Stability of Thirty-Four Analytes in Blood Samples of Diabetic Patients.

BACKGROUND: Storage of biological samples may alter the values of an analyte compared to that of initial measurement. Therefore, an optimal storage condition for every analyte in serum and whole blood samples needs to be determined. The aim of this study was to investigate stability of 34 analytes at different time and temperature conditions of storage. METHODS: This study assessed the stability of hematological parameters in whole blood sample and common biochemical analytes in serum of 40 diabetic patients after 24 and 48 hours in 2 - 8°C and after 30 days in -20°C of sample collection. The mean values of analytes in 3 different storage conditions were measured and compared to that of initial values. RESULTS: Most of the examined biochemical analytes and hematological parameters were stable up to 48 hours at 2 - 8°C after sample collection. Most of the negative changes were negligible but PTH level dramatically decreased after 48 hours in 2 - 8°C. In addition, although a clear increase in the concentration of triglycerides, Cr, Urea, T4, and 25-OH vitamin D3 was observed, it was not significant. Furthermore, a statistically significant difference was observed in the values of ALT, Ca, and T4 among the different conditions of storage. Also, values of HbA1c did not show any significant statistical changes among the 3 different conditions of storage. CONCLUSIONS: Taken together, it seems that most of the analytes in the serum of diabetic patients as well as HbA1c are stable up to 30 days of storage.

Epidemiology of Diabetes Foot Amputation and its Risk Factors in the Middle East Region: A Systematic Review and Meta-Analysis.

This study aimed to review epidemiology of diabetic foot (DF) amputation and provide a pooled estimation of DF amputation rate in the region. A comprehensive search was performed in Web of Science, PubMed, Scopus and EMBASE databases using appropriate search term. Obtained records were entered endnote software and after removing duplicats were screened by title, abstract and full text. Data was extracted from the remained documents. Random effect meta-analysis was used to pool the estimated prevalence rate due to sever heterogeneity between studies. Finally 17 articles in diabetes, 20 in patients with DFU (diabetic foot ulcer) and two in both remained after screening and included in meta-analysis. Overall pooled amputation rate in diabetes was 2% (95% CI: 1%-3%) which was not significantly different between countries. The pooled prevalence of amputation rate in DFU patients was 33% (24%-43%) and the pooled prevalence in Saudi Arabia was significantly higher than in other countries. The estimated rate of foot amputation in diabetes patients and those with DFUs in the Middle East region is approximately high, which may indicate low quality of preventive foot care, low socioeconomics and low patients awareness or education in countries with high amputation rate.

Knowledge gaps in diabetes research: an evidence mapping of the literature.

Background: Mapping the available evidence can be used to inform current diabetes research, identify relevant gaps, and prioritize future research. In this regard, we mapped diabetes research performed in Iran. Method: We searched the Scopus and PubMed databases from 01/01/2015 till 01/01/2020 using keywords such as diabetes and Iran. The included articles were classified according to their document types, level of evidence, and subject areas. Results: The majority of the included articles (53%) were related to diabetes types, followed by complications (28%). Most of the documents were original articles (82%), and reviews were 18% of the publications. Systematic reviews constitute only 6% of the total documents. Observational studies were the most common types of study designs (26%), followed by clinical trials (20%). Moreover, topics on control and management of diabetes were the most prevalent subject areas (58%), and fewer studies were on preventive strategies (6%). In diabetes management studies, less attention has been paid to evaluate psychological (10%), educational (9%), and physical activity-related (7%) interventions. There was a shortage of secondary studies related to physical activity, psychology, diagnostic, and screening-related studies. Conclusion: To fill diabetes research gaps, more investment in cost-effectiveness interventions, such as preventive strategies and behavioral self-management programs, need. Moreover, we need to pay more attention on applied sciences and real world evidence to bridge translational gaps from bench to bedside. In this regard, further data synthesis can be helpful in evaluating the effectiveness of the available studies and avoiding unnecessary investigations.

Mapping evidence of Iran diabetes research: protocol for a scoping review.

