Iranian journal of diabetes and metabolism

Effects of Exercise Training on Cardiometabolic Factors in Obese Children and Adolescents with Metabolic Syndrome: A Systematic Review and Meta-Analysis

2026-02-01T08:01:33+00:00

Background: Metabolic syndrome in obese children and adolescents raises the risk of cardiovascular disease and type2 diabetes. Research suggests that exercise training may improve cardiometabolic health in this population. This meta-analysis aims to evaluate the impact of exercise on these risk factors in children and adolescents with metabolicsyndrome., and behavioral outcomes in children and promoting awareness, self-care skills, and quality of life in families.

Methods: A systematic search of English and Persian articles was conducted from PubMed, Web of Science, and Scopusdatabases without time limits until May 2024. In data analysis, a random-effects model was used to calculate the weightedmean difference (WMD), standardized mean difference (SMD) and 95% confidence interval (CI). Also, heterogeneityof studies was assessed with the I² test.

Results: The results of 6 studies involving 1,761 participants demonstrated that exercise training led to significantreductions in body weight [WMD = −6.32 kg, P=0.001], waist circumference [WMD = −9.11 cm, P=0.001], LDL [WMD= −0.52 mmol/L, P=0.001], TC [WMD = −0.65 mmol/L, P=0.001], serum TG [WMD = -0.56 mmol/L, P=0.001)],fasting glucose [WMD = −0.19 mmol/L, P=0.03], fasting insulin [SMD = −1.01, P=0.001], and HOMA-IR [WMD =−1.60, P=0.001] compared to the control group in obese children and adolescents with metabolic syndrome.

Conclusion: Exercise interventions significantly reduce body weight, waist circumference, and blood pressure, whileimproving lipid profiles, including serum LDL, TC, and TG levels, in obese children and adolescents with metabolicsyndrome. However, these interventions exhibited no significant impact on serum HDL concentrations. Consequently,to reduce cardiovascular risk factors and improve metabolic conditions, it is essential to implement long-term exercise interventions

The Role of Telenursing in the Self-Care Education of Diabetes Patients: A Narrative Revie

2026-02-01T08:01:32+00:00

Background: Diabetes is a chronic condition that can significantly impairs quality of life and requires long-term care due to its complications. Effective self-care education plays a key role in blood glucose control and in the prevention of diabetes-related complications. Telenursing is considered a promising approach to enhance self-care education in patients with type 2 diabetes.

Methods: This study was a systematic review conducted using a three-stage search strategy. Using Persian and English keywords including "telenursing," "self-care," and "diabetes," as well as their MeSH equivalents, relevant literature was searched in Persian databases (Magiran, SID) and international databases (PubMed, Scopus, Google Scholar) within the time frame of 2000 to 2023. After applying inclusion criteria, 17 out of 1,092 retrieved articles were selected for final review and analysis.

Results: A total of 1,092 articles were initially retrieved. After removing duplicates and applying the inclusion criteria, 17 relevant articles were included in the review. These studies evaluated the use of telenursing—either via telephone or in combination with other technologies—for effectively improving self-care behaviors in diabetic patients.

Conclusion: The findings indicated that telephone calls can serve as a potential method of remote nursing care for educating patients on diabetes self-management. Nurses can utilize telenursing as an effective and efficient educational tool to enhance blood glucose control in diabetic patients. This approach not only improves the quality of healthcare services but also empowers patients to manage their disease more consciously and prevent its complications.

Association of Blood Glucose Variability with Microvascular and Macrovascular Complications of Diabetes: A Review Study

2026-02-01T08:01:31+00:00

Blood glucose variability, defined as variations in blood glucose levels over time, is increasingly recognized as asignificant factor in the pathology of diabetes complications. While chronic hyperglycemia has been linked tomicrovascular complications (retinopathy, nephropathy, and neuropathy) and macrovascular complications (coronaryartery disease, stroke, and peripheral artery disease), emerging evidence suggests that glucose variability is anindependent risk factor for these conditions. This review examined the relationship between blood glucose variabilityand the development of microvascular and macrovascular complications in diabetes, highlighting the underlyingmechanisms, clinical implications, and therapeutic approaches.

