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Diyabetik Sıçanlarda Yüzmenin Bazı Kan Parametreleri Üzerine Olumlu Etkisi

Yıl 2020, Cilt: 15 Sayı: 1, 31 - 37, 30.04.2020
https://doi.org/10.17094/ataunivbd.665357

Öz

Diyabetik sıçanlarda yüzmenin bazı hematolojik parametreler üzerindeki etkisini araştırmak bu çalışmanın temel amacıdır. 32 yetişkin sağlıklı sıçan sırasıyla Kontrol (C), Diyabetik (D), Egzersiz Kontrolü (E) ve Diyabetik + Egzersiz (DE) gruplarına ayrıldı. Kontrol grubundaki sıçanlara hiçbir uygulama yapılmazken, D ve DE gruplarına intraperitoneal (i.p.) 60 mg / kg streptozotosin (STZ) enjekte edildi. Deneme, diyabetin başlamasından sonra dört hafta devam etti. E ve DE gruplarına, diyabet oluşturulduktan sonra, deneme süresini içeren 4 haftalık periyotta, haftada 5 gün olmak üzere 1 saat yüzme egzersizi yaptırıldı. Deneme sonunda (4 hafta sonra) kan örneklerinde bazı hematolojik parametreler (RBC, Hb, Htc, trombosit, WBC, diferansiyel lökosit sayısı gibi) belirlendi. D grubunda RBC, Hb ve Htc değerleri düştü. Diğer taraftan, aynı grupta WBC ve trombosit sayısı artmıştır. DE grubunda RBC, Hb ve Htc düzeylerinin daha yüksek, WBC sayısının ise daha düşük olduğunu gözlemledik. Sonuç olarak; çalışmada düzenli aerobik egzersizin incelenen parametreleri iyileştirdiği ve olumlu etkiler gösterdiği sonucuna varılmıştır.

