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Background and objectives: Pyruvate dehydrogenase kinase 4 (PDK4) is an enzyme involved in the regulation of glucose and fatty acid metabolism and homeostasis. The purpose of this study was to investigate effects of continuous exercise and resveratrol supplementation on insulin resistance and expression of PDK4 in the soleus muscle of elderly rats with type 2 diabetes.
Methods: After inducing diabetes in 42 old male rats (mean weigh: 250-300 g, aged about two years), the rats were randomly divided into six groups: healthy control, diabetic control, continuous exercise, supplementation, continuous exercise + supplementation and sham. The continuous exercise group was subjected to eight weeks of running, five sessions a week. Daily 20 mg/Kg body weight resveratrol supplementation was administered to the supplementation and supplementation + exercise groups. To evaluate insulin resistance, the HOMA-IR insulin resistance index was calculated as the product of insulin (μIU/mL) and glucose (mmol/L) divided by 22.5. Expression of the PDK4 gene in the soleus muscle was analyzed by RT-PCR. Data were analyzed with IBM SPSS Statistics 23 using one-way ANOVA and Tukey's post hoc test at a significance level of 0.05.
Results: Resveratrol alone or combined with continuous exercise significantly increased PDK4 expression and slightly decreased insulin resistance in the subjects.
Conclusion: Our results show that diabetes is associated with reduced PDK4 expression and increased insulin resistance. These effects can be effectively reversed in the soleus muscle of elderly diabetic rats by resveratrol supplementation alone or combined with continuous exercise.
 

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Background and Objectives: Reduced insulin secretion in Type II Diabetes Mellitus (T2DM) results in fat accumulation in hepatocytes and increase in liver enzymes. The hepatocyte destruction due to non-alcoholic fatty liver is associated with increased risk of cardiovascular diseases. Therefore, the aim of this study is to evaluate the association of liver transaminases with lipid profile in T2DM patients compared to healthy subjects.
Methods: A total of 1000 subjects (500 males and females with T2DM and 500 healthy subjects) participated in this case-control study. Diagnosis of T2DM was made based on the World Health Organization (WHO) criteria. Fasting blood samples (5 ml) were obtained from all subjects in the morning and the serum was extracted for the assessment of biochemical parameters was used to compare parameters between healthy and T2DM patients. Data were analyzed by SPSS version 20 and using Mann-Whitney test and Spearman correlation coefficient.
Results: The serum total cholesterol (TCH), triglyceride, Alanine Aminotransferase (ALT), Aspartate Transaminase (AST), TCH/high density lipoprotein (HDL-C) ratio and atherogenecity index plasma were significantly higher in T2DM group compared to healthy individuals (p≤0.006). Among the lipid profile parameters only Risk ratio (TCH/HDL-C) was positively correlated with ALT (p=0.037) while no significant correlation was observed for other variables (P>0.05)
Conclusion: T2DM Patients have higher lipid profile, atherogenecity index and liver enzymes compared to healthy individuals. Furthermore, TCH/HDL-C was significantly correlated with ALT.

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Background and objectives: Fibroblast growth factor ₂₁ (FGF₂₁) and fetuin A are thought to be involved in the pathogenesis of metabolic disorders, such as type 2 diabetes. On the other hand, regular physical activity has an important role in the prevention and management of type 2 diabetes. The purpose of this study was to investigate effect of moderate aerobic exercise on serum levels of FGF₂₁ and fetuin A in women with type 2 diabetes.

Methods: This was a semi-experimental study with a pretest-posttest design. The study was performed on 28 women with type 2 diabetes aged 40-50 years (mean weight: 70.58 ± 2.11) who were randomly divided into an exercise group (n=14) and a control group (n=14). The training intervention consisted of eight weeks of moderate aerobic exercise at 60-70% of maximum heart rate, five times a week. Serum levels of FGF₂₁, fetuin A and some metabolic parameters were evaluated before the first session and 48 hours after the last session. All statistical analyses were performed in SPSS (version 24) using repeated measures ANOVA and at significance of 0.05. 
Results: The eight-week aerobic training intervention caused a significant increase in FGF₂₁ and insulin sensitivity as well as a significant decrease in fetuin A, fasting blood sugar and HbA1c (P=0.001).
Conclusion: As a complementary therapy, regular aerobic exercise can be beneficial for type 2 diabetes patients in improving some metabolic parameters as well as FGF₂₁ and fetuin A levels.