The Effectiveness of Compassion-Based Mindfulness Training on Social Isolation, Sense of Coherence, and Body Esteem in Overweight Girls

2026-02-01T08:01:29+00:00

Background: The present study aimed to investigate the effectiveness of Compassion-Focused Mindfulness Training on social isolation, sense of coherence, and body appreciation in overweight girls.

Methods: This study employed a quasi-experimental design with a pre-test/post-test control group. The statistical population consisted of overweight girls aged 14 to 18 in the city of Sari during the 2024-2025 academic year. A sample of 32 participants was selected via purposive sampling and then randomly assigned to either an experimental or a control group. The experimental group received Compassion-Focused Mindfulness Training, delivered in eight structured sessions, while the control group received no intervention. The Compassion-Focused Mindfulness protocol was developed and administered based on the therapeutic framework proposed by Sadeghi et al. (2021), the instruments used in this study included: the Body Appreciation Questionnaire by Mendelson et al. (2001), the Sense of Coherence Scale by Antonovsky (1987), the Social Isolation Questionnaire by Madrasi Yazdi et al. (2017), the collected data were analyzed using both descriptive and inferential statistics. Univariate and multivariate analysis of covariance (ANCOVA & MANCOVA) were performed using SPSS software, version 26.

Results: The results indicated that Compassion-Focused Mindfulness Training had a significant effect on self-worth, sense of coherence, and social isolation in overweight girls. Specifically, this training led to a reduction in social isolation and an improvement in self-worth and sense of coherence among the participants. (Wilks' Lambda = 0.151, F = 11.787, P< 0.001).

Conclusion: Compassion-Focused Mindfulness Training, by emphasizing the non-judgmental acceptance of experiences and fostering a meaning-centered approach, can play a vital role in enhancing psychological well-being, regulating emotions, and improving social interactions. Therefore, incorporating this effective intervention for vulnerable groups, particularly overweight girls, is crucial for designing supportive and therapeutic strategies and can significantly contribute to improving their quality of life

Protein-Protein Interaction Network: The Identification of Key Genes and Pathways Involved in Nonfunctioning Pituitary Adenoma Tumorigenesis

2026-02-01T08:01:28+00:00

Background: Nonfunctioning pituitary adenomas (NFPAs) are among the most prevalent subtypes of pituitaryadenomas, presenting no clinical hormone elevation. The lack of definitive biomarkers for prognosis and treatment,combined with a significant risk of recurrence, poses substantial challenges to management. This study aims to identifykey genes and biological pathways involved in NFPAs tumorigenesis using a systems biology approach.

Methods: The dataset with accession number GSE26966 was analyzed to identify differentially expressed genes (DEGs)in NFPAs. Interactions between DEGs at the protein level were constructed using protein-protein interaction (PPI) datacollected from the IntAct database. Cytoscape software, igraph, and MCL packages were used to construct the PPInetwork, analyze its topology, and cluster it.

Results: 1,135 differential genes were identified between NFPAs and normal pituitary samples based on |log2FC|>2 andFDR < 0.05. Of these, 323 were up-regulated and 812 were down-regulated. The constructed PPI network consisted of6,960 nodes and 15,691 edges. According to network clustering, cell cycle regulation, chromatin organization andassembly regulation, transcription regulation, and actin cytoskeleton regulation were the most significant pathways.Using topological analysis, CDKN1A, BHLHE40, FHL2, H1-2, H2BC21, and FGFR3 were identified as central hubnodes in the PPI network. These genes were also involved in the biological pathways mentioned above.