Kaynakça

  • 1. Crespilho DM., Curiacos de Almeida Leme JA., Rostom de Mello MA, Luciano E., 2010. Effects of physical training on the immune system in diabetic rats. Int J Diabetes Dev Ctries, 30, 33-37. 2. Saito M., Kuratsune H., Nitta H., Kawahara K., Hamano M., Matsuda M., Kaku K., Eto M., 2006. Plasma Lipid Levels and Nutritional İntake in Childhood- and Adolescence-Onset Young Type 1 Diabetic Patients in Japan. Diabetes Research and Clin Prac, 73, 29-34. 3. Valentovic MA., Alejandro N., Carpenter AB., Brown PI., Ramos K., 2006. Streptozotocin (STZ) diabetes enhances benzo(α)pyrene induced renal injury in Sprague Dawley rats. Toxicol Letters, 164, 214-220. 4. Cambay Z., 2011. Investigation of the effects of pomegranate flower (punica granatum) on serum aspartate aminotransferase and alanine aminotransferase levels in diabetic rats. Ecological Life Sci, 6, 124-133. 5. Tanrıverdi MH., Çelepkolu T., Aslanhan H., 2013. Diabetes mellitus and primary health care. J Clin Exp Invest, 4, 562-567. 6. Balducci S., D'Errico V., Haxhi J., Sacchetti M., Orlando G., Cardelli P., Vitale M., Bollanti L., Conti F., Zanuso S., Lucisano G., Nicolucci A., Pugliese Get., 2019. Effect of a behavioral intervention strategy on sustained change in physical activity and sedentary behavior in patients with type 2 diabetes: The IDES-2 randomized clinical trial. JAMA, 321, 880. 7. American Diabetes Association., 2019. 5. lifestyle management: standards of medical care in diabetes-2019. Diabetes Care, 42, S46. 8. Kostrycki IM., Frizzo MN., Wildner G., Donato YH., Santos AB., Rhoden CR., Ludwig MS., Heck TG., 2016. Hematological response of acute exercise in obese mice: The obesity attenuation effect on leucocytes response. J Exercise Physiol, 19, 85-93. 9. Hevener AL., Reichart D., Olefsky J., 2000. Exercise and thiazolidinedione therapy normalize insulin action in the obese Zucker fatty rat. Diabetes, 49, 2154-2159. 10. Contarteze RV., Manchado FdeB., Gobatto CA., De Mello MA., 2008. Stress biomarkers in rats submitted to swimming and treadmill running exercises. Comp Biochem Physiol Part A Mol Integr Physiol, 151, 415-422. 11. Sigal RJ., Kenny GP., Wasserman DH., Castaneda-Sceppa C., 2004. Physical activity/exercise and type 2 diabetes. Diabetes Care, 27, 2518-2539. 12. Thent ZC., Das S., Henry LJ., 2013. Role of exercise in the management of Diabetes Mellitus: The Global Scenario. PloS One, 8, e80436. 13. Ahmad MA., 2019. Moderate-intensity continuous training: is it as good as high-intensity interval training for glycemic control in type 2 diabetes? J Exerc Rehabil, 15, 327-333. 14. Hu FB., Manson J., Stampfer M., Graham C., 2001. Diet, lifestyle and risk of type 2 diabetes mellitus in women. The New England J Med, 345, 790-797. 15. Ehiaghe FA., Agbonlahor DE., Etikerentse SMO., Osadolor HB., 2013. Effect of exercise induced stress on serum cortisol level and CD4 cell count in rats. African J Cellular Path, 1, 14-18. 16. Colberg SR., Sigal RJ., Yardley JE., Riddell MC., Dunstan DW., Dempsey PC., Horton ES., Castorino K., Tate DF., 2016. Physical Activity/Exercise and Diabetes: A Position Statement of the American Diabetes Association. Diabetes Care, 39, 2065-2079. 17. Akbarzadeh A., Norouzian D., Mehrabi MR., Jamshidi Sh., Farhangi A., Allah Verdi A., Mofidian SMA., Lame Rad B., 2007. Induction of diabetes by Streptozotocin in rats. Indian J Clin Biochem, 22, 60-64. 18. Maciel RM., Costa MM., Martins DB., Franca RT., Schmatz R., Graca DL., Duarte MM., Danesi CC., Mazzanti CM., Schetinger MR., Paim FC., Palma HE., Abdala FH., Stefanello N., Zimpel CK., Felin DV., Lopes ST., 2013. Antioxidant and anti-inflammatory effects of quercetin in functional and morphological alterations in streptozotocin-induced diabetic rats. Res Vet Sci, 95, 389-397. 19. Eljsvogels TMH., Thompson PD., 2015. Exercise is medicine at any dose? JAMA, 314, 1915-1916. 