Publications by authors named "M Aalaa"

27 Publications

Empowering Health Care Providers and Self-management Education in Diabetes? A Scoping Review.

Int J Endocrinol Metab 2021 Jul 19;19(3):e111765. Epub 2021 Jul 19.

Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Context: There has been an increasing emphasis on the role of education in diabetes prevention and management, and shedding light on evidence gaps is mandatory for national action plans establishment.

Data Sources: This scoping review was part of the Iranian Diabetes Road Map project that used a systematic method based on the Arksey and O'Malley approach.

Results: After the screening, 173 articles were included, most of which were published in 2018 and focused on self-management. Most included articles were considered patient-related self-management/care/efficacy, while only a limited number of articles studied healthcare provider education and educational establishment. Additionally, a significant number of included studies were addressed virtual education, an issue as the strength of Iranian studies in diabetes education.

Conclusions: Education is an important part of diabetes, and specific needs for Iranian patients should be addressed in future studies. Paying attention to new topics and conducting high-quality interventional studies will help fill evidence gaps in this field in Iran.
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http://dx.doi.org/10.5812/ijem.111765DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8453654PMC
July 2021

Diabetic foot self-care practice in women with diabetes in Iran.

Diabetes Metab Syndr 2021 Sep-Oct;15(5):102225. Epub 2021 Jul 26.

Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. Electronic address:

Background And Aims: The present study was conducted to determine the situation of foot self-care practice among Iranian women with diabetes.

Methods: In this cross-sectional study, 475 women completed the Diabetic Foot Self-Care Questionnaire (DFSQ) along with other questions. The overall and three components scores including personal care, podiatric care, and foot wearing, were calculated and their relationship with other factors was analyzed.

Results: The average total DFSQ score was 60.38 ± 9.9, and 16.98 ± 7, 5.95 ± 2.11, and 12.26 ± 3.95 for personal care, podiatric care, and footwear respectively. Education level, self-reported health status, and life satisfaction had a significant relationship with footwear score, and smoking and life satisfaction were related to personal care and podiatric care respectively. In Pearson regression, DM self-care was correlated with all three components and total DFSQ score. Also, depression and SCS (Social Capital Status) correlated with DFSQ scores except with personal self-care and footwear respectively. Body Mass Index (BMI) and Quality of Life (QoL) were significantly correlated with footwear and podiatric care scores.

Conclusion: In this study, the DFSQ result was almost acceptable, however, it highlights the importance of suitable interventions to establish better self-care practice among Iranian diabetic women.
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http://dx.doi.org/10.1016/j.dsx.2021.102225DOI Listing
July 2021

Social-capital determinants of the women with diabetes: a population-based study.

J Diabetes Metab Disord 2021 Jun 9;20(1):511-521. Epub 2021 May 9.

Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Introduction: Social-capital level contributes to clinical factors and health outcomes of patients suffering from diabetes. Considering the social determinants of type 2 diabetes patients could benefit to prevention of diabetes complications especially in women population. This study aims to determine social capital determinants in women with diabetes.

Methods: Four hundred and thirty-five women with diabetes take-part in this cross-sectional, multi-centric study. The data was completed by a demographic questionnaire and the Social Capital instrument (SC-IQ). This study is investigating demographic (age, gender, BMI, marital, educational and social-economic status), and lifestyle factors (physical activity, nutrition), Diabetes status (HbA1c Level, medications, complications, duration of diabetes), general health status (life satisfaction, self-rated health, physical activity, and depression) and Social capital items (Value of life, Tolerance of Diversity, Neighborhood network, Family and Friends Connections, Work connections, Community participation, Feeling of trust and Safety and Proactivity). The descriptive statistics and linear regression models were used to assess the associations between social capital and determinants.

