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Abstract Glycemic Self Control in Type 2 Diabetes Mellitus Patients Wisit Chaveepojnkamjorn DVM, MPH* Natchaporn Pichainarong DrPH* Muhsin Thabirauta MPH** *Department of Epidemiology, Faculty of Public Health, Mahidol University **Nursing Academy, Health Department, Banda Aceh, Indonesia Objective: To study factors of knowledge, self care and social support affecting the glycemic control in type 2 diabetes mellitus patients. Study design: Cross-sectional descriptive study. Setting: Diabetes Clinic, BMA Medical College and Vajira Hospital. Subjects: Two hundred and fifteen type 2 diabetes mellitus patients who attended the Diabetes Clinic, BMA Medical College and Vajira Hospital from January to February 2001 were divided into glycemic control group and non control group. Methods: Data were collected by questionnaires which comprised five parts: part 1 general characteristics including demography and socio-economy, part 2 knowledge of diabetes, part 3 self care, part 4 social support, and part 5 fasting blood glucose result. The obtained data were analyzed by statistical program. Main outcome measures: Mean and standard deviation of knowledge, self care and social support factors. Results: The average knowledge of diabetes was in high level (\> 80%) while the average self care and social support were in moderate level. Both groups were similar in general except gender (p=0.047), monthly family income (p=0.017) and marital status (p=0.012). Knowledge of diabetes, self care and social support were compared between groups of FBS control and group of disable FBS control. The result revealed that knowledge of diabetes in the aspect of prevention and an overview of the former group was better than the latter one (p = 0.006 and 0.013 respectively). However the average of knowledge in cause, sign and symptom, and treatment and self care in food, exercise, and drug of the former group were higher than the latter one. Conclusion: Knowledge of diabetes mellitus in both groups was in high level. However, the knowledge of prevention in fasting blood sugar control group was statistically higher than the other while self care and social support were in moderate level in both groups. Key words: diabetes mellitus, type 2, self controlVajira Med J 2002 ; 46 : 125 - 133
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Abstract Maternal Size and the Development of Pregnancy-induced Hypertension Wisit Chaveepojnkamjorn DVM, MPH Natchaporn Pichainarong DrPH Department of Epidemiology, Faculty of Public Health, Mahidol University Objective: To study the relation between maternal size and the development of pregnancy-induced hypertension (PIH) Study design: Prospective cohort study. Setting: Four Maternal and Child Hospital (Ratchaburi, Khon Kaen, Yala and NaKhon Sawan ) and Rajvithi Hospital. Subjects: Two thousand and three hundred pregnant women who attended prenatal services and delivered at 4 Maternal and Child Hospital and Rajvithi Hospital during 9 months between 1st July 1995 and 31st March 1996. Methods: Data were collected by questionnaires, record forms and medical instruments which comprised 3 parts: part 1 general characteristics including demography and socio-economy, part 2 specific information including gestational age, history of illness during pregnancy, and part 3 measurement data including body weight, height, blood pressure etc, The obtained data were analyzed by statistical program. Main outcome measures: Mean and standard deviation of body mass index (BMA) before pregnancy and delivery, weight gain during gestational age and infant birth weight. Results: Group of BMI \< 23 kg/m2 before pregnancy had the proportion of PIH higher than those of BMI \< 21 kg/m2 and 21-23 kg/m2 (p \< 0.001, p = 0.001 respectively). Group of weight gain during pregnancy \> 16 kg had the proportion of PIH higher than those of \< 12 kg and 12-16 kg (p \< 0.001 in both groups). Group of BMI at delivery 25 kg/m2 had the proportion of PIH higher than group of BMI \< 25 kg/m2 (p \< 0.001), and infant birth weight group of lesser than 2,800 g had the proportion of PIH higher than those of 3,000 g and 2,801-2,999 g (p \< 0.001 in both groups). In the aspect of PIH status, the results revealed that the average figures of BMI before pregnancy and during the following delivery, and weight gain during gestational age in the PIH group were higher than the non-PIH group (P \< 0.001). On the reverse association, mean of birth weight in the PIH group was lesser than the latter one. Conclusion: Pregnant women of BMI \> 23 kg/m2 before pregnancy and weight gain \> 16 kg had chance more likely to develop PIH than other groups. Therefore, controlling of body weight before and during pregnancy was the essential measure to decrease the occurrence of PIH. Key words: maternal size, pregnancy-induced hypertension, birth weightVajira Med J 2003 ; 47 : 47 - 55
