Quality of diabetic care and complication status in Prapokklao Hospital.

Abstract

Objective : This retrospective study described the characteristic of diabetic patient,diabetes management, diabetic control and complication status among patient managed in OPD unit of Propoklao Hospital during the year 2007.

Material and method : The population of this study were all diabetic patients who visit OPD during the year 2007 A simple random sampling (1:13) was used to recruit the patients. Medical records were reviewed. Demographic data,type and duration of diabetes, risk factor, diabetes management and diabetic complications were collected and analyzed for prevalence of complication and association between risk factor, diabetes management and diabetes complication.

Results : There were 303 diabetic patients recruited in the study. Mean± SD of age, onset age and diabetes duration were 62.31±11.58, 54.59 ±11.42, 7.61± 5.23 years, respectively. Female were 62.4 percent and type 2 diabetic patients were 98.7 percent. Current smoking and alcoholic drinking was observed in 2.3 percent and 1.3 percent respectively. Overweight (BMI 23.0-24.9 kg/m2) and obesity were noted in 16.7 percent and 52.8 percent of the patients.Mean SD of FPG was 152.92 mg/dL and HbA1C was 7.661.56 percent.The percentage of patients with FPG was 90-130 mg/dL and 70-130 mg/dL were 27.7, 28.1 respectively. Whereas the percentage of patients with HbA1C below 7percent was 40.3 percent and HbA1C below 6.5 percent was 24.4 percent. Annual checkup for eye and foot examination was performed in 33.7 percent and 50.8 percent of the patients, respectively. Twice check up of HbA1C and annual checkup for lipid profile, serum creatinine, urinary protein, urine microalbumin were observed in 40.6 percent (72.9 percent annual of HbA1C), 72.3 percent (lipid profile), 78.9 percent (Cr), 5 percent (urine albumin), 36.4 percent(urine protein), of the patient, respectively.The prevalence of macrovascular complications included ischemic stroke 6.9 percent follow by NSTEMI/UA 6.6 percent and the prevalence of microvascular complication included retinopathy 5 percent, nephropathy 9.9 percent,and peripheral neuropathy 19.5 percent.

Conclusion : The present study demonstrated that necessary routine assessments were not regularly practiced by practitioner, especially annual albumin examination.Only 1/3 of patients achieved goal of glycemic control and peripheral neuropathy were the most common observed complications.