Results: The mean age of participants was 50 (SD: 7.7), range 28-71 year. The mean social capital score was 77.8 (SD: 15.8). In linear regression analysis, results showed that women who had the greater score in total social-capital (ß: 3.7, SE: 1.5) and Feeling of trust and Safety (ß: 0.87, SE: 0.42) had vigorous physical activity and also women who had greater score in Neighborhood Connections had moderate physical activity in comparison with patients who had low physical activity. (ß: 0.67, SE: 0.26 and ß: 0.61, SE: 0.26).Also, the findings showed that women who had had a lower score in total social-capital (ß: 6, SE: 1.47), Community participation (ß: 1.44, SE: 0.37), Value of life (ß: 1.71, SE: 0.24), Family and Friends Connections (ß: 0.88, SE: 0.25) and proactivity (ß: 0.71, SE: 0.25) had depression in comparison with patients who had no depression. The findings revealed that instead of each year increase in the duration of diabetes, the total social-capital score had decreased about the half score (ß: 0.48, SE: 0.21).

Conclusions: Important social factors that make diabetes control are alterable to health interventions. The results of the current study suggest that social capital status may determine how effectively the women with diabetes have been managed. This initial finding permits subsequent experimental investigations to identify social strategies that can be valuable to improve diabetes control.
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http://dx.doi.org/10.1007/s40200-021-00772-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8212190PMC
June 2021

The effects of dietary/herbal supplements and the serum levels of micronutrients on the healing of diabetic foot ulcers in animal and human models: a systematic review.

J Diabetes Metab Disord 2021 Jun 26;20(1):973-988. Epub 2021 May 26.

Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Purpose: Diabetic Foot Ulcer (DFU) is one of the common and serious complications in patients with Diabetes Mellitus (DM) worldwide. Given the considerable tendency of patients suffering from DFU to use the complementary therapies, the objectives of this study were to: (i) summarize the effects of dietary and herbal supplements on DFU characteristics and metabolic parameters in both animal models and clinical trials, and (ii) evaluate any links between the serum levels of micronutrients and DFU in observational studies.

Methods: A systematic search in five electronic databases including PubMed/Medline, Scopus, Web of Science, Embase, and Cochrane Library was conducted to find relevant English language published from 1990 until 31 December 2018.

Results: Of a total of 8603 studies, 30 eligible papers including animal studies ( = 15), clinical trials ( = 7), and observational works ( = 8) were included in the systematic review. We found that some dietary/herbal supplements and micronutrients had positive effects on the wound healing. However, limited evidence is existed. Also, lower serum levels of vitamin D, C, vitamin E, and selenium in patients with DFU were likely to increase the risk of DFU, leading to impaired wound healing.

Conclusion: Findings suggested that some dietary and herbal supplements such as Vitamin D, Magnesium, Vitamin E, Probiotic, Zinc, and Pycnogenol would be effective on wound healing of DFUs. However, further high-quality randomized controlled clinical trials and prospective cohort studies are needed to clarify the roles of micronutrients and other dietary and herbal supplements on the progress and treatment of DFU.
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http://dx.doi.org/10.1007/s40200-021-00793-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8212333PMC
June 2021

The rationale behind systematic reviews in clinical medicine: a conceptual framework.

J Diabetes Metab Disord 2021 Jun 8;20(1):919-929. Epub 2021 Apr 8.

Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

A systematic review (SR) is a type of review that uses a systematic method to provide a valid summary of existing literature addressing a clear and specific question. In clinical medicine (CM), the concept of SR is well recognized, especially after the introduction of evidence-based medicine; The SR of randomized clinical trials (RCTs) is considered the highest level of evidence on therapeutic effectiveness. Despite the popularity of the SRs and the increasing publication rate of SRs in CM and other healthcare literature, the concept has raised criticisms. Many of proper criticisms can be due to the deviation of some existing SRs from the original philosophy and well-established rationale behind the concept of SR. On the other hand, many criticisms are misconceptions about SRs which still exist even several decades after introducing the concept. This article presents a conceptual framework for clarifying the rationale behind SR in CM by providing the relevant concepts and their inter-relations, explaining how methodological standards of an SR and its rationale are connected, and discussing the rationale under the three-section: SR as a type of synthetic research, SR as a more informed and less biased review, and SR as an efficient scientific tool.
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http://dx.doi.org/10.1007/s40200-021-00773-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8212290PMC
June 2021
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