Introduction: Due to the worldwide prevalence of diabetes, the disease has become a pandemic giving much more weight to its side effects. One of the chronic complications related to diabetes is Diabetic Nephropathy that leads to notable rate of death. Microalbuminuria is one of the determinants that predicts the onset of diabetic nephropathy.Materials and Methods: This study was carried out on 369 type 2 diabetic patients who referred to a diabetes clinic in karaj. A questionnaire inquiring the participants’ age, gender, duration of diabetes and family history of diabetes was filled out. Body Mass Index (BMI) and Blood Urea Nitrogen (BUN), the levels of Creatinin, Cholesterol, Triglyceride as well as HbA1C measurements were examined. Then, the twelve-hour urine samples collected from the patients with standard method s were examined for urine culture, urine analysis and urine albumin.Results: Out of 369 patients, 309 (83.7%) were diagnosed as normoalbuminuric (Albumin excretion less than 20 mcg/min), 57 (15.5%) were microalbuminuric (Albumin excretion between 20- 200 mcg/min) and 3 (0.8%) were macroalbuminuric (Albumin excretion more than 200 mcg/min). Statistically, there was a significant difference between blood creatinin, BMI and HbA1C of patients in two groups of microalbuminuria and normoalbuminuria, but there were no significant differences in age, sex, duration of diabetes, family history of diabetes, blood pressure, and hyperlipidemia between the two groups of the study. Because of the small sample size of macroalbuminuric patients, statistical analyses on this group are not considered valid. Conclusion: In the mentioned population, the prevalence rate of microalbuminuria is 15.5 percentage and the increase of blood creatinin, BMI as well as the indication of poor blood Glucose control are among the risk factors that cause microalbuminuria.

Introduction: Diabetes Mellitus is the most prevalent endocrine disease. It causes several complications, such as retinopathy and nephropathy. The aim of this study is to evaluate the effect of diabetes mellitus on sensory-neuron auditory impairment.       Materials and Methods: We conducted this case - control study during the years of 2006-2008 with the collaboration of Mashhad Diabetes Center and the Audiometric Clinic at Ghaem Hospital. Considering the inclusion and exclusion criteria, 300 diabetic patients, as the case group and 300 persons as the control group entered this study. These two groups were matched by sex and age. Audiometric examinations, consisting of Pure Tone Audiometric Test, Diapason Tests and Autoscopy were administered on the participants in the present study.Results: There was a significant difference between control and case groups in sensory-neuron auditory impairment at high and low-median frequencies. Also, there was not any association between the duration of the disease and the level of sensory-neuron auditory impairment (P>0.05). In addition, the findings indicate a significant relationship between the complicated and uncomplicated groups in terms of the level of sensory-neuron auditory impairment at high frequencies. Patients with type II Diabetes Mellitus showed prominent sensory-neuron auditory impairment at high and low-median frequencies, as compared to the control group (P<0.05). There was not such association in Type I Diabetes Mellitus (P>0.05). Furthermore, there was a significant difference between two types of Diabetes Mellitus in the level of sensory-neuron auditory impairment. which was prominent in high frequencies (P<0.05). Also, this study showed that there was not any sex difference in the sensory-neuron auditory impairment (P>0.05).Conclusion: We propose the necessity of administrating regular audiometric examinations for the patients with diabetes mellitus. Early detection of sensory-neuron auditory impairment can decrease its progression due to better glycemic control.