Background: A considerable amount of research funding goes to diabetes management strategies to improve therapeutic goals and reduce the burden of diabetes. A vast amount of the budget is wasted due to unnecessary studies. A scoping review is a pivotal study to overview the available evidence and avoid research waste. In this review, we will try to find out the scope of available studies on diabetes management interventions, identify associated research gaps, and prioritize future studies. Method: We will carry out a study using Arksey and O'Malley's scoping review framework. We will search the Scopus and PubMed databases from 01/01/2015 till 01/01/2020. Only original articles related to pharmacological and non-pharmacological management interventions will be included. These interventional studies should be conducted on the Iranian population. After data extraction, a descriptive data analysis will be used to present information in different charts or tables. We will evaluate related published articles based on their document type, level of evidence, type of diabetes, subject area, interventions types, main findings and outcomes. Discussion: This study represents the first attempt to sum up available studies related to diabetes management interventions performed in Iran. The results of this study will be useful for all the stakeholders and policy-makers involved in diabetes research. It can help clinicians to be informed about studies on management interventions and can guide scientists eager to diabetes research to choose their future research plans based on diabetes research requirements and gaps.

Iran diabetes research study; knowledge discovery in diagnosis: a scoping review.

INTRODUCTION: The rising prevalence of diabetes shows high health and socio-economic burdens. Therefore, the development and evaluation of new diagnostic methods may improve the detection of disease and its complications in the early stages. This study aimed to analyze the scope of the studies related to diabetes diagnosis. MATERIAL AND METHOD: Publications from January 2015 until December 2019 (5 years) were searched with keywords of (diabetes OR diabetic) AND (Iran) in Scopus and PubMed databases. All data were reviewed by two reviewers and the included publications were categorized based on the subjects, study design, and publication year. RESULTS: Based on the selected criteria, 103 articles were included. The highest number of publications was observed in 2019. The trend of publication was slightly increased during the study period (2015-2019). Case-control and cross-sectional studies were the most common type of study design used in the included documents. Publications in the field of diagnostic models, biomarkers, and biosensors from 2015 to 2019 showed an increasing trend compared to others subjects. DISCUSSION AND CONCLUSION: Studies about proper diabetes diagnostic procedures such as new diagnostic techniques, using diagnostic models, and evaluation of new diagnostic biomarkers in Iran are remarkably increased. However, more original and review studies are needed to improve scientific methods in the field of early detection of diabetes. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40200-021-00843-x.

A Detailed Comparison of Morning and Random Urine Specimen Levels with 24 Hour Urinary Excretion Levels of Seven Biochemical Parameters with a Proposed Formula.

This study aimed to evaluate the validity of the suggested method (SM) to estimate the urinary level of seven biochemical parameters within 24 hours with an innovative formula using morning and random urine specimens. A total of 133 clients referring to the laboratory of the Endocrinology & Metabolism Research Institute, Tehran University of Medical Sciences, participated voluntarily in the investigation with providing three urine samples of 24-hour, morning and random. Seven biochemical parameters (calcium, phosphorus, urea, creatinine, uric acid, microalbumin and protein) were measured in all three samples. After applying the proposed formula and the formula of the parameter-to-creatinine ratio (p/c), the results obtained from morning and random samples were compared statistically with those of 24-hour urine samples. Compared to the p/c ratio method, nearly all the results of the SM were more correlated with the 24-hour method (24-hrM). Among the results obtained in the SM, the values of urea, calcium and phosphorus in the morning urine and those of uric acid, microalbumin, protein and creatinine in the random urine showed higher correlation with the respective results of the 24-hrM. The new method seems to be a feasible alternative to the methods of 24-hour and p/c ratio for measuring morning values of urea, calcium and phosphorus as well as random values of uric acid, microalbumin, protein and creatinine. This method is a compromised method when 24 hours urine specimen is impossible to get by certain patients.

Transitional Meningioma After Fetal Liver-Derived Cell Suspension Allotransplant: A Case Report.

Diabetes mellitus is a disease with no definite cure. In recent years, stem cell transplant has led to treatment of various diseases including diabetes. We sought to report a type 1 diabetic patient with a brain mass, diagnosed as transitional meningioma, after a fetal hematopoietic stem cell transplant. A 57-year-old woman with type 1 diabetes who previously had undergone a fetal hematopoietic stem cell transplant, attended the clinic with a history of progressive bifrontal headaches accompanied by nausea, vomiting, and visual disturbances over the previous 8 months. Investigations revealed a 2-cm mass in the right temporal region. The patient underwent a craniotomy, and the lesion was removed and sent for pathological and genetic investigations. The results indicated transitional meningioma with the origin of transplanted fetal hematopoietic stem cells. To our knowledge, this is the first report of transitional meningioma as a result of stem cell transplant. Despite all unanswered questions about the safety of stem cell transplant, this novel therapy provides hope for patients with type 1 diabetes.