Conclusion: This study demonstrated that a systems biology approach, integrating gene transcriptome data with proteininteraction data, can effectively identify pathways and biomarkers in NFPAs tumorigenesis

Investigating the Relationship Between Perceived Spousal Sacrificial Behavior and Self-Efficacy with Behavior Management in Patients with Type 2 Diabetes

2026-02-01T08:01:28+00:00

Background: Type 2 diabetes is a common chronic metabolic disease whose effective management requires attention to psychological and interpersonal factors. This study aimed to examine the relationship between the Perceived Spousal Sacrificial Behavior and self-efficacy with behavior management in patients with type2 diabetes.

Methods: This descriptive-correlational and cross-sectional study was conducted among married patients with type 2 diabetes who were referred to endocrinology and metabolism centers and primary health care units in Sari, Iran. Based on inclusion and exclusion criteria, 97 participants were selected using purposive sampling. The research instruments included the Perceived Spousal Sacrifice Scale (Harper & Figuerres, 2008), the Diabetes Self-Efficacy Scale (Fappa et al 2016), and the Behavioral Management Scale (Toobert et al., 2000). Data were analyzed using SPSS version 24 through descriptive statistics (mean, standard deviation) and inferential statistics (Pearson correlation coefficient and multiple regression analysis).

Results: Perception of the Perceived Spousal Sacrificial Behavior and self-efficacy showed a significant positive correlation with behavioral management among diabetic patients (p < 0.01). Together, these variables explained 30% of the variance in behavioral management, with Perceived Spousal Sacrificial Behavior making a greater contribution to prediction.

Conclusion: The findings highlight the significant role of Perceived Spousal Sacrificial Behavior and self-efficacy in improving behavioral management among patients with type 2 diabetes. Enhancing spousal support and strengthening patients’ self-efficacy through educational and psychological interventions may promote better self-care behaviors and disease control.

Endocrine Neoplasm Tumor Biobank as a Platform for Advancing Cancer Research: A Framework for Design, Collection, Processing, and Storage

2026-02-01T08:01:26+00:00

Background: Biobanks are biological repositories that collect, process, store, and distribute human biological samples. Among them, tumor banks play a central role in biomedical research. The overall goal of a tumor bank is to collect cancerous and normal samples under standardized conditions for basic, clinical, or applied research.

Methods: Tumor samples from patients with endocrine neoplasms were collected from excess tissue samples not required for diagnostic purposes after surgery in the surgical department of Dr. Shariati Hospital, Tehran, Iran. In addition, relevant biological samples such as serum, plasma and DNA were collected in parallel. Prior to sampling, informed consent was obtained from the patients and a questionnaire was completed. After rapid freezing with isopentane, tissue samples were stored in a liquid nitrogen tank, while other biological materials, such as serum, were stored in a -80°C freezer.

Results: Tissue, plasma, serum, and DNA samples collected from patients with endocrine neoplasms were stored in separate barcoded storage boxes in the biobank and were made available to researchers.

Conclusion: The use of bioproducts in domestic research and international networks has strengthened research collaborations through supporting the collection and distribution of tissues, especially cancer tissues. This trend plays an important role in facilitating basic and applied research in various fields of cancer, including molecular biology, immunology, genetics and pharmacology, and will pave the way for scientific advances and therapeutic innovations.

Efficacy of the Rehacom Cognitive Rehabilitation Software on Cognitive Function Improvement in Patients with Type 1 and Type 2 Diabetes Mellitus, A Randomized Clinical Trial

2026-02-01T08:01:25+00:00

Background: This study investigated the efficacy of the “Rehacom” cognitive rehabilitation software on five key cognitive domains—working memory, information processing speed, attention, inhibition, and executive functions—in patients diagnosed with Type 1 and Type 2 Diabetes Mellitus.

Methods: A pre-test/post-test experimental design with a control group was employed. A sample of 30 diabetic patients was recruited via convenience sampling and randomly allocated to either the experimental group (receiving Rehacom software intervention for 12 sessions) or the control group. Cognitive performance was assessed using the Rehacom software itself and the Barkley Deficits in Executive Functioning Scale (BDEFS). Each session lasted 45 minutes.

