Diabetic education, special consideration of Oriental patients.

The important of patient education program in the management of diabetes has been widely recognized. We studied to find out in general what the patients and their parents know about diabetes and their self-care by using a questionnaire. Then, the diabetic education was given by one-to-one basis to every patient. Thirty four insulin-dependent diabetes mellitus attended the diabetic the clinic at Siriraj Hospital, Bangkok age ranged from 4 to 22 years with peak age at 11 to 15 years. Male to female ratio was l:i. Majority came from low socioeconomic families. 23.5 percent were from separated families, one patient lived with neither her mother nor father. Only one patient had home glucose monitoring. Fourteen cases (41.2%) had been hospitalized with diabetic ketoacidosis (DKA) over the past year, however, there was no statistically significant difference between admission with DKA and low socioeconomic status. In addition to insulin, there were 8 patients taking herbs to cure diabetes. Only 6 patients were able to follow their meal plan and only one case ever used the food exchange list. Most patients accepted being diabetic and attended the clinic regularly mainly to get financial supports. The situation in our country is different from that in the western countries as the patients are low in literacy and socioeconomic status. A well-planned educational programme is essential to cater to the need to the oriental patients.

Experience in hepatitis B vaccination in general population.

There were 1,544 healthy people requested for hepatitis B vaccinations and blood testing from the Health Service Unit in the Siriraj Hospital’s Centennial Anniversary Fair from April 27, to May 7, 1988. The ages of those 689 people ranged from 1-70 years received hepatitis B vaccination. 52.8% were children under 10 years of age. The prevalence of hepatitis B infection among 1,214 people of 6-82 years were studies. HBs Ag and anti-HBc positive were found in 9.3% of the population studied 13.7% in male, and 6% in female. Only 31.2% of this group was immuned (anti-HBs and anti-HBc positive). The discrepant markers were found as followings: 9.6% had anti-HBc positive solely, 3.6% had anti-HBc positive solely and 0.3% were positive for all 3 markers. The percentage among those with neither antigen nor antibody was 45.9%.