20. Momma H., Sawada SS., Kato K., Gando Y., Kawakami R., Miyachi M., Huang C., Nagatomi R., Tashiro M., Ishizawa M., Kodama S., Iwanaga M., Fujihara K., Sone H., 2019. Physical Fitness Tests and Type 2 Diabetes Among Japanese: A Longitudinal Study From the Niigata Wellness Study, 29, 139-146. 21. Stewart KJ., 2002. Exercise training and the cardiovascular consequences of type 2 diabetes and hypertension: plausible mechanisms for improving cardiovascular health. JAMA, 288, 1622-1631. 22. Ghisai R., Soufi FG., Mohaddes G., Somi MH., Ebrahimi H., Alihemmati A., Bavil FM., Alipour MR., 2014. Effects of regular swimming on WBC profile, inflammatory mediators and histopathology of pancreatic tissue of high fat-induced diabetes in adult male rats. Bull Env Pharmacol Life Sci, 3, 14-20. 23. Nazıroglu M., Şimşek M., Kutlu M., 2004. Moderate exercise with a dietary vitamin C and E combination protects streptozotocin-induced oxidative damage to the blood and improves fetal outcomes in pregnant rats. Clin Chem Lab Med, 42, 511-517. 24. Sugiura H., Nishida H., Sugiura H., Mirbod SM., Iwata H.,2000. Immunomodulation by 8-week voluntary exercise in mice. Acta Physiol Scand, 168, 413-420. 25. Chaar V., Romana M., Tripette J., Broquere C., Huisse MG., Hue O., 2011. Hardy-Dessources MD, Connes P. Effect of strenuous physical exercise on circulating cell- derived microparticles. Clin Hemorheology and Microcirculation, 47, 15-25. 26. McFarlin BK., Mitchell JB., McFarlin MA., Steinhoff GM., 2003. Repeated endurance exercise affects leukocyte number but no NK cell activity. Med Sci Sports Exerc, 35, 1130-1138. 27. Neves PRDS., Tenorio TRDS., Lins TA., Muniz MTC., Pithon-Curi TC., Botero JP., 2015. Acute effects of high and low intensity exercise bouts on leucocyte counts. J Exerc Sci Fit, 13, 24-28. 28. Kozlov IA., Novitski VV., Baikov AN., 1995. Kinetics of blood leukocytes in mice with alloxan diabetes. Bull Exsp Biol Med, 120, 33-35. 29. Mahmoud AM., 2013. Hematological alterations in diabetic rats-role of adipocytokines and effect of citrus flavonoids. EXCLI J, 12, 647-657. 30. Keskin E., Donmez N., Kılıçarslan G., Kandır S., 2016. Beneficial Effect of Quercetin on Some Hematological Parameters in Streptozotocin-Induced Diabetic Rats. Bull Env Pharmacol Life Sci, 5, 65-68. 31. Nikseresht A., Fehresti Haghighi Sh., Solhjoo K., Kargar Jahromy H., 2013. Effect of maximum activity on the immune system cells in diabetic rats. Journal of Jahrom Unv Med Sci, 10, 42-47. 32. Nazıroglu M., Butterworth PJ., 2005. Protective effects of moderate exercise with dietary vitamin C and E on blood antioxidative defense mechanism in rats with streptozotocin- induced diabetes. Can J Appl Physiol, 30, 172-185. 33. Oyedemi SO., Yakubu MT., Afolayan AJ., 2011. Antidiabetic activities of aqueous leaves extract of Leonotis leonurus in streptozotocin induced diabetic rats. J Med Plant Res, 5, 119-125. 34. Donmez N., Donmez HH., Keskin E., Kisadere I., 2012. Effects of Aflatoxin on Some Haematological Parameters and Protective Effectiveness of Esterified Glucomannan in Merino Rams. TSWJ Article ID 342468. 35. Colak S., Geyikoğlu F., Aslan A., Deniz GY., 2014. Effect of lichen extracts on haematological parameters of rats with experimental insülin-dependent diabetes mellitus. Tox and Ind Health, 30, 878-887. 36. Hassanpour G., Hosseini SA., Keikhosravi F., Noura M., 2017. The Effect of Swimming Training with Cinnamon Extract on Hematological Factors in Diabetic Rats. Iranian J Diabetes and Obesity, 9, 101-106. 37. Silva RP., Santos RO., Matildes NEJ., Mundim AV., Garrote-Filho MD., Rodrigues PF., Penha-Silva N., 2017. Influence of the use of testosterone associated with physical training on some hematologic and physical parameters in older rats with alloxan-induced diabetes. Arch Endocrinol Metab, 61, 62-69. 38. Al Shehri ZS., 2017. The relationship between some biochemical and hematological changes in type 2 diabetes mellitus. Biomed Res and Therapy, 4, 1760-1774.

