The Comparative studies of Treatment Outcomes of Diabetes Thai patients in HRH Princess Mahachakri Sirindhorn Medical Center Using The ADA 2008 guideline.

The study aims to compare treatment outcomes and complication surveillance among diabetes mellitus type II patients in the service area of HRH Princess Mahachakri Srindhon Medical Center (MSMC) with the American Diabetes Associate guideline 2008 (ADA 2008) and comparing the difference in treatment outcomes between the primary care unit (PCU) and the tertiary care unit (TCU). Data were collected by questionnaires from all type 2 diabetes patients and their medical records during 2009 – 2010 in a cross-sectional study. There were 274 type 2 diabetes patients in this study, 131 cases in PCU and 143 cases in TCU. Glycemic controls in these patients were monitored by using HbA1c at 72.5% and 74.1% in PCU and TCU, respectively. Microalbuminuria was screened in all of patients when comparing treatment service between PCU and TCU, the patients in PCU were less accomplished and less monitored than TCU patients; however, the differences were not statistically significant according to the ADA 2008 except in eye and foot examinations. In conclusion, the majority of type II diabetes patients were monitored according to the ADA 2008. The patients in TCU successfully achieved glycemic and metabolic control better than the patients in PCU without statistical significance. In consequence, physicians should be concerned about complications among type II DM patients according to the  standard guidelines, especially, in PCU. Nevertheless, physicians also should be concerned about the quality of care index using the holistic approach