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Background and objectives: It has been suggested that irisin and fibronectin type III domain-containing protein 5 (FNDC5) can increase energy expenditure, promote weight loss and improve insulin resistance in diabetic patients by affecting white and brown adipose tissues. In this study, we investigate effect of adipose tissue-derived stem cell transplantation and six weeks of aerobic exercise on FNDC5 and irisin levels in streptozotocin-induced diabetic rats.
Methods: Forty-eight rats (weighing 220-240 g and aged nine weeks) were divided into six groups of control, sham, diabetes control, diabetes + exercise, diabetes + stem cell and diabetes+ exercise + stem cell. The exercise group ran on running wheel at intensity of 60-70% VO₂max, five days a week for six weeks. Next, 1.56 × 10⁶ stem cells extracted from human adipose tissue were injected into the tail vein of streptozotocin-induced diabetic rats. Finally, FNDC5 and irisin plasma levels of the mice were measured using enzyme-linked immunosorbent assay kits.  
Results: FNDC5 and irisin levels reduced significantly in the diabetes control group (P=0.0001). FNDC5 levels in the diabetes + exercise + stem cell and the exercise group increased significantly compared to the diabetes control group (P=0.0001). The irisin level in the diabetes + stem cell + exercise group, exercise group and stem cell group increased significantly compared to the diabetes control group (P=0.0001).  
Conclusion: The results indicate that aerobic exercise program and stem cell therapy alone and combined can significantly increase plasma irisin levels. Given the favorable effects of adipose tissue-derived stem cell injection and aerobic exercise on FNDC5 and irisin levels, this strategy could be further evaluated in coping with the adverse effects of diabetes on metabolism and aging

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Background and objectives: Diagnosis glucose intolerance in pregnancy is very important in preventing maternal and fetal complications. In this study, we compared hematological and biochemical characteristics of healthy pregnant women and women with gestational diabetes mellitus (GDM) to find predisposing and prognostic variables of GDM.

Methods: In this study, 80 pregnant women (at 24-28 weeks of pregnancy) were divided into a GDM group and non-GDM group by performing oral glucose tolerance test using 75 g glucose according to the International Association of the Diabetes and Pregnancy Study Groups criteria.
Results: The mean age of women with GDM was significantly higher than those without GDM (p=0.048). Other variables including body mass index, gestational age and daily sleep duration did not differ significantly between the two groups (P>0.05). There was a significant association between family history of diabetes and incidence of GDM (p=0.040). In addition, the C-peptide level was significantly higher in pregnant women with GDM (p=0.004).
Conclusion: Considering the role of C-peptide in predicting metabolic syndrome, it is suggested to use this factor for identification of GDM patients.

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Background and objectives: Programmed autophagy is a genetically and evolutionarily conserved process that destroys long-lived cellular proteins and organelles. This study aimed to investigate effects of continuous and interval exercise training with or without atorvastatin supplementation on Beclin1, LC3-I and LC3-П expression in old rats with type 2 diabetes.
Methods: Sixty three male Wistar rats were divided into eight groups. Continuous exercise was performed at a speed of 15-29 m/min for 5-22 minutes. Interval exercise program consisted of six 2.5-minute sets that included a four-minute rest period between each set. The rats in the supplementation groups also received 20 mg/kg body weight atorvastatin daily via intraperitoneal injection. At the end of the training period, the expression of Beclin1, LC3-I and LC3-П in soleus muscle was measured by RT-PCR. One-way ANOVA was used for data analysis at statistical significance of 0.05.
Results: The results showed that both exercise trainings with or without atorvastatin significantly reduced LC3I, LC3-II and Beclin1 compared with the diabetic control group (P<0.05). In addition, the effects of the trainings and atorvastatin supplement did not differ significantly (P>0.05).
Conclusion: The results indicate that continuous and interval exercise program alone and combined with atorvastatin supplementation could significantly reduce LC3-1, LC3-II and Beclin1 level in soleus muscle of old diabetic rats.