The Favorable Effect of Swimming on Some Blood Parameters in Diabetic Rats

Yıl 2020, Cilt: 15 Sayı: 1, 31 - 37, 30.04.2020
https://doi.org/10.17094/ataunivbd.665357

Öz

To investigate the effect of swimming on some hematological parameters in diabetic rats is the main goal of this study. 32 adult healthy rats were divided into Control (C), Diabetic (D), Exercise Control (E) and Diabetic+Exercise (DE) groups respectively. The rats in the control group were not soever treated, while the D and DE groups were injected 60 mg / kg streptozotocin (STZ) intraperitoneal (i.p). The trial continued for four weeks after the onset of diabetes. After the diabetes was formed, 1-hour swimming exercise for 4 weeks, 5 days a week was applied to groups E and DE during the trial period. At the end of the experiment (after 4 week) some hematological parameters (such as RBCs, Hb, Htc, platelet, WBC, differential leucocyte count) were determined in blood samples. RBCs, Hb and Htc values were reduced in D group. On the other hand, WBC and platelet count were increased in the same group. We observed RBC count, Hb and Htc levels were higher and WBC count was lower in DE group according to D group. As a result; current study was observed that regular aerobic exercise improves investigated parameters and demonstrates positive effects.

Kaynakça

  • 1. Crespilho DM., Curiacos de Almeida Leme JA., Rostom de Mello MA, Luciano E., 2010. Effects of physical training on the immune system in diabetic rats. Int J Diabetes Dev Ctries, 30, 33-37. 2. Saito M., Kuratsune H., Nitta H., Kawahara K., Hamano M., Matsuda M., Kaku K., Eto M., 2006. Plasma Lipid Levels and Nutritional İntake in Childhood- and Adolescence-Onset Young Type 1 Diabetic Patients in Japan. Diabetes Research and Clin Prac, 73, 29-34. 3. Valentovic MA., Alejandro N., Carpenter AB., Brown PI., Ramos K., 2006. Streptozotocin (STZ) diabetes enhances benzo(α)pyrene induced renal injury in Sprague Dawley rats. Toxicol Letters, 164, 214-220. 4. Cambay Z., 2011. Investigation of the effects of pomegranate flower (punica granatum) on serum aspartate aminotransferase and alanine aminotransferase levels in diabetic rats. Ecological Life Sci, 6, 124-133. 5. Tanrıverdi MH., Çelepkolu T., Aslanhan H., 2013. Diabetes mellitus and primary health care. J Clin Exp Invest, 4, 562-567. 6. Balducci S., D'Errico V., Haxhi J., Sacchetti M., Orlando G., Cardelli P., Vitale M., Bollanti L., Conti F., Zanuso S., Lucisano G., Nicolucci A., Pugliese Get., 2019. Effect of a behavioral intervention strategy on sustained change in physical activity and sedentary behavior in patients with type 2 diabetes: The IDES-2 randomized clinical trial. JAMA, 321, 880. 7. American Diabetes Association., 2019. 5. lifestyle management: standards of medical care in diabetes-2019. Diabetes Care, 42, S46. 8. Kostrycki IM., Frizzo MN., Wildner G., Donato YH., Santos AB., Rhoden CR., Ludwig MS., Heck TG., 2016. Hematological response of acute exercise in obese mice: The obesity attenuation effect on leucocytes response. J Exercise Physiol, 19, 85-93. 9. Hevener AL., Reichart D., Olefsky J., 2000. Exercise and thiazolidinedione therapy normalize insulin action in the obese Zucker fatty rat. Diabetes, 49, 2154-2159. 10. Contarteze RV., Manchado FdeB., Gobatto CA., De Mello MA., 2008. Stress biomarkers in rats submitted to swimming and treadmill running exercises. Comp Biochem Physiol Part A Mol Integr Physiol, 151, 415-422. 11. Sigal RJ., Kenny GP., Wasserman DH., Castaneda-Sceppa C., 2004. Physical activity/exercise and type 2 diabetes. Diabetes Care, 27, 2518-2539. 12. Thent ZC., Das S., Henry LJ., 2013. Role of exercise in the management of Diabetes Mellitus: The Global Scenario. PloS One, 8, e80436. 13. Ahmad MA., 2019. Moderate-intensity continuous training: is it as good as high-intensity interval training for glycemic control in type 2 diabetes? J Exerc Rehabil, 15, 327-333. 14. Hu FB., Manson J., Stampfer M., Graham C., 2001. Diet, lifestyle and risk of type 2 diabetes mellitus in women. The New England J Med, 345, 790-797. 15. Ehiaghe FA., Agbonlahor DE., Etikerentse SMO., Osadolor HB., 2013. Effect of exercise induced stress on serum cortisol level and CD4 cell count in rats. African J Cellular Path, 1, 14-18. 16. Colberg SR., Sigal RJ., Yardley JE., Riddell MC., Dunstan DW., Dempsey PC., Horton ES., Castorino K., Tate DF., 2016. Physical Activity/Exercise and Diabetes: A Position Statement of the American Diabetes Association. Diabetes Care, 39, 2065-2079. 17. Akbarzadeh A., Norouzian D., Mehrabi MR., Jamshidi Sh., Farhangi A., Allah Verdi A., Mofidian SMA., Lame Rad B., 2007. Induction of diabetes by Streptozotocin in rats. Indian J Clin Biochem, 22, 60-64. 