Prevalence and associated factors of hospitalization for dysglycemia among elderly type 2 diabetes patients: A nationwide study

BACKGROUND The prevalence of older individuals with type 2 diabetes mellitus (T2DM) is increasing due to the aging population and improved medical care. These patients are very susceptible to disease and treatment-related hospitalizations, resulting in higher health care costs, morbidity, and decreased quality of life. However, data of treatment-related complications, especially dysglycemiarelated hospitalizations, are lacking. AIM To assess the prevalence and associated factors for dysglycemia-related hospitalizations among elderly diabetic patients in Thailand using nationwide patient sample. METHODS T2DM patients aged ≥ 65 years who received medical care at public hospitals in Thailand in the year 2014 were included. The prevalence of hospitalization due to dysglycemia within one year was examined. Multivariable logistic regression was performed to assess the independent factors associated with hospitalization due to hypoglycemia and hyperglycemia RESULTS A total of 11404 elderly T2DM patients were enrolled in this study. The mean age was 72.9 ± 5.5 years. The prevalence of hospital admissions due to diabetic ketoacidosis, hyperosmolar hyperglycemic state, hyperglycemic dehydration syndrome, and hypoglycemia among elderly T2DM patients in the year 2014 was 0.1%, 0.1%, 1.7% and 3.1%, respectively. Increased hospitalization due to hypoglycemia was associated with older age, female sex, had hypertension, dementia, lower body mass index, elevated hemoglobin A1C (HbA1C), decreased kidney function, insulin use. Increased hospitalization due to hyperglycemia was associated with dementia, depression, lower body mass index, elevated HbA1C, and insulin use. CONCLUSION The prevalence of dysglycemia-related hospitalization in elderly T2DM patients in Thailand was 4.9%. Close monitoring of blood glucose should be provided in high-risk patients for prevention and early detection for these complications.

Associations of renal function with diabetic retinopathy and visual impairment in type 2 diabetes: A multicenter nationwide cross-sectional study

BACKGROUND Diabetic retinopathy(DR) separately has been noted as a major public health problem worldwide as well. Currently, many studies have demonstrated an association between diabetic nephropathy and DR in type 1 diabetes mellitus(T1DM) patients, but this association is less strong in T2DM. The evidence for an association between renal function and DR and visual impairment among T2DM patients is limited, particularly in the Asian population.AIM To assess the association between glomerular filtration rate(GFR) and DR, severe DR, and severe visual impairment among T2DM patients in Thailand.METHODS We conducted a nationwide cross-sectional study based on the DM/HT study of the Medical Research Network of the Consortium of Thai Medical Schools. This study evaluated adult T2DM patients from 831 public hospitals in Thailand in the year 2013. GFR was categorized into ≥ 90, 60-89, 30-59 and < 30 mL/min/1.73 m^2.The association between GFR and DR, severe DR, and severe visual impairment were assessed using multivariate logistic regression.RESULTS A total of 13192 T2DM patients with available GFR were included in the analysis.The mean GFR was 66.9 ± 25.8 mL/min/1.73 m^2. The prevalence of DR,proliferative DR, diabetic macular edema, and severe visual impairment were 12.4%, 1.8%, 0.2%, and 2.1%, respectively. Patients with GFR of 60-89, 30-59 and <30 mL/min/1.73 m^2 were significantly associated with increased DR and severe DR when compared with patients with GFR of ≥ 90 mL/min/1.73 m^2. In addition,increased severe visual impairment was associated with GFR 30-59 and < 30 m L/min/1.73 m^2.CONCLUSION Decreased GFR was independently associated with increased DR, severe DR, and severe visual impairment. GFR should be monitored in diabetic patients for DR awareness and prevention.

Trends in the prevalence of obesity among young Thai men and associated factors:From 2009 to 2016

Background:The prevalence of obesity has been increasing in both males and females worldwide.In Thailand,the National Health Examination Surveys reported that the prevalence of obesity(body mass index(BMI)≥30 kg/m^2)among Thai male adults aged 20–59 years increased from 1.7%in 1991 to 6.8%in 2009.Obesity has been confirmed to lead to health problems,including noncommunicable diseases.In the present study,we report trends in the prevalence of obesity among new conscripts from 2009 to 2016.We also investigated the associated factors of obesity.Methods:Serial cross-sectional studies were conducted from 2009 to 2016 among male Royal Thai Army(RTA)conscripts whose weight and height had been measured to determine BMI after being inducted.Each subject completed a detailed risk factor questionnaire.Obesity was defined as BMI≥30 kg/m2.Results:A total of 26,540 young Thai males conscripted into the RTA were included in this study.The prevalence of obesity was 2.2%in 2009,3.4%in 2010,2.5%in 2011,2.9%in 2012,3.4%in 2013,4.4%in 2014,5.0%in 2015,and 4.8%in 2016(P for trend<0.0001).The independent risk factors for obesity were coming from the north central and south regions compared with the northeast,higher education level,indoor occupation and no regular exercise.Conclusions:Our data emphasized that obesity constitutes a serious problem among young Thai men.We could apply these findings in military units to other groups at any age.Regular exercise should be provided to young adults and other age groups to slow the process of obesity,so that associated complications,especially noncommunicable diseases,will cease.

Associations of new-onset atrial fibrillation and severe visual impairment in type 2 diabetes:A multicenter nationwide study

BACKGROUND Many studies have demonstrated an association between type 2 diabetes mellitus(T2DM)and atrial fibrillation(AF).However,the potential independent contributions of T2DM and AF to the prevalence of visual impairment have not been evaluated.AIM To determine whether such an association between T2DM and incident AF with visual impairment exists,and if so,the prevalence and magnitude of this association.METHODS We conducted a nationwide cross-sectional study based on the DM/HT study of the Medical Research Network of the Consortium of Thai Medical Schools.This study had evaluated adult T2DM patients from 831 public hospitals in Thailand in the year 2013.T2DM patients were categorized into two groups:patients without and with incident AF.T2DM patients without AF were selected as the reference group.The association between incident AF and visual impairment among T2DM patients was assessed using multivariate logistic regression.RESULTS A total of 27281 T2DM patients with available eye examination data were included in this analysis.The mean age was 60.7±10.5 years,and 31.2%were male.The incident AF was 0.2%.The prevalence of severe visual impairment in all T2DM patients,T2DM patients without AF,and T2DM patients with incident AF were 1.4%,1.4%,and 6.3%,respectively.T2DM patients with incident AF were associated with an increased OR of 3.89(95%CI:1.17-13.38)for severe visual impairment compared with T2DM patients without AF.CONCLUSION T2DM patients with incident AF were independently associated with increased severe visual impairment.Therefore,early eye screening should be provided for these high-risk individuals.