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Background and objectives: Clinical evidence has demonstrated the important role of adiponectin in insulin signaling pathways in target tissue. The aim of this study was to determine effects of aerobic training on insulin sensitivity, glucose level, and adiponectin expression in subcutaneous adipose tissue of type 2 diabetic rats.
Methods: Type 2 diabetes was induced in 14 male wistar rats by intraperitoneal injection of nicotine amide and streptozotocin. The rats were randomly divided into an exercise group (n=7) and a control group (n=7). The rats in the exercise group performed aerobic training in from of treadmill running, five sessions a week, for 12 weeks. Subjects in the control group did not perform any training. Glucose level, insulin level, insulin sensitivity, and adiponectin expression in subcutaneous adipose tissue were determined at baseline and 48 hours after the lasting training session. Independent t-test was used for comparing the variables between the study groups.
Results: Aerobic training resulted in a significant increase in serum insulin (p=0.006), insulin sensitivity (p=0.003), and adiponectin expression in subcutaneous adipose tissue (p=0.037) compared with the control group. In addition, the training caused a significant decrease in fasting glucose level compared with the control group (p<0.001).
Conclusion: Based on these findings, the decrease in blood glucose may be attributed to the improvement of adiponectin-dependent insulin signaling pathways in adipose tissue in response to aerobic training. However, more cellular-molecular studies are needed to understand the mechanisms responsible for these changes.

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Background and objectives: Increased oxidative stress and altered antioxidant levels play an essential role in the pathogenesis of diabetes mellitus. Menopause is associated with increased food intake, weight gain, metabolic disorders, and increased level of inflammatory and oxidative stress factors. This study evaluated effects of oleuropein extract on brain tissue and serum oxidative status in ovariectomized diabetic rats.
Methods: In this study, 40 female Wistar rats weighing 250±20 grams were randomly divided into four groups: control, sham (surgery without ovariectomy), ovariectomy+diabetes, and ovariectomy+diabetes+oleuropein supplementation. Diabetes was induced by intraperitoneal injection of streptozotocin. The rats in the treatment group received 60 mg/kg of oleuropein for 30 days by oral gavage. Finally, blood glucose, superoxide dismutase, glutathione peroxidase, total antioxidant capacity, and malonaldehyde levels were evaluated in serum and brain tissue samples.
Results: Weight, blood glucose level, and antioxidant enzymes activity increased significantly in the ovariectomy+diabetes group compared to the control group.
Conclusion: This study suggested that the administration of oleuropein extract has beneficial effects on blood glucose level and antioxidant status in serum and brain tissue of ovariectomized diabetic rats.

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Background and objectives: Diabetes mellitus is the most common metabolic disorder in the world. Here, we evaluated effects of resveratrol supplementation alone and combined with exercise on blood glucose, insulin, lipid profile, apoptosis biomarkers, and expression of farnesoid X receptor (Fxr), liver X receptor (Lxr), and sirtuin 1 (Sirt 1) genes in the liver of type 1 diabetic rats.
Methods: Streptozotocin was used to induce type 1 diabetes in Wistar rats. The rats were randomly assigned into seven groups. After treatment with resveratrol alone or combined with exercise training, the animals were sacrificed and lipid profile and levels of blood glucose and insulin were measured. Hepatocyte apoptosis was assessed by measuring the level of Bax and Bcl2 proteins using enzyme-linked immunosorbent assay kits. Expression of Fxr, Lxr, and Sirt1 was evaluated using real-time polymerase chain reaction. Comparison of the mean levels of all variables between different groups was performed using one-way analysis of variance, at statistical significance level of 0.05.
Results: Resveratrol significantly reduced the level of blood glucose and insulin compared with the control groups (p<0.001). It also significantly affected the lipid profile (p<0.001). Diabetes was significantly associated with decreased expression of Sirt1, Lxr, and Fxr and increased hepatocyte apoptosis. Resveratrol significantly improved the expression of all three genes (p<0.01). Overall, resveratrol supplementation combined with exercise was more effective than other methods.
Conclusion: The results indicate that that combination of resveratrol therapy with exercise could be beneficial for diabetic patients. However, more studies are needed to confirm this finding.
 