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Abstract Factors Associaed with Diabetic Retinopathy in Type 2 Diabetes Supatra Chaikaew BNS, MSc (Public Health)* Natchaporn Pichainarong DrPH (Epidemiology)** Wisit Chaveepojnkamjorn DVM, MPH** Piangchan Rojanavipart MHS (Biostatistics)*** Petch Rawdaree MD,MSc (Epidemiology)**** * Amnatchareon Hospital ** Department of Epidemiology, Faculty of Public Health, Mahidol University *** Department of Biostatistic, Biostatic, Faculty of Public Health, Mahidol University **** Department of Medicine, BMA Medical college and Vajira HospItal Objective: To determine factors associated with diabetic retinopathy in type 2 diabetes. Study design: Hospital based case-control study. Setting: Diabetes Clinic, BMA Medical college and Vajira Hospital from May 2003 to September 2003. Subjects: Two hundred and sixty type 2 diabetes mellitus. One hundred and thirty patients with diabetic retinopathy were case and 130 patients without diabetic retinopathy were control. Methods: Data were collected from medical record and interview questionnaire. It is divided into 3 sections: Information from interview; part 1 general information including demography and socio-economy, part 2 illness factors, part 3 laboratory data which was obtained from medical record. The obtained data were analyzed by statistical program. Main outcome measures: Odds ratio and 95% CI of odds ratio of hyperglycemia, hypertension, type of therapy, smoking, (Body mass index : BMI), age at onset, alcohol consumption, dyslipidemia and duration of diabetes. Results: There were only five variable that were significantly associated with diabetic retinopathy. After adjusting the effect of each variables, the magnitude of association between each variables and diabetic retinopathy were fasting plasma glucose (FPG) between 161-180 mg/dl and \>180 mg/dl (OR=3.82, 95% CI 1.02-14.24 and OR=5.98, 95% CI 1.66-21.56), HbA1c \>9%(OR=4.09, 95% CI 1.69-9.92), hypertension (OR=5.00, 95% CI 2.64-9.46), systolic blood pressure between 140-159 mmHg and 160 mmHg (OR=3.22, 95% CI 1.50-6.88 and OR=9.98, 95% CI 1.38-58.41) and BMI between 23-24.9, 25-29 and 30 kg/m (OR=0.20, 95% CI 0.08-0.49, OR=0.36, 95% CI 0.16-0.83 and OR=0.10, 95% CI 0.03-0.32) respectively. Other variables consisted of diastolic blood pressure, cholesterol, triglyceride, type of therapy, age at onset duration of diabetes, smoking and alcohol consumption did not show significant association with diabetic retinopathy. Conclusion: The factors found to be significantly associated with diabetic retinopathy were FPG, HbA1c, BMI, hypertension and systolic blood pressure. Key words: Type 2 diabetes, diabetic retinopathy, risk factors Vajira Med J 2004 ; 48 : 97 - 106
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The objective of this research was to study self-esteem and drinking refusal self-efficacy related to hazardous alcohol consumption among upper-secondary school students. Eight hundred and fifty upper-secondary school students from Amphoe Muang, Nakhon Ratchasima Province were classified into 2 groups according to hazardous drinking (yes=107, no=743). Data were collected by questionnaires which comprised 4 parts: part 1 general characteristics, part 2 the Alcohol Use Disorders Identification Test (AUDIT), part 3 The Rosenberg Self-Esteem Questionnaire, and part 4 The Drinking Refusal Self-Efficacy Questionnaire. The obtained data were analyzed by using descriptive statistics and analytic statistics by computerized statistical package. The results revealed the percent of student’s hazardous drinking was 12.6%. Demographic factors related to hazardous drinking were age, gender and Grade Point Average (p \< 0.05). In addtion, factors of self-esteem and drinking refusal self-efficacy associated with hazardous alcohol consumption (p \< 0.001). Therefore, Evaluation of self-esteem and drinking refusal self-efficacy are the tools for surveillance of alcohol risk groups.