Thailand Diabetes Registry Project: Prevalence of Vascular Complications in Long-standing Type 2 Diabetes
Rattana Leelawattana MD*, Thongchai Pratipanawatr MD**, Pongamorn Bunnag MD***, Natapong Kosachunhanun MD****, Sompongse Suwanwalaikorn MD*****, Sirinate Krittiyawong MD******, Thanya Chetthakul MD*******, Nattachet Plengvidhya MD********, Yupin Benjasuratwong MD*********, Chaicharn Deerochanawong MD**********, Sirima Mongkolsomlit BS***********, Chardpraorn Ngarmukos MD***, Petch Rawdaree MD************
Affiliation : * Department of Medicine, Faculty of Medicine, Prince of Songkla University ** Deptpartment of Medicine, Faculty of Medicine, Khon Kaen University *** Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University **** Department of Medicine, Faculty of Medicine, Chiang Mai University ***** Department of Medicine, Faculty of Medicine, Chulalongkorn University ****** Theptarin General Hospital, ******* Department of Medicine, Maharat Nakhon Ratchasima Hospital ******** Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University ********* Department of Internal Medicine, Phramongkutklao Hospital, ********** Rajavithi Hospital *********** TDR research coordinator, ************ BMA Medical Collage and Vajira Hospital
Objective : To explore the nature of diabetic complications in type 2 diabetic patients who had had diabetes
for longer than 15 years (long-DM), compared to those with duration of less than 15 years (short-DM).
Materials and Methods : Patients studied were adult type 2 diabetic patients registered to the Diabetes Registry
Project, a nationwide cross-sectional study of diabetes mellitus in Thailand. Information collected included
demographic data, age at diagnosis of diabetes, blood pressure, body mass index, fasting plasma glucose,
HbA1c, serum creatinine, and major diabetic vascular complications, including diabetic retinopathy (DR),
albuminuria or renal insufficiency (diabetic nephropathy; DN), myocardial infarction (MI), stroke, peripheral
arterial disease (PAD), foot ulcer and amputation.
Results : There were 9284 patients, consisting of 2244 (24.17%) subjects with long-DM (mean + SD, mean
duration of DM 21.3 + 5.8 years), and 7040 subjects with short-DM (mean duration 7.0 + 3.9 years). The long-
DM group was older than the short-DM group (65.5 + 10.3 vs 58.2 + 12.6 year-old, p less than 0.0001), and
had higher HbA1c (8.5 vs 8.0%, p = 0.009). The prevalence of diabetic complications in the long-DM group
was higher than that in the short-DM group (DN 49.4% vs 33.9%, DR 54.3% vs 22.8%; MI 9.4% vs 3.5%, PAD
17.3% vs 5.5%, foot ulcer 13.4% vs 5.3%,, stroke 9.4% vs 7.0% and amputation 5.5% vs 2.0%; all p values less
than 0.01). The duration of DM significantly affected the risk of diabetic complications after adjustment for
age, hypertension, and levels of glycemic control.
Conclusion : Diabetic duration was independently associated with increased risk of having diabetes-related
complications without threshold. Monitoring of complications in patients having long-standing diabetes is
warranted in order to provide appropriate management.
Keywords : Vascular complications, Long-standing diabetes