Iran diabetes research roadmap (IDRR) study: a preliminary study on diabetes research in the world and Iran.

BACKGROUNDS: Diabetes is one of the most common metabolic disorders worldwide. This study aim was to provide detail analysis of diabetes research output and its trend in Iran as well as in the world and compare them. METHODS: Data was retrieved from PubMed database using a suitable search strategy and application of proper operator "AND", "OR" and "NOT". All English documents published from 2008 to 2012 were included. Meeting abstract, letter to the editor, guidelines, consensus and reviews were excluded. Obtained documents for Iran and world were categorized in eleven groups including diabetes management, education, paediatrics, nutrition, epidemiology, diabetes complications, stem cells, gestational diabetes mellitus (GDM), psychiatrics, genetics and prevention and were compared. RESULTS: Total number of DM publications was 59513 for world and 648 for Iran. Trend of DM publications was increasing during the 5 years with a growth rate of 22.5% for world and 23.4% for Iran. Contribution of Iran in the world diabetes output reached 1.08 in 2012. The most and the least number of DM documents were related to complications and preventions, respectively both in Iran and the world. Three leading countries with highest proportion of RCTs (randomized clinical trial) to their total DM publications were Italy, Germany and Iran. CONCLUSION: The most number of diabetes research was in the field of diabetes complication, management and genetics in the world as well as in Iran. During the 5-year period, despite of the world sanctions against Iran, diabetes research trend was increasing in Iran relatively parallel to the world research and sanction had no significant effect on Iran.

Effectiveness of short message service-based intervention (SMS) on self-care in type 2 diabetes: A feasibility study.

AIM: The objective of the current study is to assess the effectiveness of Mobile Short Message Service (SMS) intervention on education of basic self-care skills in patients with type 2 diabetes. Moreover, we aimed to determine whether delivering individually-tailored educational messages can be more effective than general educational messages. METHODS: A total of 150 patients with diabetes type 2 were randomized into three groups: tailored SMS group, non-tailored SMS group, and the control group. Biochemical parameters including HbA1c, FBS, lipid profile were evaluated for the three groups at baseline and after 12 weeks. Moreover, self-care Inventory (SCI), Diabetes Management Self-Efficacy Scale (DMSES) and Diabetes Self-Care Barriers assessment scale for Older Adults (DSCB-OA) were completed. In the tailored SMS group, each person received 75% of their messages based on the top two barriers to adherence that they had experienced and reported in their scale. In the non-tailored SMS group, random messages were sent to every patient. RESULTS: After 12 weeks, although HgA1c levels did not significantly change, significant decline was observed in FBS and mean BMI in both intervention groups. Mean SCI-R scores significantly increased and mean DSCB and DMSES scores significantly decreased in both tailored and non-tailored SMS groups. In the control group, mean SCI-R scores decreased and mean DSCB and DMSES scores significantly increased (P<0.001). CONCLUSION: Sending short text messages as a method of education in conjunction with conventional diabetes treatment can improve glycemic control and positively influence other aspects of diabetes self-care. According to our findings, sending SMS regularly in particular times appears to be as effective as sending individually tailored messages.

Developing a Clinical Diabetes Guideline in Diabetes Research Network in Iran.

Development of evidence-based clinical guidelines to raising standards of medical care in diabetes is a core element of coping with the global diabetes epidemic. The purpose of this study was to develop a systematic clinical diabetes guideline from the latest scientific evidences and also to localize its recommendations according to regional and cultural needs of our society. Searches were conducted using NICE, SIGN, WDPCP, IDF, JDC, ADA, AACE, ICSI, CDA, AMDA, IDC, NyDoH guidelines which were examined and criticized and scored using Agree method. Guidelines which got higher score in some important areas of Agree scale including: rigor of development, clarity and comprehensiveness of the recommendations and applicability, especially in the climatic conditions of our country were selected. The existing recommendations were extracted by committee members and supporting evidences of each recommendation were determined based on the sources listed in the clinical guideline. Recommendations grading were classified from grade A to D based on the quality of their supporting evidences (BEL1-5). This guideline covered all areas related to diabetes including screening and diagnosis, lifestyle modification and patient education, management, complications and hypoglycemia. Regarding capacities of this guideline and lack of comprehensive and updated guidelines in our country and region, it is suggested that designing a pilot study to implement this Learner-centered guideline and finding its weaknesses can lead to patient care improvement and also propel us towards our goal to design a comprehensive guideline in compliance with regional and national needs in Middle East.