Prevalence of Vitamin D Deficiency among Adult Population of Isfahan City, Iran

Determination of vitamin D status in different age-groups in a community and in different climates of a country is necessary and has important implications for general health. The study was conducted to determine the prevalence of vitamin D deficiency among the adult population of Isfahan, a centrally-located city in Iran. In this cross-sectional study, 1,111 healthy people—243 men and 868 women—aged 41.4 (mean 14 and range 20-80) years, who attended a single-consultation outpatient clinic, were selected. Serum 25-hydroxy vitamin D (25-OHD), parathyroid hormone (PTH), calcium and phosphorus concentrations were measured. Mild, moderate and severe vitamin D deficiencies were defined as 25-OHD values of 20-30 ng/mL, 10-20 ng/mL, and <10 ng/mL respectively. The median (range) concentrations of 25-OHD were 21 (4.0-105.0) ng/mL in males and 18 (1.5-117) ng/mL in females (p=0.05). The prevalence of mild, moderate and severe vitamin D deficiencies among the adult population was 19.6%, 23.9%, and 26.9% respectively. Vitamin D deficiency was more prevalent among women (p=0.001) and younger age-group (p=0.001). Medians of 25-OHD in spring-summer and autumn-winter were 21 ng/mL and 18 ng/mL respectively (p=0.005). The prevalence of severe vitamin D deficiency was higher in autumn-winter than in spring-summer (odds ratio=1.6, 95% confidence interval 1.2-2.2, p=0.001). The prevalence of vitamin D deficiency was high in a sunny city—Isfahan— especially among women and younger population. The high prevalence of vitamin D deficiency in this city emphasizes the necessity of vitamin D supplementation as more exposure to sun is limited due to the type of clothing required by current law

Cardiovascular risk factors in relatives of type 2 diabetics with normal glucose tolerance test and elevated one-hour plasma glucose

Introduction: To investigate the effect of elevated one hour post-load plasma glucose on cardiovascular risk factors, in normal glucose tolerance (NGT) people, who are first degree relatives of type 2 diabetics. Material and methods: A cross-sectional study on 1475 NGT subjects (Arian ethnicity), who had one hour post-load plasma glucose was carried out. We compared the mean of age, sex, body mass index, waist circumference, blood pressure, lipid profile, and area under the curve of glucose (AUC-G) of 1190 out of 1475 NGT subjects with one hour plasma glucose (1hpG) &#8805; 155 mg/dL, and 285 NGT subjects with 1hpG < 155 mg/dL. Results: The mean age, body mass index, waist circumference, blood pressure, lipid profile (but not low HDL-cholesterol), and area under the curve of glucose (AUC-G) was significantly higher in NGT subjects with 1hpG &#8805; 155 mg/dL (P < 0.05). Normal glucose tolerance people (first degree relatives of type 2 diabetic patients) with 1hpG &#8805; 155 mg/dL were older and heavier than those with 1hpG < 155 mg/dL. Cardiovascular risk factors (but not low HDL and hypertension) were more prevalent in those with elevated one hour post-load group (P < 0.05). Conclusions: NGT subjects with elevated one hour post-load plasma glucose (1hpG &#8805; 155 mg/dL) had higher prevalence of most cardiovascular risk factors in comparison with those with 1hpG < 155 mg/dL. (Pol J Endocrinol 2010; 61 (4): 359-363)Wstęp: Celem badania była ocena wpływu podwyższonej glikemii w pierwszej godzinie po obciążeniu glukozą na czynniki ryzyka sercowo- naczyniowego u osób z prawidłową tolerancją glukozy (NGT, normal glucose tolerance) będących krewnymi pierwszego stopnia chorych na cukrzycę typu 2. Materiał i metody: Badanie wieloośrodkowe objęło 1475 osób z prawidłową tolerancją glikemii (etniczni Arianie), u których oznaczono stężenie glukozy w osoczu w godzinę po doustnym obciążeniu glukozą. Wszystkich chorych podzielono na dwie grupy w zależności od wartości glikemii: 1190, u których glikemia 1 godzinę po obciążeniu glukozą wynosiła &#8805; 155 mg/dl i 285 osób < 155 mg/dl. W obu grupach porównano średnie wartości następujących parametrów: wieku, płci, wskaźnika masy ciała, obwodu talii, ciśnienia tętniczego, profilu lipidowego i pola pod krzywą stężenia glukozy. Wyniki: U osób z prawidłową tolerancją glikemii (będących krewnymi pierwszego stopnia chorych na cukrzycę typu 2), u których glikemia na czczo w godzinę po doustnym obciążeniu glukozą wynosiła &#8805; 155 mg/dl (p < 0,05) stwierdzono istotnie wyższe wartości następujących parametrów: średni wiek, wskaźnik masy ciała, obwód talii, ciśnienie tętnicze, stężenia lipidów (z wyjątkiem cholesterolu frakcji HDL) i pola pod krzywą stężenia glukozy. Osoby, u których glikemia w godzinę po obciążeniu glukozą wynosiła &#8805; 155 mg/dl były starsze i cięższe niż osoby z niższym poposiłkowym stężeniem glukozy (< 155 mg/dl). Czynniki ryzyka sercowo-naczyniowego (z wyjątkiem niskiego stężenia cholesterolu frakcji HDL i nadciśnienia tętniczego) występowały częściej u osób z wyższymi wartościami glikemii w godzinę po obciążeniu glukozą (p < 0,05). Wnioski: U osób z prawidłową tolerancją glukozy i wyższymi wartościami glikemii w godzinę po obciążeniu glukozą (&#8805; 155 mg/dl) stwierdzono częstsze występowanie czynników ryzyka chorób sercowo-naczyniowego niż u osób, u których glikemia w godzinę po obciążeniu glukozą wynosiła < 155 mg/dl. (Endokrynol Pol 2010; 61 (4): 359-363

