Assessment and prevalences of diabetic complications in 722 Thai type 2 diabetes patients

The purpose of this study is to determine the percent of patients who have been assessed as having diabetic complications as recommended by American Diabetes Association. The secondary goals were to determine factor(s) associated with reduced assessment of diabetic complication and to determine the prevalence of diabetic complications in Thai type 2 diabetes patients.

We conducted a retrospective review of medical records of Thai type 2 diabetes patients who were followed up at the out-patient department (OPD) of Department of Internal Medicine at Siriraj Hospital Mahidol University Thailand during 1st January to 31st December 2006.

Of 722 diabetes patients who were recruited, 7.5% were treated by general practitioners (GP), 10.4% by internal medicine residents (Res), 49.9% by internist (Int), 11.8% by endocrinologist (Endo) and 20.5% was indeterminate because they could not identify the field of the health care provider. 38.4% of patients received an eye examination by an ophthalmologist. 42% were screened for diabetic nephropathy. Serum creatinine level was measured in 83.5%. Foot examination was done in only 125 patients (17.3%). We founded that patients taken care by GP and Int received less intensive and less extensive assessment for diabetic complications than those taken care by Res and Endo. The prevalences of diabetic nephropathy and chronic kidney disease of at least stage 3 were 37 and 48.2%, respectively. Diabetic retinopathy occurred in 31.2%, cardiovascular disease in 28.9%, cerebrovascular disease in 10.6% and diabetic foot in 40%.

There was a high prevalence rate of diabetic complications in patients with type 2 diabetes. Screening for diabetic complications will help to identify patients at high risk of concomitant complications eventhough some practitioners are not initially aware of the importance of the diabetic complication screening. These data may help the physician decide to modify treatment to prevent disabilities.