset of subclinical islet autoimmunity places a premium on safety, a requirement met only by lifestyle–dietary approaches or autoantigen-based vaccination to induce protective immune tolerance. Insulin is the key driver of autoimmune β-cell destruction in the nonobese diabetic (NOD) mouse model of T1D and is an early autoimmune target in children at risk for T1D. In the NOD mouse, mucosal administration of insulin induces regulatory T cells that protect against diabetes. The promise of autoantigen-specific vaccination in humans has yet to be realized, but recent trials of oral and nasal insulin vaccination in at-risk humans provide grounds for cautious optimism.

Maternal serum adiponectin concentration in gestational diabetes

Aim. Adiponectin is an insulin sensitizing protein. Because gestational diabetes mellitus is associated with insulin resistance, we compared serum adiponectin levels in women with gestational diabetes mellitus and healthy pregnant women. Study design. Twenty-nine women with gestational diabetes and 26 women with impaired glucose tolerance were compared with 27 normal pregnant women in control group. Controls were matched for gestational age, age and body mass index (BMI) before pregnancy with two other groups. At 28 weeks of gestation serum concentration of adiponectin, insulin and insulin resistance (calculated by the homeostasis model assessment) were measured in three groups. Main findings. The serum adiponectin level in gestational diabetes (6379.31 ± 1934.90 ng/ml), was significantly lower than the impaired glucose tolerance test (7384.61 ± 1626.70 ng/ml) and control groups (7962.96 ± 2667.20 ng/ml),(p = 0.02). Serum level of insulin and HOMA index in gestational diabetes were higher than the normal group (p > 0.05). In patients with gestational diabetes, there was a significant correlation between serum adiponectin level and BMI before pregnancy (r = −0.531, p = 0.013). Also, the correlation between maternal serum adiponectin levels and neonatal birth weight was not significant (r = −0.07, p value = 0.73). Conclusion. Our data show that serum adiponectin level was significantly lower in gestational diabetes in comparison with healthy pregnant women.

Maternal serum leptin concentration in gestational diabetes.

OBJECTIVE The aim of this study was to evaluate fasting serum leptin concentration and its relation to insulin resistance in women with gestational diabetes mellitus (GDM) and gestational impaired glucose tolerance (IGT). MATERIALS AND METHODS This case-control study, at 28 weeks of gestation, measured serum concentration of fasting leptin, insulin, and homeostatic model assessment index in three groups, GDM, IGT, and normal control, and compared them with each other. RESULTS The serum leptin level was significantly higher in women with GDM than in the two other groups (p=0.03). In women with GDM and IGT, leptin was significantly positively related with insulin and homeostatic model assessment index (r=0.221, p=0.03) and (r=0.246, p=0.03), respectively. In all of the participants, there was a significant correlation between leptin and body mass index before pregnancy (r=0.416, p=0.001). CONCLUSION Our data showed that serum leptin level was higher in GDM and had a positive correlation with insulin resistance. Our findings suggest that high leptin levels might be a risk factor for GDM and IGT in pregnant women.

Incidence and Trend of a Metabolic Syndrome Phenotype Among Tehranian Adolescents Findings from the Tehran Lipid and Glucose Study, 1998–2001 to 2003–2006

OBJECTIVE To assess the incidence and trend of the metabolic syndrome phenotype in adolescents from the Tehran Lipid and Glucose Study during 3.6 years of follow-up. RESEARCH DESIGN AND METHODS A total of 932 adolescents, aged 10–19 years, who had complete data and returned for reassessment 3.6 years later were investigated. RESULTS Prevalence of metabolic syndrome at baseline and after 3.6 years was 7.4 and 6.7%, respectively, based on the Adult Treatment Panel (ATP) III definitions; 3.5 and 8.0%, respectively, based on the International Diabetes Federation (IDF) definitions; 4.1 and 9.4%, respectively, based on the American Heart Association (AHA) definitions; and 13.6 and 13.4%, respectively, based on the National Health and Nutrition Examination Survey (NHANES) definitions. Incidence rates were 5.2% (95% CI 3–6) based on ATP III, 6.8% (5–8) based on IDF, 8.3% (6–10) based on AHA, and 8.8% (6–10) based on NHANES definitions. CONCLUSIONS Incidence of metabolic syndrome is high in Tehranian adolescents.

Wolfram Syndrome presenting with optic atrophy and diabetes mellitus: two case reports.

Wolfram syndrome is the constellation of juvenile onset diabetes mellitus and optic atrophy, known as DIDMOAD (Diabetes Insipidus, Diabetes Mellitus, Optic Atrophy, and Deafness).Patients demonstrate diabetes mellitus followed by optic atrophy in the first decade, diabetes insipidus and sensorineural deafness in the second decade, dilated renal outflow tracts early in the third decade, and multiple neurological abnormalities early in the fourth decade.This study reports two siblings with late diagnosed wolfram syndrome with diabetes insipidus, diabetes mellitus, optic atrophy, deafness and severe urological abnormalities.In conclusion, cases having early onset insulin-dependent diabetes mellitus and optic atrophy together need to be evaluated with respect to Wolfram.

Incidence and trend of a metabolic syndrome phenotype among Tehranian adolescents; Finding from TLGS 1998-2001 to 2003-2006

OBJECTIVE To assess the incidence and trend of the metabolic syndrome phenotype in adolescents from the Tehran Lipid and Glucose Study during 3.6 years of follow-up. RESEARCH DESIGN AND METHODS A total of 932 adolescents, aged 10–19 years, who had complete data and returned for reassessment 3.6 years later were investigated. RESULTS Prevalence of metabolic syndrome at baseline and after 3.6 years was 7.4 and 6.7%, respectively, based on the Adult Treatment Panel (ATP) III definitions; 3.5 and 8.0%, respectively, based on the International Diabetes Federation (IDF) definitions; 4.1 and 9.4%, respectively, based on the American Heart Association (AHA) definitions; and 13.6 and 13.4%, respectively, based on the National Health and Nutrition Examination Survey (NHANES) definitions. Incidence rates were 5.2% (95% CI 3–6) based on ATP III, 6.8% (5–8) based on IDF, 8.3% (6–10) based on AHA, and 8.8% (6–10) based on NHANES definitions. CONCLUSIONS Incidence of metabolic syndrome is high in Tehranian adolescents.