Background: Diabetic patients have higher mortality rate after acute MI. Prevalence of DM in Yazd is 2.5 fold higher than general population of U. S and is common risk factor in MI patients. The main aims of this study were evaluation of control rate of DM and prognosis of diabetic patients after acute MI. Materials and Methods: 102 diabetic patients with acute MI (48 men and 54 women) between may 2001 to February 2002 with mean age 61.52±11.45 year hospitalized in ccus of yazd included in this analytical cross sectional study. Level of HbAIC was determined. Results: Analysis of data showed 91.3% diabetics have HbAIC>7% (93 vs 9). Total in-hospital mortality was 10.7%% (8 women vs 3 men). All death was occurred in uncontrolled diabetics (11.8% vs 0%) PV = 0.042. Conclusion: This study showes almost all diabetic patients presented with acute MI had uncontrolled DM with higher mortality in comparison with controlled diabetic patients. We recommend measurment of HbAIC in all diabetic patients after admision for acute MI as determinant of prognosis.

Introduction: In this study, the effect of stress management training on glycemic control has been investigated in type 1 diabetic patients.Methods: The participants were 60 type 1 diabetic patients (Aged 16-30). 30 Subjects attended in 3-month stress management training classes during which the prescribed insulin remained constant, but the other 30 one's did not. HbA1c from all patients were measured before and after the intervention.Besides, in order to assess the ways of coping, a questionnaire was completed by every patient and the scores were compared between two groups.Results: Trained patients showed significantly improved ways of coping. HbA1c changed from 11.7±2.9 and 10.9±2.1 before training to 8.5±1.7 and 10.3±2.1 after intervention in trained and control groups respectively and the changes were significant in case group (p=0.000). In addition, the difference between HbA1c of two groups was statistically significant at the end of the study (p=0.001).Discussion: Results show a clinically significant beneficial effect of stress management training on glycemic control among type 1 diabetic patients. It is recommended to consider this type of trainings an addition to the treatment program in type 1 diabetic patients.

Background: Helicobacter pylori (H. Pylori) are a most common infection throughout the world. A high prevalence of H. Pylori infection has recently been reported in diabetic patients; but data on relation between H. Pylori and glycemic control (HbA1C level) are not enough and are controversial. This study aimed to investigate this relation in diabetic patients referred to endocrine clinics of Shaheed Labafinegad and Shohada Tajrish hospitals between years of 1386-87.Materials and Methods: This is an experimental (before-after) study, it was done on 61 type II DM patients with or without dyspepsia symptoms that HP Infection identified by serologic test (IgG Anti H. Pylori) and then all patients were treated with Quadriple therapy (Bismuth, Metronidazole, Tetracycline, Omeperazole). HbA1C was measured before eradication H. Pylori and 2month after eradication H. Pylori. Eradication of H.Pylori infection was documented by UBT (Urea Breath test). Mean of HbA1C level before and after H. Pylori eradication was compared by SPSS and paired T Test.Results: In this study mean age was 52.4±10.04 years. The number of male was 39 (63.9%) and female was 22 (36.1%) duration of diabetes was 8.7±5.5 years. H. Pylori infection was eradicated in all of the patients (100%). Mean of HbA1C level before eradication was 8.6±1.2 and after eradication was 7.9±1.2; and their difference was 0.7 that is statistically were significant (p<0.05).Conclusion: According to this study, possible influence of H. Pylori eradication on glycemic control in diabetic patients (reduction in HbA1C); it is recommended to more studies about screening diabetic patients to identify and eradication H. Pylori infection to assess better glycemic control.

Aims: Diabetes is the source of stress for people suffering from the disease. Diabetesrelated stress has numerous negative psychological effects. This study was conducted aiming at determining the role of type D personality in the effect of stress on HbAlc and cortisol secretion.Methods: the present correlational study which was a retrospective research, was conducted in 2011 and 2012 on all women with type II diabetes, who were member of Yazd Diabetes Research Centre, 80 patients were selected by multistage cluster sampling. They completed some questionnaires including the depression scale, anxiety scale (DASS), stress as well as type D personality questionnaires. Then, their fasting blood was tested and the effect of stress and personality type on HbAlc and cortisol level was evaluated. Data was analyzed using SPSS 18 software and statistical tests including Pearson correlation coefficient and stepwise regression analysis.Results: There were significant relationship between stress and personality type; cortisol and HbAlc; and cortisol and HbAlc. Based on the results of the regression analysis, stress factor by itself (p=0.001), and together with personality type (p=0.001) had effect on HbAlc. Moreover, stress factor by itself (p=0.002), and together with personality type (p=0.001) had effect on cortisol level. Stress and personality type scales explained 0.312 of the HbAlc variance and 0.28 of the cortisol variance.Conclusion: Stress and personality type are correlated with the level of cortisol serum and HbAlc. Moreover, personality type acts in line with the increase in the impact of stress on patients with diabetes.

