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.