The association between serum selenium and gestational diabetes mellitus: a systematic review and meta-analysis

Background: Results of the studies about association between serum selenium concentration and gestational hyperglycemia are inconsistent. Some studies have demonstrated that women with gestational diabetesmellitus (GDM) have lower Se concentrations while contrary results are reported in other studies. Aim: The aim of this study is to compare the serum Se concentration in women with GDM and normoglycemic pregnant women via a systematic review and meta-analysis. Methods: A computerized literature search on four databases (PubMed, Cochrane register of control trials, Scopus and Google scholar) was performed from inception through August 2013. Necessary data were extracted and random effects model was used to conduct the meta-analysis. Results: Six observational studies (containing 147 women with GDM and 360 normoglycemic pregnant women) were found, which had compared serum Se concentration in women suffering from GDM with normal pregnant ones. Our meta-analysis revealed that serum Se concentration was lower in women with GDM compared to normoglycemic pregnant women (Hedges = −1.34; 95% CI: −2.33 to −0.36; P < 0.01). Stratified meta-analysis demonstrated that concentration of Se in the sera of women with GDM was lower than normal pregnant women both in second and third trimesters, but the result was not significant in second trimester (second trimester: Hedges = −0.68; 95% CI: −1.60−0.25; P = 0.15, third trimester: Hedges = −2.81; 95% CI: −5.21 to −0.42; P < 0.05). It was also demonstrated that serum Se status was lower in pregnant women with impaired glucose tolerance (IGT) compared to normoglycemic pregnant women (Hedges = −0.85; 95% CI: −1.18 to −0.52). Conclusion: The available evidences suggest that serum Se concentration is significantly lower in pregnant women with gestational hyperglycemia compared to normal pregnant women

Strategies to overcome type 1 diabetes–related social stigma in the Iranian society

Background: This study explored the strategies to overcome diabetes-related social stigma in Iran. Materials and Methods: This paper is part of an action research study which was designed in Iran in 2012 to plan and implement a program for overcoming diabetes-related stigma. Participants were people with type 1 diabetes, their family members, people without diabetes, and care providers in a diabetes center. Data collection was done through unstructured in-depth interviews, focus groups, e-mail, Short Message Service (SMS), and telephone interview. Data were analyzed using inductive content analysis approach. Results: Participants believed that it is impossible to overcome the stigma without community-based strategies. Community-based strategies include education, advocacy, contact, and protest. Conclusions: The anti-stigma strategies obtained in the study are based on the cultural context in Iran. They are extracted from statements of a wide range of people (with and without diabetes). However, during planning for stigma reduction, it is necessary to note that the effectiveness of social strategies varies in different studies and in different stigmatizing conditions and many factors are involved. These strategies should be implemented simultaneously at different levels to produce structural and social changes. It should be accepted that research on reducing health-related stigma has shown that it is very diffi cult to change beliefs and behavior. Evidence suggests that individuals and their families should be involved in all aspects of the program, and plans should be made according to the local conditions

Effect of Simulation-Based Debriefing on Nursing Students’ Competence in Medication Administration: An Experimental Study

Background: Medication error represents one of the parameters of patient safety. Objectives: The aim of present study was to investigate the effect of the effect of simulation-based debriefing on adherence to correct principles and medication administration competence in nursing students. Methods: Internship nursing students entered this experimental study using the census method. Afterward, the participants were assigned to intervention (n=18) and control (n=17) groups. Two methods were employed for data collection, namely observation and self-report questionnaires. The collected data were analyzed using STATA software (version 12) and non-parametric statistical tests. Results: A significant statistical difference was found between the mean scores of adherence to correct principles of medication administration and medication administration competence before, 2, and 5 weeks after the simulation in the intervention group (P=0.0001). Conclusion: The results revealed that the simulation-based debriefing improved the nursing students’ competence in medication administration. Therefore, this method in various groups of students and a clinical and practical environment is highly recommended for other students in clinical settings. Keywords: Students, Nursing, Medication Errors, Simulation Trainin