18. Maciel RM., Costa MM., Martins DB., Franca RT., Schmatz R., Graca DL., Duarte MM., Danesi CC., Mazzanti CM., Schetinger MR., Paim FC., Palma HE., Abdala FH., Stefanello N., Zimpel CK., Felin DV., Lopes ST., 2013. Antioxidant and anti-inflammatory effects of quercetin in functional and morphological alterations in streptozotocin-induced diabetic rats. Res Vet Sci, 95, 389-397. 19. Eljsvogels TMH., Thompson PD., 2015. Exercise is medicine at any dose? JAMA, 314, 1915-1916. 20. Momma H., Sawada SS., Kato K., Gando Y., Kawakami R., Miyachi M., Huang C., Nagatomi R., Tashiro M., Ishizawa M., Kodama S., Iwanaga M., Fujihara K., Sone H., 2019. Physical Fitness Tests and Type 2 Diabetes Among Japanese: A Longitudinal Study From the Niigata Wellness Study, 29, 139-146. 21. Stewart KJ., 2002. Exercise training and the cardiovascular consequences of type 2 diabetes and hypertension: plausible mechanisms for improving cardiovascular health. JAMA, 288, 1622-1631. 22. Ghisai R., Soufi FG., Mohaddes G., Somi MH., Ebrahimi H., Alihemmati A., Bavil FM., Alipour MR., 2014. Effects of regular swimming on WBC profile, inflammatory mediators and histopathology of pancreatic tissue of high fat-induced diabetes in adult male rats. Bull Env Pharmacol Life Sci, 3, 14-20. 23. Nazıroglu M., Şimşek M., Kutlu M., 2004. Moderate exercise with a dietary vitamin C and E combination protects streptozotocin-induced oxidative damage to the blood and improves fetal outcomes in pregnant rats. Clin Chem Lab Med, 42, 511-517. 24. Sugiura H., Nishida H., Sugiura H., Mirbod SM., Iwata H.,2000. Immunomodulation by 8-week voluntary exercise in mice. Acta Physiol Scand, 168, 413-420. 25. Chaar V., Romana M., Tripette J., Broquere C., Huisse MG., Hue O., 2011. Hardy-Dessources MD, Connes P. Effect of strenuous physical exercise on circulating cell- derived microparticles. Clin Hemorheology and Microcirculation, 47, 15-25. 26. McFarlin BK., Mitchell JB., McFarlin MA., Steinhoff GM., 2003. Repeated endurance exercise affects leukocyte number but no NK cell activity. Med Sci Sports Exerc, 35, 1130-1138. 27. Neves PRDS., Tenorio TRDS., Lins TA., Muniz MTC., Pithon-Curi TC., Botero JP., 2015. Acute effects of high and low intensity exercise bouts on leucocyte counts. J Exerc Sci Fit, 13, 24-28. 28. Kozlov IA., Novitski VV., Baikov AN., 1995. Kinetics of blood leukocytes in mice with alloxan diabetes. Bull Exsp Biol Med, 120, 33-35. 29. Mahmoud AM., 2013. Hematological alterations in diabetic rats-role of adipocytokines and effect of citrus flavonoids. EXCLI J, 12, 647-657. 30. Keskin E., Donmez N., Kılıçarslan G., Kandır S., 2016. Beneficial Effect of Quercetin on Some Hematological Parameters in Streptozotocin-Induced Diabetic Rats. Bull Env Pharmacol Life Sci, 5, 65-68. 31. Nikseresht A., Fehresti Haghighi Sh., Solhjoo K., Kargar Jahromy H., 2013. Effect of maximum activity on the immune system cells in diabetic rats. Journal of Jahrom Unv Med Sci, 10, 42-47. 32. Nazıroglu M., Butterworth PJ., 2005. Protective effects of moderate exercise with dietary vitamin C and E on blood antioxidative defense mechanism in rats with streptozotocin- induced diabetes. Can J Appl Physiol, 30, 172-185. 33. Oyedemi SO., Yakubu MT., Afolayan AJ., 2011. Antidiabetic activities of aqueous leaves extract of Leonotis leonurus in streptozotocin induced diabetic rats. J Med Plant Res, 5, 119-125. 34. Donmez N., Donmez HH., Keskin E., Kisadere I., 2012. Effects of Aflatoxin on Some Haematological Parameters and Protective Effectiveness of Esterified Glucomannan in Merino Rams. TSWJ Article ID 342468. 35. Colak S., Geyikoğlu F., Aslan A., Deniz GY., 2014. Effect of lichen extracts on haematological parameters of rats with experimental insülin-dependent diabetes mellitus. Tox and Ind Health, 30, 878-887. 36. Hassanpour G., Hosseini SA., Keikhosravi F., Noura M., 2017. The Effect of Swimming Training with Cinnamon Extract on Hematological Factors in Diabetic Rats. Iranian J Diabetes and Obesity, 9, 101-106. 37. Silva RP., Santos RO., Matildes NEJ., Mundim AV., Garrote-Filho MD., Rodrigues PF., Penha-Silva N., 2017. Influence of the use of testosterone associated with physical training on some hematologic and physical parameters in older rats with alloxan-induced diabetes. Arch Endocrinol Metab, 61, 62-69. 38. Al Shehri ZS., 2017. The relationship between some biochemical and hematological changes in type 2 diabetes mellitus. Biomed Res and Therapy, 4, 1760-1774.
Toplam 1 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma Makaleleri
Yazarlar

