The evolutionary conserved family of heat shock proteins (HSP) is responsible for protecting cells against different types of stress, including oxidative stress. Although the levels of HSPs can be readily measured in blood serum, the levels of HSP70 in patients with different durations of diabetes have not been studied before. We quantified serum HSP70 levels in a healthy control group (n=36) and two groups of type 2 diabetic patients, defined as newly diagnosed diabetes (n=36) and patients with diabetes duration of more than 5 years (n=37). The clinical characteristics and biochemical parameters were evaluated in the studied population. We found that serum HSP70 levels were significantly higher in patients with diabetes when compared with controls (p<0.001) and it was higher in patients with disease for more than 5 years than in newly diagnosed patients (p<0.001). Serum HSP70 was inversely correlated with fasting blood sugar in patients with diabetes for more than 5 years (r=−0.500, p=0.002), positively correlated with the history of hypertension in newly diagnosed patients (p<0.001), and positively correlated with age in patients with diabetes (r=0.531, p=0.001). Serum level of HSP70 is significantly higher in patients with diabetes and correlates with the duration of disease. Higher HSP70 in prolonged diabetes versus newly diagnosed diabetes may be an indicator of metabolic derangement in the course of diabetes.

Oxidized low-density lipoprotein (ox-LDL) plays a key role in the progression of atherosclerosis and diabetes complications. The aim of this study was first, to evaluate the association between ox-LDL and diabetes duration, and second, to examine serum level of ox-LDL in patients with prolonged diabetes and a desirable LDL-cholesterol level. A total of 36 type-2 diabetic patients with a diabetes duration of more than 5 years, 36 newly diagnosed diabetic patients, and 36 age-, sex- and BMI-matched healthy participants were recruited. Healthy participants and newly diagnosed patients were not receiving any treatment. All patients with prolonged diabetes had desirable LDL-cholesterol levels (<100 mg/dL), according to the adult treatment panel-III guidelines. While LDL-cholesterol was significantly lower in patients with diabetes duration >5 years, in comparison to newly diagnosed patients (P < 0.01), ox-LDL was significantly higher in patients with prolonged diabetes (P < 0.001). The ox-LDL-to-LDL ratio was dramatically higher in patients with diabetes duration >5 years in comparison to newly diagnosed patients and healthy participants (P < 0.001). Ox-LDL was significantly associated with diabetes duration (r = 0.519, P = 0.001). In multivariate analysis, this association remained significant (beta = 0.501, P = 0.003) after adjustment for potential confounders. In conclusion, this study showed that the serum ox-LDL level increases with the length of diabetes, even though the patients' LDL-cholesterol level is maintained at a desirable level. Our findings highlight that possibly more attention should be focused on markers of oxidative stress in the management of lipids in diabetic patients.

Methanol poisoning continues to be a serious problem in Iran; however, there is not yet any report of the prevalence of methanol intoxication. This report is a descriptive study of methanol intoxication in Iran. We performed a cross-sectional analysis of 51 patients with methanol intoxication who were admitted to Noor Hospital affiliated with Isfahan University of Medical Science (Isfahan, Iran) from January 2000 to December 2009. Characteristics of the participants, including age, sex, amount of methanol ingestion, exposure type, time from ingestion to presentation, and patient outcome, were recorded. There were 51 patients (84.3% male and 15.7% female; mean age: 32.5 ± 15.2 and 20.1 ± 7.5 years, respectively). Of the patients, 13.7% were under 20 years in age, 51% were from 20 to 29, 11.8% were from 30 to 39, and 23.5% were above 40. Four patients died, 15 survived with late complications, and 32 survived without any complications. There are a growing number of patients presenting with acute poisonings in Iran. Early diagnosis and treatment is necessary to prevent long-term complications.

Diabetic foot ulceration has been a serious issue over the past decades in Asia, causing economic and social problems. Therefore, it is important to identify and reduce the risk factors of diabetic foot. Cigarette smoking has been reported to be associated with diabetes and its macrovascular complications, but the relationship between smoking and diabetic foot ulcers is still unclear. In the present review, we summarize the effects of cigarette smoking on diabetic foot ulcers with respect to peripheral neuropathy, vascular alterations and wound healing. One underlying mechanism of these impacts might be the smoking‐induced oxidative stress inside the cells. At the end of this review, the current mainstream therapies for smoking cessation are also outlined. We believe that it is urgent for all diabetic patients to quit smoking so as to reduce their chances of developing foot ulcers and to improve the prognosis of diabetic foot ulcers.

Several studies suggest that the response to various stressors differs between the sexes. We aimed to study serum HSP70 and levels of oxidized-LDL (ox-LDL) as markers of oxidative stress in men and women with type 2 diabetes. We quantified serum HSP70 and levels of ox-LDL in three cohorts; patients with newly diagnosed diabetes, patients with long-standing diabetes and normal controls. The cohort of patients with newly diagnosed diabetes was followed up for 3 months under glucoselowering therapy with metformin. Our findings showed that serum HSP70 level was increased in women with long-standing diabetes in comparison with men. HSP70 did not decrease after glucose lowering therapy in women with newly diagnosed diabetes, but it did decrease in men. There was no significant difference on ox-LDL between men and women in any of the studied cohorts. It decreased significantly in the cohort of patients with newly diagnosed diabetes after treatment, regardless of sex. There was no significant correlation between HSP70 and ox-LDL in any of the studied cohorts except among normal women. We suggest that diabetes induces an immune response and impairs cellular defense mechanisms against oxidative stress more commonly in women with type 2 diabetes than in men.