Prevalence of Vitamin D Deficiency among Adult Population of Isfahan City, Iran

Determination of vitamin D status in different age-groups in a community and in different climates of a country is necessary and has important implications for general health. The study was conducted to determine the prevalence of vitamin D deficiency among the adult population of Isfahan, a centrallylocated city in Iran. In this cross-sectional study, 1,111 healthy people\u2014243 men and 868 women\u2014aged 41.4 (mean 14 and range 20-80) years, who attended a single-consultation outpatient clinic, were selected. Serum 25-hydroxy vitamin D (25-OHD), parathyroid hormone (PTH), calcium and phosphorus concentrations were measured. Mild, moderate and severe vitamin D deficiencies were defined as 25-OHD values of 20-30 ng/mL, 10-20 ng/mL, and &lt;10 ng/mL respectively. The median (range) concentrations of 25-OHD were 21 (4.0-105.0) ng/mL in males and 18 (1.5-117) ng/mL in females (p=0.05). The prevalence of mild, moderate and severe vitamin D deficiencies among the adult population was 19.6%, 23.9%, and 26.9% respectively. Vitamin D deficiency was more prevalent among women (p=0.001) and younger age-group (p=0.001). Medians of 25-OHD in spring-summer and autumn-winter were 21 ng/mL and 18 ng/mL respectively (p=0.005). The prevalence of severe vitamin D deficiency was higher in autumn-winter than in spring-summer (odds ratio=1.6, 95% confidence interval 1.2-2.2, p=0.001). The prevalence of vitamin D deficiency was high in a sunny city\u2014Isfahan\u2014 especially among women and younger population. The high prevalence of vitamin D deficiency in this city emphasizes the necessity of vitamin D supplementation as more exposure to sun is limited due to the type of clothing required by current law

Effects of vitamin D-fortified low fat yogurt on glycemic status, anthropometric indexes, inflammation, and bone turnover in diabetic postmenopausal women: a rando...

Background & aims: Low levels of serum 25-hydroxy vitamin D (25(OH)D) are common in type 2 diabetic patients and cause several complications particularly, in postmenopausal women due to their senile and physiological conditions. This study aimed to assess the effects of vitamin D-fortified low fat yogurt on glycemic status, anthropometric indexes, inflammation, and bone turnover in diabetic postmenopausal women. Methods: In a randomized, placebo-controlled, double-blind parallel-group clinical trial, 59 postmenopausal women with type 2 diabetes received fortified yogurt (FY; 2000 IU vitamin D in 100 g/day) or plain yogurt (PY) for 12 weeks. Glycemic markers, anthropometric indexes, inflammatory, and bone turnover markers were assessed at baseline and after 12 weeks. Results: After intervention, in FY group (vs PY group), were observed: significant increase in serum 25(OH)D and decrease of PTH (stable values in PY); significant improvement in serum fasting insulin, HOMA-IR, HOMA-B, QUICKI, and no changes in serum fasting glucose and HbA1c (significant worsening of all indexes in PY); significant improvement in WC, WHR, FM, and no change in weight and BMI (stable values in PY); significant increase of omentin (stable in PY) and decrease of sNTX (significant increase in PY). Final values of glycemic markers (except HbA1c), omentin, and bone turnover markers significantly improved in FY group compared to PY group. Regarding final values of serum 25(OH)D in FY group, subjects were classified in insufficient and sufficient categories. Glycemic status improved more significantly in the insufficient rather than sufficient category; whereas the other parameters had more amelioration in the sufficient category. Conclusions: Daily consumption of 2000 IU vitamin D-fortified yogurt for 12 weeks improved glycemic markers (except HbA1c), anthropometric indexes, inflammation, and bone turnover markers in postmenopausal women with type 2 diabetes

The effect of curcumin-piperine on cardiometabolic, inflammatory and oxidative stress factors and macular vascular density in optical coherence tomography angiography (OCTA) in patients with non-proliferative diabetic retinopathy: Study protocol for a randomized, double-blind controlled trial

Objective: Curcumin is a safe phytochemical with antioxidant, anti-inflammatory, antidiabetic, and lipid-lowering effects. This study aims to investigate the efficacy of curcumin-piperine in non-proliferative diabetic retinopathy.Materials and Methods: In this double-blind randomized trial, 60 diabetic retinopathy patients after meeting the inclusion criteria will be randomly assigned to two groups of curcumin-piperine supplementation (1000 mg per day for 12 weeks) or receiving placebo. The density of small blood vessels in the retina by optical coherence tomography angiography (OCTA), fasting blood glucose, triglyceride, renal indices (blood urea nitrogen and creatinine), high-sensitivity C-reactive protein, total antioxidant capacity, total oxidant status, body mass index, waist circumference, and weight will be measured.Conclusion: If the beneficial effects of curcumin on diabetic retinopathy are observed, this safe, this natural and inexpensive herbal supplement can be considered a therapeutic solution in these patients