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Background and objectives: Considering racial/ethnic differences is necessary when recommending lifestyle modifications for patients with diabetes. Racial/ethnic diversity may affect hypoadiponectinemia responses to exercise training among individuals with type 2 diabetes. This systematic review and meta-analysis is the first to investigate effects of exercise training on circulating adiponectin concentrations in Iranians with type 2 diabetes.
Methods: Literature searches of the Cochrane Central Register of Controlled Trials were carried out using the following search strategy: [exercise OR training OR physical activity OR Training] AND diabetes AND adiponectin. Next, RCTs were included and compared with each type of supervised exercise (aerobic training, resistance training, or combined training). Pooled intervention effects were evaluated and reported as standardized mean difference (MD) and 95% confidence intervals using a random effects model. Subgroup and sensitivity analysis was performed for study heterogeneity and following primary screening full text of the articles was evaluated.
Results: Fourteen studies with 444 individuals (236 men and 128 women) were included in the analysis. The age of the participants ranged between 18 and 60 years. The number of exercise sessions per week ranged between 3 and 5. The duration of interventions ranged between 6 and 12 weeks. The meta-analysis showed that adiponectin levels increased significantly in diabetic subjects after physical activity (MD: 0.72 ng/dl, p<0.001,), but the heterogeneity of the study remained significant (I²= 89%).
Conclusion: Overall, physical exercise, particularly aerobic exercise, increases adiponectin levels in Iranians with diabetes. However, this effect of exercise may be influenced by race/ethnic differences, type of training, frequency, type of adiponectin measurement, and complex and heterogeneous exercise responses of individual with diabetes.

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Background: Omentin-1 plays an important role in insulin function. Despite numerous studies, the effect of interval training on this adipokine is still vague. This study aimed to elucidate the effect of high-intensity interval training (HIIT) on serum glucose, insulin, insulin resistance (IR), omentin-1 serum levels, and gene expression in the visceral adipose tissue in type 2 diabetic (T2D) rats.
Methods: In an experimental study, 20 male rats (8-10 weeks, weight: 250-270 g) were randomly divided into 2 groups: diabetic control (N=10) and diabetic training (N=10). The training protocol was 30 minutes of HIIT (1-min run, 2-min rest) performed 5 days a week for 4 weeks. Fasting blood glucose, insulin resistance, omentin-1 serum level, and gene expression were measured in the visceral fat 48 hours after the last exercise for both groups.
Results: The HIIT resulted in lower serum glucose and insulin resistance (P = 0.001), higher serum omentin-1 levels (P = 0.001), and higher visceral fat gene expression (P = 0.004) in the training group compared to the control group.
Conclusion: Lower serum glucose and insulin resistance and higher omentin-1 serum levels and gene expression in the training group can prove the effectiveness of HIIT training in T2D, although further research is required.
 

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Background: A higher occurrence of raised homocysteine levels has been reported in individuals with type 2 diabetes (T2D), particularly those with macroangiopathy and nephropathy. Given that hyperhomocysteinemia is a risk factor for T2D, mitigating this condition could potentially benefit T2D patients. This study aimed to investigate the influence of homocysteine on T2D and cardiovascular disease (CVD), as well as the factors that modify homocysteine levels.
Methods: This cross sectional, observational study was conducted on 122 individuals in a tertiary care center in Western India. Data related to anthropometry, demography, and biochemistry were gathered following established standards. Statistical analysis was performed using Chi-square test. A P-value of <0.05 was considered statistically significant.
Results: The findings indicated a significantly larger percentage of hyperhomocysteinemia in males, smokers, and individuals with elevated fasting blood sugar and HbA1c levels. The proportion of subjects with high homocysteine levels was notably greater in those with high total cholesterol and triglyceride levels. A significant correlation was observed between increased serum homocysteine levels and decreased serum folic acid and vitamin B12 levels in patients with ischemic heart disease.
Conclusion: Elevated homocysteine levels are observed in smokers and diabetic patients, potentially leading to CVD. Furthermore, this study found a correlation between an increase in serum homocysteine levels and a decrease in serum folic acid and vitamin B12 levels in patients with ischemic heart disease.
 

