Real-world use of once-weekly semaglutide in Thai patients with type 2 diabetes mellitus in a private hospital setting / Journal of the ASEAN Federation of Endocrine Societies

Objective@#To evaluate the real-world use of once-weekly semaglutide among Thai patients with type 2 diabetes (T2DM) in a private hospital setting.@*Methodology@#A retrospective review of Thai patients with T2DM who have initiated semaglutide for at least 1 month between June 2020 and March 2022 at Theptarin Hospital, Bangkok, Thailand.@*Results@#A total of 58 patients (50% female, mean age 55.6 ± 15.9 years, with duration of diabetes 12.6 ± 10.3 years, BMI 31.5 ± 4.4 kg/m2, baseline HbA1c 7.9 ± 1.9%, with prior GLP-1 RA use 24.1%, and concomitant SGLT2i intake (41.4%) were included. During a median follow-up of 6 months, the mean serum HbA1c level reduction was 1.3 ± 1.7% with weight loss of 4.7 ± 4.1 kg. The proportion of patients who achieved optimal and sustainable glycemic control (HbA1c <7.0%) increased from 43.1% to 55.8% at the last follow-up. The proportion of patients reaching both HbA1c targets of <7.0% and 5% weight loss was 27.8%. No cases of pancreatitis, cancer, or progressive retinopathy were observed.@*Conclusion@#In this single center undertaking, it was shown that in among persons with T2DM and obesity in Thailand, semaglutide was associated with short-term glycemic control and weight loss comparable with what has been observed in randomized clinical trials and other RWE.

Clinical characteristics, residual beta-cell function and pancreatic auto-antibodies in Thai people with long-standing type 1 diabetes mellitus / Journal of the ASEAN Federation of Endocrine Societies

@#Objectives. To describe the characteristics of long-standing T1DM in Thai patients and assess residual beta-cell function with status of pancreatic autoantibodies. Methodology. This is a cross-sectional study of Thai subjects with T1DM and disease duration ≥ 25 years seen at the Theptarin Hospital. Random plasma C-peptide and pancreatic auto-antibodies (Anti-GAD, Anti-IA2, and Anti-ZnT8) were measured. Patients who developed complications were compared with those who remained free of complications. Results. A total of 20 patients (males 65%, mean age 49.4±12.0 years, BMI 22.5±3.1 kg/m2, A1C 7.9±1.6%) with diabetes duration of 31.9±5.1 years were studied. Half of the participants remained free from any diabetic complications while the proportions reporting retinopathy, nephropathy, and neuropathy were 40%, 30%, and 15%, respectively. HDL cholesterol was significantly higher and triglyceride concentration significantly lower in patients who were free from diabetic nephropathy but not in those who were free from other complications. The prevalence rates of anti-GAD, anti- IA2, and anti-ZnT8 were 65%, 20%, and 10%, respectively. None of the patients who tested negative for both anti-GAD and anti-IA2 was positive for anti-ZnT8. Residual beta-cell function based on detectable random plasma C-peptide (≥ 0.1 ng/mL) and MMTT was found in only 3 patients (15%). There was no relationship between residual beta-cell function and protective effects of diabetic complications. Conclusion. Endogenous insulin secretion persists in some patients with long-standing T1DM and half of longstanding T1DM in Thai patients showed no diabetic complications. HDL cholesterol was significantly higher and triglyceride concentration significantly lower in patients who were free from diabetic nephropathy

Percutaneous ethanol injection efficacy in benign thyroid nodules: a descriptive retrospective study

Background: In benign nodular thyroid diseases, percutaneous ethanol injection (PEI) has been introduced as an alternative to surgery for more than 10 years. Previous studies confirmed the safety and efficacy of PEI in reducing the size of thyroid nodules, including cystic thyroid. PEI can be performed as an out-patient procedure. Objective: To evaluate the efficacy and safety of PEI treatment for reducing the size of benign thyroid nodules. Material and methods: Descriptive retrospective study was made for patients with non-toxic thyroid nodules treated by PEI at Theptarin Hospital (Bangkok, Thailand) during a five year period (Jan 2002 and Dec 2006). The volume of nodules was measured using ultrasound technique before and after PEI treatment. Any complications were also recorded. In the present analysis, the nodules were classified into four groups: solid, cystic, mixed solid-cystic nodules, and multinodular goiters. Results: Of the 167 treated nodules in the study, initial nodule volume was 10.14 ± 12.32 mL, median number of injections was 5 times with total ethanol volume injected 0.99 ± 0.54 mL per mL nodule volume. Percentage volume reduction was 66.67 ± 32.19% at the median time of 14 months follow-up. Overall, 80% of treated nodules achieved ≥ 50% volume reduction. The mean volume reduction in this group was 79.61%. In the subgroup of solid thyroid nodule (65 nodules), the mean volume reduction was 58.73 ± 35.33%. In the subgroup of cystic thyroid (8 nodules), the mean volume reduction was 92.38 ± 6.57%. In the subgroup of mixed solid-cystic nodule (44 nodules), the mean volume reduction was 67.35 ± 35.18%. In the subgroup of multinodular goiters (50 nodules), the mean volume reduction was 72.27 ± 23.76%. Only two patients developed temporary vocal cord paresis. No permanent or serious complications were experienced. Conclusion: PEI proved to be a safe and effective therapeutic procedure for patients with benign thyroid nodules. Recurrent thyroid cysts could be also managed with this treatment.