Nurcan Dönmez

Ercan Keskin

Mehmet Özsan

Omer Mahruf Ali Shoshın Bu kişi benim

Bekir Mehtap

Yayımlanma Tarihi 30 Nisan 2020
Yayımlandığı Sayı Yıl 2020 Cilt: 15 Sayı: 1

Kaynak Göster

APA Dönmez, N., Keskin, E., Özsan, M., Ali Shoshın, O. M., vd. (2020). The Favorable Effect of Swimming on Some Blood Parameters in Diabetic Rats. Atatürk Üniversitesi Veteriner Bilimleri Dergisi, 15(1), 31-37. https://doi.org/10.17094/ataunivbd.665357
AMA Dönmez N, Keskin E, Özsan M, Ali Shoshın OM, Mehtap B. The Favorable Effect of Swimming on Some Blood Parameters in Diabetic Rats. Atatürk Üniversitesi Veteriner Bilimleri Dergisi. Nisan 2020;15(1):31-37. doi:10.17094/ataunivbd.665357
Chicago Dönmez, Nurcan, Ercan Keskin, Mehmet Özsan, Omer Mahruf Ali Shoshın, ve Bekir Mehtap. “The Favorable Effect of Swimming on Some Blood Parameters in Diabetic Rats”. Atatürk Üniversitesi Veteriner Bilimleri Dergisi 15, sy. 1 (Nisan 2020): 31-37. https://doi.org/10.17094/ataunivbd.665357.
EndNote Dönmez N, Keskin E, Özsan M, Ali Shoshın OM, Mehtap B (01 Nisan 2020) The Favorable Effect of Swimming on Some Blood Parameters in Diabetic Rats. Atatürk Üniversitesi Veteriner Bilimleri Dergisi 15 1 31–37.
IEEE N. Dönmez, E. Keskin, M. Özsan, O. M. Ali Shoshın, ve B. Mehtap, “The Favorable Effect of Swimming on Some Blood Parameters in Diabetic Rats”, Atatürk Üniversitesi Veteriner Bilimleri Dergisi, c. 15, sy. 1, ss. 31–37, 2020, doi: 10.17094/ataunivbd.665357.
ISNAD Dönmez, Nurcan vd. “The Favorable Effect of Swimming on Some Blood Parameters in Diabetic Rats”. Atatürk Üniversitesi Veteriner Bilimleri Dergisi 15/1 (Nisan 2020), 31-37. https://doi.org/10.17094/ataunivbd.665357.
JAMA Dönmez N, Keskin E, Özsan M, Ali Shoshın OM, Mehtap B. The Favorable Effect of Swimming on Some Blood Parameters in Diabetic Rats. Atatürk Üniversitesi Veteriner Bilimleri Dergisi. 2020;15:31–37.
MLA Dönmez, Nurcan vd. “The Favorable Effect of Swimming on Some Blood Parameters in Diabetic Rats”. Atatürk Üniversitesi Veteriner Bilimleri Dergisi, c. 15, sy. 1, 2020, ss. 31-37, doi:10.17094/ataunivbd.665357.
Vancouver Dönmez N, Keskin E, Özsan M, Ali Shoshın OM, Mehtap B. The Favorable Effect of Swimming on Some Blood Parameters in Diabetic Rats. Atatürk Üniversitesi Veteriner Bilimleri Dergisi. 2020;15(1):31-7.