Introduction: Liver is the main organ in the metabolic process of carbohydrates. Alterations in carbohydrates metabolism and diabetes mellitus (DM) are common in cirrhotic patients. For instance, resistance to insulin is an important prognostic factor in liver cirrhosis. The aim of this study is to determine the incidence of diabetes and its effective factors in cirrhosis patients, as compared to the normal group. Materials and Methods: This case-control study was conducted on 100 patients with cirrhosis who were admitted to Aria, Bahman 2nd and Shahrivar 17th Hospitals. The subjects were selected through simple random sampling. Based on the criteria adopted for this study, the patients were qualified to enroll in the study. Checklists were completed for the patients. The presence of DM on the part of the subjects was diagnosed either by having a history of DM and the use of anti-diabetic drugs such as glybenclamid and insulin, or FBS ³ 126 mg/dL at two times. Data analysis was performed using Pearson Chi-square and Fisher exact test.Results: Out of all patients 37 were females and 63 were males (Mean age 63.57 years). Prevalence of DM and IFG in these patients were much more than normal population (P<0.05). There were significant statistically relationship between sex (F>M) and age>60 years in diabetes and cirrhosis patients in compare with normal group (P<0.05). Family history of DM and severity of cirrhosis were also associated with DM (P<0.05). Among complications of cirrhosis, prevalence of DM was more in patients with encephalopathy and ascites.Conclusion: In this study, our findings indicate that cirrhotic patients are at the increased risk of DM occurrence. Female sex, age>60 years, family history of DM, severity of liver disease and presence of encephalopathy and ascites were associated with DM occurrence in these patients. The Regular screening for DM can be useful for early diagnosis and treatment of these patients.

Introduction: Polyneuropathy is defined as a diffused peripheral nerve disorder that presents with sensory, motor or autonomic dysfunctions. This study aims at determining the causes of polyneuropathy among patients who referred to Bahman 22nd  Hospital in Mashhad.Materials and Methods: This is a descriptive study that was carried out on 31 patients suspected to polyneuropathy referring  to Bahman 22nd  Hospital in Mashhad during the years of 2007-2008.  The study collected data on the patients’ past medical history, drug history and family history of manifesting similar symptoms. Also, the research undertook neurological examinations and neurophysiologic studies on all the participating patients. Polyneuropathy was confirmed using electrophysiologic studies. Supplementary laboratory exams were conducted with patients’ consent to diagnose polyneuropathy. Statistical analysis was then done on the collected data using SPSS software.Results: The most frequent cause of  polyneuropathy was found to be CIDP. The other causes were determined as diabetes mellitus in 16.5% of the participants, GBS in 16.5% as well as leprosy, toxic and hereditary causes each in 9.7% of the participants . Also Vitamine B12 deficiency was determined to be the cause in 6.5% of the cases. We didn’t find any determinative cause of the disease in 9.7% of the cases; so, they were classified as cryptogenic. Among the predominating clinical manifestation was sensory complains (66.7%). Pain and temperature disorders were the most common presentations (87.1%). It was also found that muscle tonicity affected mostly the distal area of lower extremities. Muscle strength was found to be diminished in the distal areas of both lower and upper extremities. Moreover, Achilles Reflex function was reduced in 87.1% of the patients in this study.Conclusion: The most frequent causes of polyneuropathy were inflammation and metabolic disorders. Muscle tonicity, muscle strength and deep tendon reflexes were reduced in the distal areas of extremities. Therefore, in neurological examinations, detailed evaluation of distal areas is essential.

Introduction: Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance with onset or first recognition during pregnancy. The prevalence range from 1 to 14% of all pregnancies, depending on the population studied and the diagnostic tests employed. Risk assessment for GDM should be undertaken at the prenatal visit. Women with clinical characteristics of GDM should undergo glucose testing as soon as possible. If they are found not to have GDM at that initial screening, they should be retested between 24 and 28 weeks of gestation. Women of average risk should have testing undertaken at 24-28 weeks of gestation.Low risk status requires no glucose testing. Risk factors of GDM include, obesity, history of diabetes in first degree relatives, previous history of diabetes, glycosusia, history of birth with more than 4 kg still birth or malformation, polyhydamnius, age more than 25 years, member of an ethnic group with a high prevalence of diabetes, maternal low birth weight.  GDM of any severity increases the risk of fetal macrosomia, neonatal hypoglycemia, heart hyperthrophy, jaundice, polycythemia, and hypocalcemia, obesity and stillbirth.