Objective: The role of environmental factors in the development of type1 diabetes mellitus (T1D) is inconclusive. This study aimed to investigate the associations between selected environmental factors and T1D. Materials and Methods: This group matched case-control study included diabetic and healthy subjects younger than 19 years old in 2017. Cases were diabetic subjects diagnosed before the age of 19 years and controls were healthy subjects with similar distributions of age, sex, and place of living. Information including demographic characteristics, birth season, duration of breastfeeding and major psychological stressors was obtained by a parent-administered questionnaire. Data were analyzed using SPSS version 16 and T-test and chi-square test. Statistical significance was defined as P< 0.05. Results: The mean age of cases was 12.5 (±5.2) years and 13 (±6.7) in controls (P: 0.55). Compared to controls, children with T1D had a higher chance of having a major psychological stressor in the family before the onset of diabetes (P: 0.0001) with odds ratio (OR) 3.3, higher neonatal jaundice (P: 0.01, OR: 2.25), infection leading to hospitalization within the first year of life (P: 0.007, OR: 6.46), and lower family income (P: 0.018). Duration of breastfeeding was shorter inT1D group (P: 0.018, OR: 3.46) and they had started cereals one month earlier (P: 0.015). Conclusion: Certain environmental factors including major psychological stressors, neonatal jaundice, infection leading to hospitalization within first year of birth and shorter duration of breastfeeding were associated with the development of T1D.

Objective: Diabetes mellitus (DM) is known as the silent pandemic. It is hypothesized that other endocrine systems are affected by the metabolic changes occurring due to DM. We aimed to investigate the correlation of thyroid hormones with glycaemic and lipid parameters. Materials and Methods: 81 diabetic patients and 81 non-diabetic age and sex-matched healthy volunteers participated in the study. Their blood samples were analysed for fasting blood glucose (FBG), glycosylated haemoglobin (HbA1C), total tri-iodothyronine (T3), total thyroxine (T4), free T3 (FT3), free T4 (FT4), thyroid-stimulating hormone (TSH), total cholesterol (CHOL), High-Density-Lipoprotein cholesterol (HDLC) and Low-Density-Lipoprotein cholesterol (LDLC). Data was analysed using appropriate statistical tests. Results: Among the cases, 70.37% were euthyroid, while 24.7% had subclinical hypothyroidism, 2.47% had clinical hypothyroidism, 1.23% had subclinical and 1.23% had clinical hyperthyroidism. FBG, HbA1c and TSH (P< 0.05) were significantly higher in diabetics compared to controls. On the other hand, T3, FT3, FT4, and HDLC (P< 0.05) were significantly lower in diabetics compared to controls. A significant negative correlation (P< 0.05) was found when T3 and FT3 were compared against age, FBG and HbA1c. A significant positive correlation (P< 0.05) was found when T3 and FT3 were compared against HDLC, LDLC & CHOL. Conclusion: Our statistics show that high-normal levels of T3 and FT3 are correlated with lower levels of FBG and HbA1c, hence improved glycaemic control. We recommend that thyroid profile of diabetic patients with poor control should be monitored regularly. Early detection of thyroid dysfunction and initiation of therapy for it, can improve the treatment outcome of hypoglycaemic drugs.

Objective: Epidemiological evidence shows that the prevalence of patients with comorbidity of diabetes mellitus (DM), in Coronavirus disease 2019 (COVID-19) is remarkable and they have poor prognosis. We aimed to investigate the comorbidity of diabetes and covid-19 in positive Polymerase Chain Reaction people in Yazd. Materials and Methods: This retrospective cohort study included data of 570 COVID-19 positive patients, admitted to Shahid Sadoughi Hospital in Yazd, Iran, from February2019 to May 2020, including demographic data and clinical outcome of COVID-19. Study data were analyzed using SPSS software-22 and T-test, Chi-square and a binary logistic regression model were used for modeling. Results: Prevalence of COVID-19 patients with diabetes was 27% and the percentage of male patients was 62.6%. Additionally, duration of hospitalization significantly higher in diabetic patients (P= 0.004), need to invasive mechanical ventilation in diabetic patients was significantly higher than non-diabetic patients (P? 0.001) Conclusion: DM is one of the most important comorbidity with COVID-19 patients and this comorbidity affects the severity of the disease and the outcome of patients.

