IRANIAN JOURNAL OF ENDOCRINOLOGY AND METABOLISM (IJEM)
Year:2002 | Volume:4 | Issue:2 (SN 14)|Papers Count:11

Introduction: Physical diseases and human psychological structure are closely interlinked and their effects on each other have been the subject of discussion for scientists for many years. In psychiatric classification, diabetes mellitus is categorized in psychosomatic diseases and the effect of behavior patterns and mental stresses on development of the diseases are dicussed in the above-mentaned category. The aim of this research was to study the relationship between type A behavior pattern and type 1 and 2 diabetes.  Materials and methods: The sample consisted of 150 people, 50 were type 1 diabetics, 50 type 2 and 50 formed our control group. The Jenkins questionnaire was used to determine type A & B behaviors. Results: In statistical analysis type A behavior pattern was seen more in type 1 diabetics (74%) which in comparison with the control group and type 2 diabetetics (54%) was significant (p<0.05). Conclusion: These findings demonstrate the role of behavior patterns and psychologic factors on the clinical course of diabetes and stress the importance of psychologic intervention in the management of diabetics.

Introduction: Psychological and sexual problems are more prevalent among diabetic women, and diabetes, as a chronic disease threatens mental health itself. Considering the fact that both factors can affect family relationship, and that family relations are the cornerstones of an ideal community relationship, this study was conducted to assess and compare the family relationship of diabetic and non-diabetic women. Materials and methods: Data were collected from 198 and 81 non-diabetic and diabetic 25-50 year old married women, respectively, who were randomly selected and administered the Stevens Relationship Questionnaire (SRQ), previously validated for Iran by one of the researchers. This 72-item questionnaire measures Assertive Conflict Resolution (ACR), Intimate Communication (Int), Romantic Attitudes and Behaviors (Rom), Equality (Eq), Independence (Ind), and Liberated Role Beliefs (Lib). The total score of this questionnaire is between +144 and – 144. Results: Mean ages of the women with and without diabetes were 36.4±11.2 and 33.8±7.8 years, respectively. Mean overall SRQ scores in non-diabetic and diabetic individuals were –3.37±22 and –1.15±20, respectively, without any significant statistical difference. Romantic family relationship scores (Rom) in diabetic women and non-diabetic women were +2.92±7.2 and +5/13±9.1, respectively, (p<0.05), and Intimacy in family relationship scores (Int) were lower in diabetic women than in the non-diabetics (-1.92±5.1 vs. –0.93±4.4, p<0.05). On the other hand, Independence (Ind) in diabetic women was more than the non-diabetics (-4.58±4.8 vs. –6.74 ± 7.4, p<0.05). Conclusion: No significant difference was found in overall SRQ scores between diabetic and non-diabetic women, although none of the diabetic and non-diabetic women SRQ scores were suitable.

Introduction: Diabetes is an important public health problem resulting in substantial morbidity and mortality and naturally, significant medical costs. This study was performed to determine the direct and indirect medical costs attributable to type 2 diabetes and calculate total and per capita expenditures of type 2 diabetic patients in Isfahan- Iran in 1998. Materials and methods: Consistent with prior cost-of- illness studies, direct medical expenditures were estimated after calculating the cost imposed by diabetes-related chronic complications and general medical conditions in people with type 2 diabetes and multiplying the results by their corresponding disease- related etiologic fraction. Indirect costs were estimated after calculating the value of productivity lost due to work loss, restricted activity and bed days, disability and premature death. Results: Direct medical expenditures and indirect costs attrtibutable to type 2 diabetes in 22349 patients in Isfahan (1998) totalled about 8.998 and 167 billion rials respectively, resulting in total economic costs of about 176.4 billion rials or 7893868.3 rials per capita. Taking into account the 1.2 million type 2 diabetic patients living in Iran, the total expenditures attributable to type 2 diabetes were estimated to be 6472.6 billion rials in the Islamic Republic of Iran in 1998. Conclusions: The economic burden of type 2 diabetes mellitus in the Islamic Republic of Iran is enormous. It is necessary to pay more attention to medical interventions that can delay the onset and slow the progression of diabetes and its complications in order to improve the patient’s quality of life and mitigate the burden of associated expenses.

Introduction: Investigations have revealed that diabetics are more prone to develop infections than are the normal population. Oral candidiasis is one of the most common infections in diabetics and people with impaired immune systems. The purpose of this study was to identify the oral fungal flora and determine the prevalence of fungal infections. Materials and methods: 132 type 2 diabetics (109 females and 23 males, aged 25 – 65 years) and 130 (107 females and 23 males) healthy age and sex–matched subjects were studied. Blood and saliva samples were obtained during fasting state. Four samples from different sites of the mouth were collected for culture. Blood groups were also tested. HbA1c was employed to assess the glycemic control of subjects. Results: Candida Albicans was the most frequent species in the mouths of diabetics and controls. The prevalence of oral candida was significantly higher in diabetics than in controls (40.2% VS 16.2%, p<0.001). Blood glucose levels showed a positive and significant correlation with saliva glucose levels (p<0.001) and HbA1c (p<0.02). Saliva glucose demonstrated a positive and significant correlation with HbA1c (p<0.02). Poor glycemic control, denture use, and poor oral hygiene were the most important factors for developing oral candidosis in diabetics. “AB” blood group showed a positive correlation with oral lichen lesions. Conclusions: This study showed that a significant percentage of individuals are carriers of oral candida, without showing any symptoms of infection. In addition, oral candidal carriage and infections in diabetic patients is complex and includes species which have not been previously reported. Better glycemic control, oral hygiene and use of mouthwashes may reduce the chances of oral candidal carriage and infections in subjects.

