Diabetes is the most common metabolic causes of increased mortality rate due to its multiple complications. Diabetes, thus, influences patients’ quality of life because of its resultant physical disabilities and mental health problems. This study aimed to investigate health-related quality of life among Iranian patients with type 2 diabetes. In this meta-analysis study, a search was conducted using the keywords: Quality of Life, Health-Related Quality of Life, QoL, HRQoL, Shortform questionnaire 36, SF-36, Diabetes and Iran in the national and international databases such as SID, MagIran, ISI/Web of Science, PubMed [including Medline], and Scopus between 2011 and 2018. Based on the heterogeneity of data, the random effects model was used. Data was analyzed using the Stata software version 14. Overall, 17 studies were eligible, with a total sample size of 5472 patients, and they showed that the mean score of the physical dimension in patients with type 2 diabetes (53.5, 95% CI: 43.1–63.9) was less than the mean of mental dimension score (54.5, 95% CI: 47–61.9). By increasing age of the samples, the mean of the HRQoL score of the Iranian patients with type 2 diabetes was significantly decreased (p = 0.015). The highest and lowest scores for the quality of life subscales were social function and general health, respectively. In conclusion, patients with type 2 diabetes have been shown to have moderate quality of life. Providing solutions to improve the quality of life in this group of patients, especially in the physical aspect, is required.

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Health-related quality of life in Iranian patients with type 2 diabetes: An updated meta-analysis.

The serpin peptidase inhibitor, clade E, member 2 (SERPINE2) inhibits urokinase-type plasminogen activator (PLAU) and tissue-type plasminogen activator. Higher SERPINE2 expression levels were detected in cumulus cells of human immature oocytes than in those of mature oocytes. The objective of this study was to evaluate whether high SERPINE2 levels in cumulus cells are associated with oocyte immaturity. Using the mouse cumulus-oocyte complex as an experimental model, the effects of elimination and overexpression of SERPINE2 in cumulus cells on cumulus expansion and oocyte maturation were assayed by in vitro maturation. Serpine2 and PLAU transcripts were the most highly expressed serpins and plasminogen activators, respectively. Their expression was coordinately regulated in cumulus cells during gonadotropin-induced oocyte maturation. Silencing of Serpine2 expression using small interfering RNAs or blockage of SERPINE2 protein using a specific antibody had no effect on oocyte maturation. However, overexpression of Serpine2 or exogenous supplementation with high levels of SERPINE2 impaired cumulus expansion and oocyte maturation, probably by decreasing hyaluronan synthase 2 (Has2) and versican (Vcan) mRNA expression. Amiloride, a specific PLAU inhibitor, also suppressed these processes. PLAU supplementation of the oocyte in vitro maturation medium caused earlier and more extensive expansion of cumulus cells and oocyte maturation that may be mediated by increased Has2 mRNA expression. However, these effects were neutralized by coincubation with SERPINE2 or amiloride and PLAU. In conclusion, SERPINE2 and PLAU are involved in cumulus expansion and oocyte maturation. High SERPINE2 levels impair these processes, probably by decreasing cumulus matrix gene expression as well as reducing cumulus hyaluronan contents and inhibiting PLAU activity. These findings may explain why cumulus cells surrounding immature human oocytes express high SERPINE2 levels.

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Involvement of the Serine Protease Inhibitor, SERPINE2, and the Urokinase Plasminogen Activator in Cumulus Expansion and Oocyte Maturation

Introduction: In vitro maturation (IVM) of oocytes and subsequent, in vitro fertilization (IVF) for the generation of embryos in the laboratory has important values. Growth factors are a component of a complex system of autocrine and paracrine factors that have a regulatory role in ovarian function and affect oocyte maturation. Therefore, the aim of this study is to evaluate the effect of IGF-I on IVM and IVF of mice oocytes during culture with α-MEM and TCM199 medium.

Materials and Methods: Cumulus oocyte complexes (COCs) and denuded oocyte were obtained from 4-6 week old NMRI mice and underwent in vitro maturation and in vitro fertilization in presence or absence of IGF-I with α-MEM and TCM199.

Result: Maturation rate (79.6%), fertilization rate (87.2%), two cells development rate (79.5%) and blastocyst rate(43.2%) was higher in COCs cultured in α-MEM with IGF-I, while lower maturation rate (50.6%) fertilization rate (61%), two cells development rate (48.8%) and blastocyst rate(14.6%) were seen in cultured denuded oocytes (DOs) in TCM199 without growth factor. As well as, maturation fertilization, two cells development and blastocyst rates in COCs were higher than DOs.

Conclusion: Our findings have shown that IGF-I is involved in the oocyte biology and improve the oocyte maturation, fertilization and embryo development to blastocyst competence in vitro. In addition, it has also shown that cumulus cells are vital for oocyte development when IGF-1 added to the mediums.

Influence of Insulin-Like Growth Factor-I on Maturation and Fertilization Rate of Immature Oocyte and Embryo Development in NMRI Mouse with TCM199 and α-MEM Medium.

Purpose
Evaluation of viability and subsequent developmental ability of mouse germinal vesicle breakdown oocytes vitrified in conventional straws.

Mouse oocyte vitrification: the effects of two methods on maturing germinal vesicle breakdown oocytes.

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.

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Developing a Clinical Diabetes Guideline in Diabetes Research Network in Iran

Health related quality of life in patients with of type II diabetes in Iran

Received: 10/Sep/2008, Accepted: 8/Mar/2009 Objective: The purpose of this study is to investigate the effect of cumulus cells on maturation, fertilization and subsequent development of mouse germinal vesicle oocytes. Materials and Methods: A total of 470 germinal vesicle (GV) oocytes were obtained from 26 ovaries of 3- 4 week old ICR female mice 48 hours after injection of 5 IU pregnant mare serum gonadotropin (PMSG). Collected oocytes were divided into two groups; group I: GV oocytes without cumulus cells (denuded oocyte), group II: GV oocytes with cumulus cells (cumulus-oocyte complex). The oocytes in both groups were cultured in TCM-199 medium supplemented with 10% fetal bovine serum (FBS) for 22- 24 hours in a humidified atmosphere of 5% CO 2 in air at 37°C. Oocyte maturation was scored under inverted microscope. To do in vitro fertilization, matured oocytes from each group were placed in T6 medium and capacitated spermatozoa were added. Then the fertilized oocytes were cultured and assessed for cleavage to the 2-cell stage 24 hours and production of blastocyst 120 hours after fertilization. Data was analyzed by chi-square test and differences in the values were considerable significant when p<0.05. Results: Maturation, fertilization, cleavage and blastocyst rates in denuded oocytes were: 76.32%, 57.49%, 51.15% and 19.14% respectively. In the cumulus-oocyte complex rates were: 89.41%, 80.76%, 75.58% and 45.62% respectively; all in the cumulus-oocyte complex were significantly higher than those of denuded oocytes (p<0.05). Conclusion: The present study indicates that cumulus cells have important role during maturation, fertilization and subsequent embryo development to the blastocyst stage.

Abou Alhasani Farid

Papers

Health related quality of life in patients with of type II diabetes in Iran

Cumulus cell role on mouse germinal vesicle oocyte maturation, fertilization, and subsequent embryo development to blastocyst stage in vitro

The effects of vitrification on spindle apparatus of in vitro matured germinal vesicle in mice