Objective: The parent-child relationship and the daily blood sugar control by adolescents can affect family functioning. This study aimed to evaluate the effectiveness of unified trans-diagnostic treatment protocols on parent-child interaction and blood sugar levels in adolescents with type 1 diabetes. Materials and Methods: The present study was quasi-experimental with a pretest and posttest design and a control group. The statistical population of the study included all adolescents aged 12-15 years with type 1 diabetes referred to the Iranian Diabetes Society and their parents in 2020. Out of this population, 44 were selected using the convenience judgmental sampling method and randomly divided into two groups (n= 22). The Child-Parent Relationship Scale (CPRS) was used to investigate the parent-child interaction, and hemoglobin pre-and post-program tests were used to assess blood sugar. Adolescents and parents in the experimental group received the program during 17 sessions. Data were analyzed using the analysis of covariance. Statistical analyses were performed by SPSS software version 22. Results: The means of corrected post-test scores of the Child-Parent Relationship Scale and hemoglobin A1c tests were significantly different in the experimental and control groups (P= 0.001). Conclusion: The unified trans-diagnostic treatment protocols affect parent-child interaction and blood sugar levels in adolescents with type 1 diabetes. It is possible to use this program to educate adolescents with diabetes and their families and preventive interventions.

Objective: The parent-child relationship and the daily blood sugar control by adolescents can affect family functioning. This study aimed to evaluate the effectiveness of unified trans-diagnostic treatment protocols on parent-child interaction and blood sugar levels in adolescents with type 1 diabetes. Materials and Methods: The present study was quasi-experimental with a pretest and posttest design and a control group. The statistical population of the study included all adolescents aged 12-15 years with type 1 diabetes referred to the Iranian Diabetes Society and their parents in 2020. Out of this population, 44 were selected using the convenience judgmental sampling method and randomly divided into two groups (n= 22). The Child-Parent Relationship Scale (CPRS) was used to investigate the parent-child interaction, and hemoglobin pre-and post-program tests were used to assess blood sugar. Adolescents and parents in the experimental group received the program during 17 sessions. Data were analyzed using the analysis of covariance. Statistical analyses were performed by SPSS software version 22. Results: The means of corrected post-test scores of the Child-Parent Relationship Scale and hemoglobin A1c tests were significantly different in the experimental and control groups (P= 0.001). Conclusion: The unified trans-diagnostic treatment protocols affect parent-child interaction and blood sugar levels in adolescents with type 1 diabetes. It is possible to use this program to educate adolescents with diabetes and their families and preventive interventions.

Objective: Evaluation of the effect of 8 weeks of High-Intensity Interval Training (HIIT) on the serum level of cardiac troponin T (cTnT) in sedentary obese young men. Materials and Methods: Thirty sedentary men were randomly divided into 3 groups: the 30s HIIT training group (n=10), the 60s training group (n=10), and the control group (no exercise) (n=10). Interval training with 90 %VO2peak was done in 3 sessions for 8 weeks. cTnT was measured 5 times; pre-exercise, 4hrs, and 24hrs after the first session (4hF, 24hF), and 4hrs and 24hrs after the last training session (4hL, 24hL). ANOVA with repeated measures and Bonferroni post-hoc tests were used by SPSS 23 with a significance level of (P< 0.05). Results: The significant increase in serum levels of cTnT in the post-tests of the 60s HIIT compared to the first 24hrs and the last 24hrs (P= 0.0001). But in the 30s group it was not significant compared to the other measurements (P= 0/05). In the 2 training groups, serum levels of cTnT in the last 4hr post-tests of the last week were not significantly different from the 4hrs post-tests of the first week (P= 0.05). Conclusion: It seems that none of these activities cause heart damage sustained, and changes in cTnT levels in two 4hrs compared to the first and last 24hrs of the 60s group may be due to reversible leakage of cardiac cell membranes, and may continuous exercise will reduce this reduction.

Type 2 diabetes causes structural and functional changes in the myocardium, which is called cardiomyopathy. Diabetic cardiomyopathy (DCM) is a distinct primary disorder process, independent of coronary artery disease, which leads to heart failure in diabetic patients. Also, DCM is a multifaceted disorder that is one of the leading causes of death in elderly and postmenopausal women. Menopause is associated with decreased and stopped ovarian function, which reduces and stops the production of ovarian hormones, especially estrogen. Moreover, menopause is associated with an increased risk of cardiovascular diseases. Sex steroids such as 17-ß estradiol have a variety of protective effects on many tissues in the body, including the cardiovascular system. In this article, the concept of DCM, the underlying molecular signaling pathway, and, finally, the role of 17-ß estradiol as one of the most important estrogens in moderating DCM are discussed to provide a theoretical basis for in-depth study.

