Improvement of diabetic care at Maharat Nakhon Ratchasima Hospital (the study of Diabcare-Asia from 1997 to 2003).

Diabcare-Asia, the largest, multicenter observational study in Asia, surveyed the status of diabetic control among Asian diabetics, including Thais. Maharat Nakhon Ratchasima Hospital is a regional hospital in Northeast Thailand that participated in Diabcare-Asia. In 1997, 1998 and 2003, the authors recruited 200, 100, 204 diabetic patients for analysis, respectively. Most (93 per cent) of the patients had type 2 diabetes. In the present study, patients with a BMI > or = 25 kg/m2 increased from 38, 45 and 47 percent in 1997, 1998 and 2003, respectively. Annual check-ups for diabetic complications increased to nearly 100 per cent by 2003; however, only 72 per cent were examined for diabetic retinopathy, but that number is up from the 33 per cent in 1997. In the present study, diabetic retinopathy was detected in 8, 16 and 25 per cent of patients, respectively. Diabetic nephropathy (urine albumin > or = 1 + by urine strip) decreased from approximately 50 per cent in 1997/98 to 19 per cent in 2003. Patients were able to achieve the target blood sugar better than in the past. The number of patients with HbA1c < 7 per cent and FPG < or = 130 mg/dL was 8, 21, 38 and 30, 39 and 40 per cent in 1997, 1998 and 2003, respectively. The proportion of patients who achieved the American Diabetic Association blood pressure, total cholesterol and LDL-C targets in 2004 was < 50 per cent. In conclusion, the present study showed the improvement of diabetic control at Maharat Nakhon Ratchasima Hospital between 1997 and 2003. A similar hospital-based diabetic care system should be implemented at other Thai hospitals for the early identification and prevention of diabetic complications in the future.

Improved glycemic control among Thai children and young adults with type 1 diabetes participating in the diabetes camp.

Diabetes Education Program, Faculty of Medicine Siriraj Hospital has provided summer camps for Thai children with type 1 diabetes since 1990. The objective of this study was to evaluate the effectiveness of the diabetes camp in glycemic control. Twenty male and forty-two female patients participated in the 5-day diabetes camp held in Karnchanaburi, Thailand in 2003. The mean age was 14.1 +/- 4.3 years and the mean duration of disease was 4.5 +/- 3.5 years. Fifty out of sixty-two patients returned for a 3-month-postcamp visit. The glycemic control improved significantly. The mean precamp and postcamp HbA1c levels were 10.0 +/- 3.1% and 9.0 +/- 2.6% (p = 0.008) respectively. The diabetes camp is a valuable program for patients to learn diabetes-self management skills, especially in countries where the diabetes education programs are not always available.