BackgroundDespite the certain role of both vitamin D and adiponectin in the regulation of insulin sensitivity, the interaction between these two agents has remained uncertain.ObjectiveThe present study aimed to determine whether vitamin D is able to change plasma adiponectin and affect glucose homeostasis and insulin sensitivity in first-degree relatives of subjects with type 2 diabetes.MethodsThis randomized clinical trial was conducted at Clinic of Shahid Sadoughi Hospital in Yazd, Iran, from January 25, 2012 to December 25, 2014. In this randomized, double-blinded controlled trial, 64 first-degree relatives of type 2 diabetic patients were assigned randomly to receive either vitamin D supplement (50000 IU vitamin D tablet weekly) plus lifestyle change as the intervention group (n = 32) or placebo plus lifestyle change as the control group (n = 32) for twelve weeks (three months).ResultsFifty-three patients (28 in the intervention group and 25 in the control group) completed the study. Serum levels of vitamin D increased while insulin level and consequently insulin resistance (calculated by HOMA formula) significantly decreased in the case group (p-value <0.001 for all variables). Although the values of these three biomarkers showed a slight increase in control group, the changes were not statistically significant. The levels of the changes in other markers including adiponectin, Fasting Blood Sugar (FBS), triglyceride, and total cholesterol remained insignificant in both study groups after completing interventions compared with before interventions.ConclusionThis study showed that decreased insulin resistance is expected by administrating vitamin D supplement in first-degree relatives of the patients with diabetes mellitus.Trial RegistrationThe trial was registered at the Iranian Registry of Clinical Trials (http://www.irct.ir) with the IRCT ID: 201105176430N1.FundingThe authors received no financial support for the research or publication of this article.

Purpose Diabetes mellitus (DM) is a heterogeneous group of metabolic disorders characterized by chronic hyperglycemia that results by relative or absolute insulin deficiency. Hearing disorders is common otological disorders in diabetic patients. This study aimed to investigate the frequency of hearing impairment among DM patients and its association with diabetes complications and blood sugar control. Methods This analytical cross-sectional study was conducted from 2016 to 2017 on 81 patients with type 2 diabetes mellitus (T2DM), aged 40-65 years who were referred to Yazd diabetic research center. Air conduction pure tone hearing thresholds were obtained for each ear at frequencies of 250, 500, 1000, 2000, 4000 and 8000 Hz. We defined hearing impairment as the pure-tone average ≥ 25 dB hearing level of pure-tone thresholds at low frequencies (500; 1000; and 2000 Hz) and high frequencies (4000 and 8000 Hz. The demographic data and diabetes complications frequency were gathered. All statistical analysis was done in SPSS 22. Results The mean (±SD) age of participants was 56.38 ± 5.68 years (range 40-65 years), 32(39.5%) were males and 49(60.5%) were females. The prevalence of hearing loss in high frequency in right ear was higher in male (p value = 0.047). The grade of diabetic retinopathy and nephropathy were significantly associated with hearing impairment in high frequency in both ears (p value<0.05). Finally, the results showed that even after adjustment of confounding variables using logistic regression analysis there were no relationship between hearing impairment and variables in both ears. Conclusion The hearing impairment was associated with diabetes complications as retinopathy and nephropathy. The association was significant in high frequency.

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Objective: Diabetes is a non-communicable disease. The patient satisfaction with treatment is a key point of patient’s compliance. Definitive treatment for patients with type 1 diabetes is lifelong insulin injections, but type 1 diabetic patients are commonly in poor glycemic state due to poor compliance. Therefore, it is necessary to check insulin treatment satisfaction in this population. Therefore, the main purpose of this study was to evaluate the satisfaction of insulin treatment in patients with type 1 diabetes in Yazd. Materials and Methods: In this cross-sectional study, 114 patients with type 1 diabetes participated. Persian version of Insulin Treatment Satisfaction Questionnaire (ITSQ) used. All analyzes were performed by SPSS 22. Results: The overall satisfaction mean score in this study was 49.72(± 8.88). Insulin treatment satisfaction score had a significant positive correlation with BMI (P: 0.00) and age (P: 0.04). Hypoglycemic control subscale showed a positive correlation with BMI (P: 0.01) and age (P: 0.01). Also, inconvenience of insulin therapy regimen sub-scale showed a significant positive correlation with age (P: 0.04). Overall satisfaction and sub-groups had no significant correlation with other variables. Conclusion: The overall satisfaction in type 1 diabetics was unacceptable. Understanding the pathogenesis of this problem could guide health care providers for better and effective management of type 1 diabetes. Also, a more comprehensive approach with consider all potentially relevant variables is necessary.

Objective: Pioglitazone is one of the oral medications of type 2 diabetes (T2DM). The purpose of this study was to evaluate the effect of pioglitazone on asthma and diabetes treatment outcomes among patients with concurrent asthma and T2DM. Materials and Methods: We conducted a quasi-experimental study on 11 patients with concurrent asthma and T2DM in Yazd Afshar Hospital and Yazd diabetic research center 2014-2017. The inclusion criteria were patients between 20-60 years old, at least one year with concurrent asthma and T2DM (documented with spirometer, bronchodilator test), ejection fraction more than 50%. Patients who were smoker, on oral corticosteroids, phenobarbital, methotrexate, rifampin, phenytoin and gemfibrozil were excluded. Laboratory tests (FBS, HbA1c, 2hpp, leptin), spirometer test, exhaled nitric oxide were done before and after 10 weeks of pioglitazone medication. All patients were visited every two weeks. The before and after pioglitazone treatment differences were checked by paired t-test and Wilcoxon Rank sum test. Results: The mean (± SD) age of participants was 55.81 (±7.66). The median of differences of leptin (p-value: 0.885), FEV1 to FVC ( P -value: 0.185), FEV1 (p-value: 0.386), NO ( P -value: 0.574), FVC percent ( P -value: 0.477), FEV1 percent ( P -value: 0.515) did not differ before and after pioglitazone treatment. Conclusion: Our finding suggested that pioglitazone may not be effective in the treatment and improvement of respiratory function in T2DM with concurrent asthma.