Objective: The role of environmental factors in the development of type1 diabetes mellitus (T1D) is inconclusive. This study aimed to investigate the associations between selected environmental factors and T1D. Materials and Methods: This group matched case-control study included diabetic and healthy subjects younger than 19 years old in 2017. Cases were diabetic subjects diagnosed before the age of 19 years and controls were healthy subjects with similar distributions of age, sex, and place of living. Information including demographic characteristics, birth season, duration of breastfeeding and major psychological stressors was obtained by a parent-administered questionnaire. Data were analyzed using SPSS version 16 and T-test and chi-square test. Statistical significance was defined as P< 0.05. Results: The mean age of cases was 12.5 (±5.2) years and 13 (±6.7) in controls (P: 0.55). Compared to controls, children with T1D had a higher chance of having a major psychological stressor in the family before the onset of diabetes (P: 0.0001) with odds ratio (OR) 3.3, higher neonatal jaundice (P: 0.01, OR: 2.25), infection leading to hospitalization within the first year of life (P: 0.007, OR: 6.46), and lower family income (P: 0.018). Duration of breastfeeding was shorter inT1D group (P: 0.018, OR: 3.46) and they had started cereals one month earlier (P: 0.015). Conclusion: Certain environmental factors including major psychological stressors, neonatal jaundice, infection leading to hospitalization within first year of birth and shorter duration of breastfeeding were associated with the development of T1D.

Objective: Diabetes mellitus (DM) is known as the silent pandemic. It is hypothesized that other endocrine systems are affected by the metabolic changes occurring due to DM. We aimed to investigate the correlation of thyroid hormones with glycaemic and lipid parameters. Materials and Methods: 81 diabetic patients and 81 non-diabetic age and sex-matched healthy volunteers participated in the study. Their blood samples were analysed for fasting blood glucose (FBG), glycosylated haemoglobin (HbA1C), total tri-iodothyronine (T3), total thyroxine (T4), free T3 (FT3), free T4 (FT4), thyroid-stimulating hormone (TSH), total cholesterol (CHOL), High-Density-Lipoprotein cholesterol (HDLC) and Low-Density-Lipoprotein cholesterol (LDLC). Data was analysed using appropriate statistical tests. Results: Among the cases, 70.37% were euthyroid, while 24.7% had subclinical hypothyroidism, 2.47% had clinical hypothyroidism, 1.23% had subclinical and 1.23% had clinical hyperthyroidism. FBG, HbA1c and TSH (P< 0.05) were significantly higher in diabetics compared to controls. On the other hand, T3, FT3, FT4, and HDLC (P< 0.05) were significantly lower in diabetics compared to controls. A significant negative correlation (P< 0.05) was found when T3 and FT3 were compared against age, FBG and HbA1c. A significant positive correlation (P< 0.05) was found when T3 and FT3 were compared against HDLC, LDLC & CHOL. Conclusion: Our statistics show that high-normal levels of T3 and FT3 are correlated with lower levels of FBG and HbA1c, hence improved glycaemic control. We recommend that thyroid profile of diabetic patients with poor control should be monitored regularly. Early detection of thyroid dysfunction and initiation of therapy for it, can improve the treatment outcome of hypoglycaemic drugs.

Objective: Evaluation of the effect of 8 weeks of High-Intensity Interval Training (HIIT) on the serum level of cardiac troponin T (cTnT) in sedentary obese young men. Materials and Methods: Thirty sedentary men were randomly divided into 3 groups: the 30s HIIT training group (n=10), the 60s training group (n=10), and the control group (no exercise) (n=10). Interval training with 90 %VO2peak was done in 3 sessions for 8 weeks. cTnT was measured 5 times; pre-exercise, 4hrs, and 24hrs after the first session (4hF, 24hF), and 4hrs and 24hrs after the last training session (4hL, 24hL). ANOVA with repeated measures and Bonferroni post-hoc tests were used by SPSS 23 with a significance level of (P< 0.05). Results: The significant increase in serum levels of cTnT in the post-tests of the 60s HIIT compared to the first 24hrs and the last 24hrs (P= 0.0001). But in the 30s group it was not significant compared to the other measurements (P= 0/05). In the 2 training groups, serum levels of cTnT in the last 4hr post-tests of the last week were not significantly different from the 4hrs post-tests of the first week (P= 0.05). Conclusion: It seems that none of these activities cause heart damage sustained, and changes in cTnT levels in two 4hrs compared to the first and last 24hrs of the 60s group may be due to reversible leakage of cardiac cell membranes, and may continuous exercise will reduce this reduction.

