Thailand Diabetes Registry Project: Current Status of Dyslipidemia in Thai Diabetic Patients
Thongchai Pratipanawatr MD*, Petch Rawdaree MD**, Thanya Chetthakul MD***, Pongamorn Bunnag MD****, Chardpraorn Ngarmukos MD****, Yupin Benjasuratwong MD*****, Rattana Leelawatana MD******, Natapong Kosachunhanun MD*******, Nattachet Plengvidhya MD********, Chaicharn Deerochanawong MD*********, Sompongse Suwanwalaikorn MD**********, Sirinate Krittiyawong MD*********** , Sirima Mongkolsomlit BS**, Chulaluk Komoltri PhD************
Affiliation : * Department of Medicine, Faculty of Medicine, Khon Kaen University, ** BMA Medical College and Vajira Hospital *** Department of Medicine, Maharat Nakhon Ratchasrima Hospital **** Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University ***** Department of Internal Medicine, Phramongkutklao Hospital ****** Department of Medicine, Faculty of Medicine, Prince of Songkla University ******* Department of Medicine, Faculty of Medicine, Chiang Mai University ******** Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University ********* Rajavithi Hospital, ********** Department of Medicine, Faculty of Medicine, Chulalongkorn University *********** Theptarin General Hospital ************ Division of Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University
Objective : To determine the prevalence of dyslipidemia in adult Thai type 2 diabetes who attended diabetes clinics in university
and tertiary-care hospitals.
Materials and Methods : A cross-sectional, multi-center, hospital-based diabetes registry was conducted in 11 diabetic clinics
in tertiary medical centers in Bangkok and major provinces between April and December, 2003. A group of 9,419 diabetic
patients were registered. Individual Demographic data including education and socioeconomic status were collected. The
results of the physical examination for complications, history screening and laboratory results were recorded. The prevalence
of the various complications of diabetes was analyzed and the percentage achievement of metabolic control calculated.
Results : Of the 9,419 diabetic patients registered 8,769 had complete demographic and plasma lipid data. Mean age was 59.5
(cid:31) 13.3 years. The percentage of male patients was 33.9%. In the present study, there were 8464 type 2 diabetes and 383 type
1 diabetes. History of coronary artery disease and cerebrovascular disease were present in 8.1 and 4.2 percent of the patients,
respectively. More than 80% of the patients had dyslipidemia. The patients with CVD had higher proportion of achieving the
LDL target (< 100 mg/dl, 43 vs 34%). More than half of the patients (55%) were taking lipid lowering medications, but one-
third (30%) did not despite having fulfilled indications. The patients covered by government supported health plan were less
likely to received lipid-lowering medication than the patients covered by private health plans(OR 0.65, 95%CI 0.57-0.75).
The two most commonly used lipid-lowering agents were HMG CoA reductase inhibitors (76%) and fibrates (19%), both
agents were used in combination in 5% of the patients. Only 40.1% of the patients on lipid-lowering medications reached the
target LDL goal (<100 mg/dl).
Conclusion : Elevated LDL cholesterol was the most common lipid abnormality in the present study. Although 55% of the
patients were taking lipid lowering agents, another 42% of the patients needed the medication. More than half of the patients
treated needed more intensive lipid lowering in order to achieve the LDL goal. If the authors wish to follow the current(2005)
American Diabetes Association recommendations, we would have to treat up to 97% of diabetic patients with lipid lowering
agents.
Keywords : Diabetes registry, Diabetes, Dyslipidemia, Lipid lowering agents