Results: Multivariate Analysis of Covariance (MANCOVA) revealed a significant overall effect of the intervention on the composite of dependent variables (Wilks’ Lambda= 0.184, F (5.24)= 7.978, P< 0.001). Subsequent Analysis of Covariance (ANCOVA) indicated that the intervention significantly enhanced “attention” (η²= 0.236, P= 0.016) and “executive functions” (η²= 0.621, P< 0.001). However, no significant impact was observed on working memory, information processing speed, or inhibition.

Conclusion: The findings suggest that the Rehacom software serves as an effective tool for improving attention and executive functions in diabetic patients. The notable effect sizes for these two domains underscore its clinical utility in cognitive rehabilitation programs for chronic patients. The absence of effects on other components may be attributable to factors such as the limited duration of the intervention, specific software exercises, or the underlying neurochemical and pathophysiological characteristics of diabetes, warranting further investigation with more robust designs

Association of Anthropometric Indices with Type 2 Diabetes Prevalence: Evidence from the Rural Fasa Cohort

2026-02-01T08:01:24+00:00

Background: Type 2 diabetes is rapidly increasing, particularly in the Middle East where central obesity is a major contributor to disease burden. Identifying high-risk individuals requires indices that assess visceral adiposity more effectively than body mass index (BMI). This study compared nine anthropometric indices in relation to diabetes and determined their predictive capacity and optimal cut-off values.

Methods: This cross-sectional analysis included 10,103 adults aged 35–70 years from the FASA cohort. Diabetes was defined as fasting glucose ≥126 mg/dL or antidiabetic medication use. Measurements included BMI, waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), body roundness index (BRI), body adiposity index (BAI), a body shape index (ABSI), abdominal volume index (AVI), and weight- adjusted waist index (WWI). Associations were examined using logistic regression (crude and adjusted models). Discriminatory accuracy was assessed using receiver operating characteristic (ROC) curves, area under the curve (AUC), and Youden's index.

Results: Individuals with diabetes exhibited higher values across anthropometric indices (p< 0.05). In adjusted models, WC, WHR, WHtR, AVI, and WWI remained significant predictors (p< 0.05). WHR demonstrated the highest AUC (0.651, p< 0.001). Optimal cut-off values with high sensitivity and specificity included WHR= 0.91, WHtR= 0.53, and BRI= 4.1.

Conclusion: Central obesity indices—particularly WHR, WHtR, and BRI—demonstrated superior discriminatory capacity for diabetes and support the use of simple waist-based indices for early screening

A Novel Mutation in an Iranian Patient Affected by Cystinosis: A Case Report and Literature Review

2026-02-01T08:01:23+00:00

Background: Cystinosis is a rare lysosomal storage disorder with autosomal recessive inheritance caused by mutations in the CTNS gene, which leads to the accumulation of cystine crystals in lysosomes and gradual damage to various tissues and organs in the body. In this study, we investigated the variants in the CTNS gene of two cystinosis patients who were referred to Ali Asghar Children's Hospital. Additionally, we review previouse reports of pathogenic/likely pathogenic variants in the CTNS gene in Iran and some Middle Eastern countries, including Saudi Arabia, Turkey, and Egypt.

Methods: After collecting clinical and paraclinical data, sequencing of all exons of the CTNS gene along with its boundary regions was performed. To interpret the identified variants, bioinformatics tools based on the ACMG guideline were used.

Results: In the first patient, a novel variant c.1055A>G was found in the homozygous state, which, based on bioinformatics criteria, was classified as a "likely pathogenic" variant. In the second patient, a known homozygous of c.1015G>A was identified in the which has been previously reported as a pathogenic variant.

Conclusion: The results of this study introduce a new variant in the CTNS gene. Furthermore, by comparing reported variants in countries from the Middle East, including Iran, Saudi Arabia, Turkey, and Egypt, the c.681G>A variant was identified as the most common variant in Iran, Turkey, and Saudi Arabia, while the c.829dup variant was the most common in Egypt. The findings highlight the importance of genetic testing for definitive diagnosis and the need for targeted screening strategies in populations with high rates of consanguineous marriage