Objective: Evaluation of the effect of 8 weeks of High-Intensity Interval Training (HIIT) on the serum level of cardiac troponin T (cTnT) in sedentary obese young men. Materials and Methods: Thirty sedentary men were randomly divided into 3 groups: the 30s HIIT training group (n=10), the 60s training group (n=10), and the control group (no exercise) (n=10). Interval training with 90 %VO2peak was done in 3 sessions for 8 weeks. cTnT was measured 5 times; pre-exercise, 4hrs, and 24hrs after the first session (4hF, 24hF), and 4hrs and 24hrs after the last training session (4hL, 24hL). ANOVA with repeated measures and Bonferroni post-hoc tests were used by SPSS 23 with a significance level of (P< 0.05). Results: The significant increase in serum levels of cTnT in the post-tests of the 60s HIIT compared to the first 24hrs and the last 24hrs (P= 0.0001). But in the 30s group it was not significant compared to the other measurements (P= 0/05). In the 2 training groups, serum levels of cTnT in the last 4hr post-tests of the last week were not significantly different from the 4hrs post-tests of the first week (P= 0.05). Conclusion: It seems that none of these activities cause heart damage sustained, and changes in cTnT levels in two 4hrs compared to the first and last 24hrs of the 60s group may be due to reversible leakage of cardiac cell membranes, and may continuous exercise will reduce this reduction.

Objective: Diabetes is a major health concern worldwide. Diabetic patients experience many issues that affect their lives. Poor self-care and compliance in type 2 diabetes mellitus (T2DM) patients cause chronic hyperglycemia and irreversible complications. The study aimed to explore the lived experiences of T2DM patients with irreversible complications. Materials and Methods: The qualitative phenomenology study was conducted through a semi-structured interview. The collected data were analyzed using Braun and Clarke framework for thematic analysis. Participants included 15 T2DM with irreversible complications who were selected to conduct the study through purposive sampling in Zabol, Iran. Results: Research findings were classified into three main themes "past negligence, future threat", "suffering from disastrous complications" and "complicated life with diabetes". Some of the sub-themes were as follows: being sorry for previous unhealthy behaviors, fearing the future with the disease, successive challenges of the disease, losing the importance of life, poverty, losing family and social communications, gradual involvement of body organs, and life and death. Conclusion: Patients with no self-confidence are defeated by the disease and have no control over the conditions in different dimensions of life, considering the irreversible diabetes complications. Besides, patients need the support and attention of care providers and families to take the health-related behaviors, embrace the disease condition and move toward dominating the present situation.

Type 2 diabetes causes structural and functional changes in the myocardium, which is called cardiomyopathy. Diabetic cardiomyopathy (DCM) is a distinct primary disorder process, independent of coronary artery disease, which leads to heart failure in diabetic patients. Also, DCM is a multifaceted disorder that is one of the leading causes of death in elderly and postmenopausal women. Menopause is associated with decreased and stopped ovarian function, which reduces and stops the production of ovarian hormones, especially estrogen. Moreover, menopause is associated with an increased risk of cardiovascular diseases. Sex steroids such as 17-ß estradiol have a variety of protective effects on many tissues in the body, including the cardiovascular system. In this article, the concept of DCM, the underlying molecular signaling pathway, and, finally, the role of 17-ß estradiol as one of the most important estrogens in moderating DCM are discussed to provide a theoretical basis for in-depth study.

Objective: Diabetic patients are more likely to be infected and are at the higher risk of morbidity and mortality in COVID-19 pandemic. The aim of this study was to compare the preventive behaviours and perceived risk of COVID-19 in women with and without type 2 diabetes mellitus (T2DM).

Objective: Diabetic patients are more likely to be infected and are at the higher risk of morbidity and mortality in COVID-19 pandemic. The aim of this study was to compare the preventive behaviours and perceived risk of COVID-19 in women with and without type 2 diabetes mellitus (T2DM).

Objective: Epidemiological evidence shows that the prevalence of patients with comorbidity of diabetes mellitus (DM), in Coronavirus disease 2019 (COVID-19) is remarkable and they have poor prognosis. We aimed to investigate the comorbidity of diabetes and covid-19 in positive Polymerase Chain Reaction people in Yazd. Materials and Methods: This retrospective cohort study included data of 570 COVID-19 positive patients, admitted to Shahid Sadoughi Hospital in Yazd, Iran, from February2019 to May 2020, including demographic data and clinical outcome of COVID-19. Study data were analyzed using SPSS software-22 and T-test, Chi-square and a binary logistic regression model were used for modeling. Results: Prevalence of COVID-19 patients with diabetes was 27% and the percentage of male patients was 62.6%. Additionally, duration of hospitalization significantly higher in diabetic patients (P= 0.004), need to invasive mechanical ventilation in diabetic patients was significantly higher than non-diabetic patients (P? 0.001) Conclusion: DM is one of the most important comorbidity with COVID-19 patients and this comorbidity affects the severity of the disease and the outcome of patients.