AimsThe aims of this study were to evaluate the outcomes of treatment among hospitalized patients with diabetic foot ulcers, the risk factors for non-healing ulcers, and the rate of major amputation among Thai patients.MethodsA retrospective study of hospitalized diabetic foot patients treated at Theptarin Hospital during the period of 2009–2013. The complete healing rate was assessed at 12 months after admission.ResultsDuring the study period, 232 patients (123 males and 109 females) with 262 admissions were included (mean age 65.6 ± 11.9 years, mean duration of diabetes 17.2 ± 9.9 years) with a mean follow-up of 17.5 ± 16.7 months. Major amputations were performed in 4.2% of the patients and peripheral vascular disease (PVD) was a predictive factor (OR 5.25; 95% CI [1.43–19.29]; p-value 0.006). Complete healing (including minor amputations) was achieved in 82.1% of the admissions. Only DFU of the heel was a statistically significant (OR 3.34; 95% CI [1.11–10.24]; p-value 0.041) predictor of non-healing ulcers. Three patients (1.1%) died during hospitalization.ConclusionsManagement of diabetes-related foot ulcers with a multidisciplinary approach resulted in a limb salvage rate that was greater than 90% and a complete healing rate that was greater than 80%. Successful management of diabetic foot ulcers might be possible in Thailand utilizing this approach.

BackgroundCharcot foot is a rare but a serious diabetic condition. Recognition of this often overlooked condition to provide timely and proper management is important for a better prognosis. Limited data on Charcot foot was available in Asians.AimsThe aim of this study is to describe salient features and outcomes of Charcot foot in Thai patients.MethodWe presented our experience of 40 cases of Charcot foot patients who were treated from 2000 to 2016 at Theptarin Hospital, Bangkok, Thailand.ResultsA total of 40 Charcot foot patients were identified (13 acute, 27 chronic; mean age 58.7 ± 10.2 years; duration of diabetes 18.0 ± 8.8 years; T2DM 95%). The average serum HbA1c level was 9.2 ± 1.9%. While acute Charcot foot was frequently misdiagnosed as cellulitis in almost one-third of patients, osteomyelitis was a leading cause of misdiagnosis in 15% of chronic Charcot foot patients. Ulcer-free rate at 6 and 12 months were observed in 60% and 58% of patients, respectively. The mortality rate was 13% during a median follow-up period of 57 months. Only 61% of the patients resumed walking normally while almost one-fourth of them were wheelchair-bound.ConclusionsCharcot foot in Thai patients mainly developed in long-standing poorly controlled type 2 diabetes with neuropathy, and presented late in the course of the disease. It was often misdiagnosed resulting in improper management and poor outcome which included amputation.

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Background: Early detection of diabetes allows prompt access to interventions that can improve microvascular and macrovascular disease outcomes. Multiple strategies have been employed, i.e., the use of diabetes risk scores including blood testing. Objective: The study aimed to evaluate the correlation between point-of-care hemoglobin A1c (POC HbA1c) and Thai diabetes risk score. Methods: A cross-sectional study was conducted consisting of 252 individuals without diabetes over the age of 35. Demographic data and anthropometric measures were recorded and the blood test for POC HbA1c including plasma glucose were performed. Results: Of 252 participants, the mean HbA1c was 5.56 ± 0.73%, the median Thai diabetes risk score was 7 [5-10] and American Diabetes Association (ADA) risk score was 3 [2.3-4]. Males had higher risk scores than females. Weak positive correlations were observed between POC HbA1c and both Thai and ADA risk score (r = 0.226 and 0.279, respectively, p<0.001). The predictors of higher HbA1c among males were high BMI and waist circumference. Conclusion: A weak correlation of POC HbA1c and Thai diabetes risk score suggested that POC HbA1c may not be beneficial in screening diabetes in out-of-clinic situations; however, male participants with WC >100 cm and BMI >27.5 kg/m2 were associated with highest HbA1c.