Sunthorn Tandhanand

Maharat Nakhon Ratchasima Hospital, Khorat, Nakhon Ratchasima, Thailand

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Publications (4)5 Total impact

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    ABSTRACT: To describe the clinical characteristics and chronic diabetic complications in early (EOD) and late onset type 2 diabetes mellitus (LOD) in Asia. Retrospective collection of information (basic patient data, treatment received for diabetes, hypertension, dyslipidaemia, clinical measurements, complications, life-style management, etc.) on paper form and prospective collection of blood samples for HbA(1c) assessment were performed. Means, proportions and associated factors were analyzed using non-parametric and logistic regression. The frequency of EOD (<30 years) varies in different Asian countries (0.4-5.3%). Overweight (BMI>or=23 kg/m2) was common in both EOD (60%) and LOD (66%). EOD was characterized by significantly higher levels of HbA(1c) (median 8.9% versus 7.9%) and FPG (median 9.8 mmol/L versus 8.3 mmol/L) but hypertension was less common (43% versus 59%). Lipid profiles (cholesterol and triglycerides) were similar between both groups of patients. Cataract was more common in LOD and was associated with onset age and diabetes duration whereas an increase in frequency of advanced eye disease, retinopathy and history of photocoagulation was found in EOD cohort. In addition to diabetic control and duration of the disease, the onset age conferred risk to certain subsets of chronic complications in type 2 diabetes population.
    Diabetes Research and Clinical Practice 03/2006; 71(2):146-55. · 2.74 Impact Factor
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    ABSTRACT: 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.
    Journal of the Medical Association of Thailand = Chotmaihet thangphaet 02/2006; 89(1):56-62.
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    ABSTRACT: 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.
    Journal of the Medical Association of Thailand = Chotmaihet thangphaet 12/2005; 88 Suppl 8:S38-43.
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    ABSTRACT: The aim of this study was to describe the glycaemic and metabolic control and diabetes-related complications in type 1 and type 2 Asian patients. Data of diabetes patients from 230 diabetes centres in 12 Asian regions were collected on a retrospective-prospective basis through review of medical records, interview and laboratory assessments. Analysis of glycated haemoglobin (HbA1c) was carried out in central laboratories appointed by Bio-Rad. The data collection case record forms were scanned electronically. 22177 patients with valid data made up the analysis population. Among patents with type 1 and type 2 diabetes, there was a higher proportion of women than men (53% vs. 47% for type 1 patients and 56% vs. 44% for type 2 diabetes). Hypertension (61%) and overweight (40% with BMI > or = 25 kg/m2 were common in type 2 patients. Dyslipidaemia was also present in at least half of both types of patients. Control of glycaemia (mean HbA,1c and fasting blood glucose [FBG]) was poor in type 1 (9.9 +/- 2.5%; 10.2 +/- 5.2 mmol/l) and type 2 patients (8.5 +/- 2.0%; 8.9 +/- 3.4 mmol/l). Glycaemia in the majority of both types of patients fell short of those stipulated by various guidelines. In type 2 patients, glycaemia deteriorated (HbA1c > 7.5%, FBG > or = 7.0 mmol/l) with duration of diabetes > 7 years. Both types of diabetes appear to share a similar high prevalence of complications of cataract, retinopathy and neuropathy, although the prevalence of cataract (27%) and neuropathy (35%) was higher in type 2 diabetes. Screening for microalbuminuria was not common. The Inadequate metabolic and hypertension control, especially in type 2 patients, needs to be addressed.
    Current Medical Research and Opinion 02/2002; 18(5):317-27. · 2.26 Impact Factor