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Background: Type 2 DM is a heterogeneous group of disorders characterized by insulin resistance, impaired insulin secretion, increased glucose production, and abnormal fat metabolism. Diabetes mortality primarily results from microvascular complications such as diabetic retinopathy, nephropathy, and neuropathy, as well as macrovascular complications like coronary artery, peripheral vascular, and cerebrovascular diseases. Patients with diabetes usually have changes in adipose tissue metabolism and abnormalities in the secretion of adipokines such as leptin. The present study aims to study the relationship between serum leptin levels and lipid profile parameters among non-obese type 2 diabetes mellitus patients and non-diabetic individuals.
Methods: This hospital-based cross-sectional study was conducted among 41 type 2 diabetic patients and 41 non-diabetic individuals of both sexes between the ages of 40 and 70. Fasting blood glucose (FBS), serum leptin, total cholesterol (TC), triglyceride (TG), and high-density lipoprotein (HDL) levels were assayed.
Results: The mean serum leptin levels among diabetic patients were lower than those of non-diabetic individuals, and this difference in mean was statistically significant. The study showed a significant negative correlation between serum leptin, TC, TG, and low-density lipoprotein (LDL), and a positive correlation with HDL. In the final regression model, serum leptin showed a statistically significant association with FBS and HDL.
Conclusion: This study demonstrated that serum leptin levels can be a strong predictor of low HDL levels in diabetic patients. It can also contribute to raised levels of total cholesterol, triglyceride, and LDL, which are responsible for macrovascular complications in diabetics.
 

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Background: Anti-diabetic properties of several Ficus species have been explored in animal studies; nevertheless, there is a dearth of research on the hypoglycemic effects of the bark of Ficus Lacor Buch.-Ham. To address this knowledge gap, this study was conducted to assess the hypoglycemic activity of an aqueous extract derived from the bark of Ficus Lacor Buch.-Ham in diabetic rabbits.
Methods: Diabetes was induced in rabbits using alloxan monohydrate (120 mg/kg intravenously). A total of thirty-six rabbits were divided into six groups, each consisting of six animals. The control groups comprised a non-diabetic control group and a diabetic control group. Two test groups, designated as the low-dose and high-dose extract group, received Ficus Lacor extract orally at doses of 100 and 200 mg/kg, respectively, for 6 weeks. Metformin was utilized as an active control group. To evaluate the hypoglycemic effects in normal rabbits, a group of non-diabetic rabbits received Ficus Lacor extract at a dose of 200 mg/kg. Fasting and post-prandial blood sugar levels were monitored on a weekly basis for 6 weeks and subsequently compared. The percentage reduction in blood sugar levels was calculated for each group and compared among the study groups.
Results: At the end of the 6-week, the low-dose Ficus Lacor extract led to an average reduction of 38.3% in FBS and 40.5% in PP2BS, while the high-dose Ficus Lacor extract resulted in an average reduction of 35.3% in FBS and 36.3% in PP2BS.
Conclusion: Aqueous extract of bark of Ficus Lacor demonstrates significant hypoglycemic activity.

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Introduction:Diabetes Mellitus is a metabolic disorder whose pathophysiology has been linked to various genetic and environmental factors. The main mechanism of the development of complications has been implicated as inflammation mediated. Various blood cell parameters are being used as early indicators of inflammation mediated endothelial dysfunction and thereby predict the severity or prognosis of diabetes mellitus. In this study, we aim to evaluate the role of Platelet-lymphocyte ratio in predicting the glycemic control of diabetic patients.
Methods:This is a retrospective, hospital based study conducted from August 2023 to December 2023. A total of 134 patients were included in the study. The hematological and biochemical reports of the study population were retrieved, and the data obtained was analyzed using SPSS software version 16.0.
Results: In this study, it has been found that the platelet lymphocyte ratio is significantly increased in diabetic patients with poor glycemic control as compared to diabetic patients with good glycemic control (p<0.001). This is in concordance with other studies that reported a positive association between platelet lymphocyte ratio and disease severity.
Conclusion:Platelet lymphocyte ratio can be used as a predictive marker in assessing the severity and prognosis of diabetic patients, but the exact cut off value is yet to be determined.