Introduction: Given the high prevalence of Type 2 diabetes and it’s psychological, social and economic negative effects, nowadays empowerment approaches to type 2 diabetic care have been extended. This study intented to investigate the status of empowerment index and its related factors in type 2 diabetis Patients of Sirjan city.Methods: This cross sectional study was performed on 160 type 2 diabetic patients referred to health centers in Sirjan. Patient's empowerment was measured by DES (Diabetes Empowerment Scale) self-report scale. Collected data were analyzed using SPSS software (version 18) and descriptive and analytical statistics.Results: Respondents aged in range of 35 to 81. Mean duration of diabetes was 3.2±2.4 years. The mean score of Diabetes Empowerment Scale among respondents was 101.5±12.5. Setting and achieving diabetes goal was considered as the most important domain in measuring diabetes self-management.35% of participants had optimal control according to World Health Organization criteria. Diabetes empowerment index showed a significant and positive relation with educational level and duration of diabetes (p<0.05).Furthermore, ordinal regression test revealed that having diploma and higher education (p<0.05), and Optimal and borderline HbAlc (p<0.05) were effective factors in empowering diabetic patients.Conclusion: The study showed that efforts to improve the ability of diabetics can result in better control of the disease. Empowering can be achieved only if the patients receive the necessary information and are actively informed and educated about their health condition.

Background: Type 2 diabetic patients have 2 or 4 fold risk of coronary heart diseases. According to researches, all types of dyslipidemia independently have atherogenic properties; so it seems small dense LDL has the most effects in this case. To investigate whether glycemic control, which is assessed by concurrent HbAlc, has any favorable impact on LDL size we determined the relation between LDL size and HbAlc in diabetics.Methods: In this study, LDL size was determined by non-denaturing polyacrylamide gel electrophoresis in 81 type 2 diabetics 50 to 70 aged. BMI was calculated in all participants as weight (Kg) divided by height (m2). TG and HDL-C were measured using enzymatic kits. HbAlc was determined using immunoturbidometric method.Results: Based on results obtained LDL size in diabetics was significantly correlated with TG (r=- 0.281, P<0.05), sex (r=-0.276, P<0.05), HbAlc (r=-0.232, P<0.05) and HDL-C (r=0.215, P<0.01). In linear regression analysis TG (standardized β =-0.192 p<0.054), HDL-C (standardized β =0.214 p<0.05) and female sex (standardized β =0.196 p<0.056) were the independent determinants of LDL size (although they showed borderline significance). HbAlc showed high co linearity with HDL-C and was excluded from the model.Conclusion: HbAlc is inversely correlated with LDL size in diabetics. However it is not an independent predictor of LDL size. It is likely that decrease in HDL-C levels due to poor glycemic control results in decrease in LDL size.

Background: Oral glucose tolerance testing (OGTT) is the gold standard for the diagnosis of diabetes mellitus and impaired glucose tolerance (IGT), but is time consuming and difficult to perform. We investigated the value of glycosylated hemoglobin (HbAlc) in screening for diabetes mellitus and IGT. Methods: In a cross-sectional study, we measured the HBAlc levels of 497 people referred for OGTT. We calculated the sensitivity and specificity of HbAlc at 1, 2, 3 and 4 SD above the normal mean. We plotted receiver operating characteristic (ROC) curves after assigning our subjects to the diabetic, IGT, "diabetic+IGT", or normal group, based on WHO criteria for OGTT. Results: HbAlc levels (mean±SD) in the four groups were 9.2±l.5, 8.4±1.3, and 7.9±0.8 and 6.8±0.7 percent in the diabetic, diabetic+ IGT, IGT and normal groups, respectively. All differences were statistically significant (p<0.000l). ROC curve analysis showed that HbA1C levels above 7.5% (mean+1 SD) gave the best combination of sensitivity and specificity for the detection of diabetes (97.53% and 73.8%), IGT (66.37 and 69.44%), and diabetes+IGT (80.22% and 86.66%). Conclusions: An HbAlc level of >7.5% is an optimal cutoff point for diabetes screening programs.

Background: Diabetes is a common endocrine disease with complications such as retinopathy, nephropathy and neuropathy which has it’s monitoring through biomarkers desirable. At present, glycosylated hemoglobin (HbalC) is used for monitoring the long term control of glucose levels in diabetic patients. However, absence of a standardized range, has led to investigations that recently have suggested insulin- like growth factor-I (IGF-I) as a good biomarker for monitoring blood glucose levels in diabetics. The aim of this study was to examine the correlation between IGF-I and HbAlc in Type 1 diabetes. Methods: We designed a cross-sectional case-control study. The study composed of 26 newly diagnosed patients with Type 1 diabetes (15 male and 11 female: mean age, 23.7±9.1 years) and 26 healthy controls (9 male and 17 female: mean age, 24.1±4.4 years). Levels of fasting plasma glucose (FPG), HbAlC , IGF-I and IGF-binding protein-3 (IGFBP-3) were measured in both groups. FPG was measured by enzymatic glucose oxidase method and the colorimetric method was used to measure HbAlC. Determination of total serum levels of IGF-I and IGFBP-3 were done using immunoassay methods. P-value<0.05 was considered as statistically significant. Results: The mean value of IGF-I concentrations in type 1 diabetics was significantly lower than controls (p<0.05). A reverse correlation was observed between IGF-I and HbA1c. Conclusion: The study indicates that in poorly controlled diabetics, levels of FPG and HbAlC rise concurrent with a drop in levels of IGF-I decreases. Our study also showed a significant correlation between IGF-I and HbAlC. Therefore, IGF-I could be indirectly used as a biomarker for controlling glucose levels in diabetics.