Introduction: There are conflicting reports concerning the effects of magnetic fields (MF) on different aspects of vitality. We have studied the effects of a 0.05 Tesla MF on the growth and blood glucose levels of mice. Materials and methods: Twenty-two young BALB/C strain mice were divided into two groups. The experimental group was exposed to a constant homogenous MF of 0.05 Tesla inductance for ten hours a day for ten days. The MF was induced by two blades of permanent magnets. The control group were in similar conditions except for MF exposure. The weight of both groups were measured ten days before, during and ten days after the experiment. Following this, the experimental group was again exposed to the same MF for fifteen days. Then blood sampling from both groups was done by decapitation. Results: Weight gain of the exposed group was 0.3±0.03 (Mean±SEM) grams per day which was insignificantly higher than the control group (0.25±0.03 gram per day). There was no significant difference in the blood glucose levels of the two groups (114.3±8.81 mg/dL vs 113.81±4.64 mg/dL). Conclusions: Previous reports indicate that constant MFs of 0.001 and 0.01 Tesla induced by electromagnet increase blood glucose levels. There are similar reports about the effects of 0.9 Tesla MF on weight loss. These experiments lack control for mechanical or sonic frequency vibrations or temperature produced by electromagnets. We conclude that constant MF with theintensity's we used has no dangerous effect on growth and blood glucose levels

Introduction: Hypothyroidism causes many hematologic abnormalities including anemia. Anemia can be due to iron deficiency, impaired hemoglobin synthesis, poor diet, structural abnormalities of the red blood cells (RBC) and reduced half-life of RBC. In this study RBC fragility in hypothyroid rats were compared to that of control animals Materials and method: Hypothyroidism was induced by methimazole (500 mg/L of drinking water for 20 days) in the rats (body weight, 246±5gr). Blood samples were collected through carotid vein on EDTA for osmotic fragility test. RBC fragility of RBC was tested by a routine method in which the cells were placed in different concentrations of NaCl (0.09 gr/L) and hemolysis was determined by colorimetric method. The hemolysis precentage of the samples in each solution was calculated on the basis of the 100% hemolysis in distilled water. Results: RBCs from hypothyroid animals had significantly (p<0.05) higher hemolysis in NaCl concentrations of 2.5, 3, 4, 4.5, 5, 5.5, 6 and 7 gr/L as compared to control animals. Conclusion: Results of this study prove that anemia in hypothyroid rats could also be due to increased fragility of RBC.

Introduction: Height and weight growth are influenced by both genetic and environmental factors. In order to elucidate the role of socioeconomic factors on height and weight, the height and weight growth curves of 15-17 year-old male, high school students from two socioeconomic backgrounds were compared. Materials and methods: By referring to local education authorities, privileged and underprivileged high schools were categorized. Then, by cluster sampling, 1800 students from each economic background (total of 3600) were selected. Height and weight of each student was measured by standard methods and recorded according to the age of the subject, and related growth curves were obtained for each economic background. Results: In all age groups and in 5th, 50th and 95th percentiles, the economically privileged teenagers were taller than less privileged ones and the difference occasionally reached up to 5 centimeters. By comparing the 50th percentile centiles of our height curves with those from the United States, it was seen that American teenagers are taller than their Shirazi counterparts. Our weight curves showed that in all age groups and in all centiles, economically privileged high school students were heavier than the less privileged and the difference occasionally reached up to 5kg. Conclusion: Our data shows the effects of socioeconomic factors on weight and height growth and emphasizes the need for a more equalized distribution of opportunities for all socioeconomic groups.

Tumoral calcinosis is an inherited disorder characterized by periarticular calcified masses and hyperphosphatemia. It is associated with increased serum 1,25 dihydroxy-vitamin D and serum phosphate. Surgical extraction of the tumor masses may lead to new lesions and pharmacologic therapies have produced only limited success. We present an 18 year old man with multiple periarticular soft tissue masses and hyperphosphatemia. After biochemical and pathological assessments, primary tumoral calcinosis was diagnosed and the patient was treated with acetazolamide. After four weeks of therapy with acetazolamide soft tissue, masses regressed significantly, and the serum phosphate level returned to the normal range.

Following the use of GnRH analogues for treatment of precocious puberty and their effect on preserving final height, physicians are more encouraged to treat the idiopathic type of this entity. In 1999, a study reported about 20 girls with slowly progressive and unsustained precocious puberty with mean age of 4.1±0.2 years who achieved normal final height without any treatment. Appearance of first signs of puberty in 95% of the population or 2 standard deviations below the mean age of puberty in normal girls is the definition of age limit of normal puberty. In 1997 a study conducted in Pediatric Research Network, based on pubertal staging of over 17000 girls between 3-12 years of age indicated that breast development occurred at 9.96±1.82 years of age in white girls and at 8.87±1.93 years in African American girls, about 1 year earlier in white girls and 2 years earlier in African American girls than what previous studies had shown. On the other hand, treatment of precocious puberty is based on suppression of hypothalamo-pituitary-gonadal axis with GnRH analogue, so this axis needs to be activated first. The interpretation of LH and FSH levels depends on laboratory methods of assessment, the latest being ICMA (immunochemiluminometric assay) which is more sensitive than older methods like radioimmunoassay. With the new ICMA method, basal LH>0.3 IU/L and with post GnRH test, peak LH>5 IU/L are diagnostic. The younger the age at onset of puberty, the longer the duration of puberty that results in a more prolonged pubertal growth spurt. The mean increase in stature after menarche is about 10 cm for girls with early menarche and about 5 cm for those with delayed menarche. Hence in this article, clinical and laboratory criteria and the age limit for defining precocious puberty are reviewed to distinguish those requiring treatment.