Diabetes Centre

Having diabetes means you need to take greater care of yourself. There's more to it than just blood sugar - other health risks are raised as well.

Diabetes Mellitus   is characterised by an abnormality of glucose metabolism, which causes elevated glucose levels (hyperglycaemia) in both the blood and the urine. This failure of the human body to properly handle glucose, results directly from decreased insulin secretion, action or both. Insulin, produced by beta cells in the pancreas, allows the body's cells to use glucose as an energy fuel. When this cannot occur the body attempts to introduce more fuel (food) and starts to use alternate sources, such as stored fats. Consequently blood glucose levels rapidly rise and potentially poisonous by-products (ketones) are released from the accompanying and extensive fat metabolism. Unchecked this sequence of events can finally lead to a life-threatening condition known as diabetic ketoacidosis. Management of diabetes therefore attempts to restore blood glucose levels to near-normal using combinations of diet, exercise, drugs and insulin therapy.

Diabetes can be broadly classified into two main forms, referred to as type 1 or type 2 and each with its own particular characteristics. These differences are summarised opposite and highlight that type 1 diabetes is essentially associated with initial onset during a young age, hence the reason it is also commonly referred to as juvenile-onset diabetes.

Type 1 diabetes is in fact less prevalent than type 2. It is also suggested that for every diagnosed type 2, there is one other undiagnosed type 2. Based on that estimate the actual proportion of people with type 1 diabetes is only about 10% of the total diabetes population.

In some individuals diabetes may result from other specific causes or use of certain drugs. For example hyperglycaemia may be secondary to certain pancreatic and endocrine diseases, drugs, chemicals, infections and genetic defects. Such occurrences however are uncommon.

Common Symptoms of Undiagnosed Diabetes

• Excessive desire to drink
• Frequent passage of urine
• Increased fatigue or lethargy
• Severe irritation and itching
• Excessive hunger
• Blurred vision
• Weight Loss
• For face, neck, chest, hands, arms, back and scalp.

type 1 Diabetes

• abrupt onset
• normally age < 20 yr
• symptoms at diagnosis
• autoimmune mediated
• no Beta cell function
• no insulin production
• insulin therapy required
• not usually overweight

type 2 Diabetes

• gradual onset
• normally age > 35 yr
• frequently no symptoms
• erratic Beta cell function
• insulin normal or raised or decreased
• oral drugs may be used
• family history common
• usually overweight

What happens to my heart and blood vessels ?

Diabetes is a condition that affects blood glucose control. If your blood glucose levels are high over a long period of time, it can damage many blood vessels and organs. People with diabetes get two to three times more heart attacks, heart failure and strokes than people without diabetes.

The risk of heart attacks is even greater amongst women with diabetes. Diabetes is often associated with other risk factors for heart disease, such as high blood pressure, high blood cholesterol, not being physically active and being overweight. The risk of heart attack escalates when any of these conditions are present with diabetes. Diabetes speeds up any thickening and narrowing inside the blood vessels (atherosclerosis) that might occur because of the risk factors mentioned above, and also as a part of ageing. Diabetes also allows blood clots to form more easily within the blood vessels. Blockages in the coronary arteries cause a heart attack and blockages in the arteries to the brain cause a stroke. Blockages in the arteries to the legs cause poor circulation, pain on walking and they can lead to amputation.

How do I know if I have heart disease?

You may start having chest pain (angina) when you exercise or exert yourself, or you may get short of breath when doing everyday activities. However, more often than not, heart disease sneaks up on you and you don't know you have it until it is already quite advanced. If you have diabetes, it is therefore very important that you should have blood pressure controlled, that your diabetes is well controlled at all times as well as your lipid profile to lessen damaging your arteries and heart, and that you adopt heart-healthy habits.

Can there be other complications from diabetes?

Peoples with diabetes can develop high blood pressure (hypertension). In younger people this usually results from kidney damage. There can be rapid development of hardening of the arteries (arteriosclerosis) and this can lead to heart disease and impaired blood supply to the legs. The eyes can be affected (this is called retinopathy) with some people becoming blind.

All people with diabetes are at risk of the condition which is largely related to the duration of the diabetes. In younger insulin dependent people with diabetes, the onset of the condition is rapid, whereas, in older people with diabetes, it comes on more slowly and the exact onset is therefore more difficult to pinpoint. After ten years of the disease all people with diabetes will have some degree of retinopathy and about 40% to 50% will develop complications which can cause an effect on vision.

Can it be prevented ?

Good control of the blood glucose will reduce the incidence of retinopathy and control of hypertension is also important. Smoking is associated with greater risk of the condition. The most important preventive measure with regard to visual loss from diabetes is regular examinations by an eye specialist to detect the early changes of retinopathy. Special care needs to be taken in pregnant diabetic patients.

Our Expertise

At Kasemrad Hospital Prachachuen Diabetes Centre, we are committed to providing individualised, personal care to each person we see. Our patients are an important part of our team. All working together, we can identify, delay or prevent complications from diabetes.

Our Philosophy

Diabetes is a disease in which the person with diabetes has 99% of the responsibility for their care and 100% of the consequences of how well they do.

Diabetes is not a subject to be mastered or a set of skills to be learned. Diabetes is a lived experience inseparable from life, family, work, worries, hopes and dreams.

Kasemrad Diabetes Centre at Prachachuen strives to teach people to live with their disease successfully as they define success.

We try to accept people where they are, respect their efforts and the reality of their experience. We ask questions and listen to responses. We offer choices and honour the choices that our patients make. We strive to maintain a loving and empowering relationship with our patients.

We ask our patients:

• What their questions are
• What their fears are
• What they want to accomplish

We provide:

• A problem-solving approach to living with diabetes
• Skills education focused on daily care and patient specific needs
• The latest information in diabetes care and management

We employ the latest:

• Technological advances
• Pharmaceutical products
• Educational resources

We believe that the person with diabetes has the ability to control his/her blood glucose as well as he or she wants to. Our job is coach, resource, and cheerleader.

Our medical director, Ketnapa Teganjanavanich MD , is board certified in Endocrinology and Metabolism. Her interests are in the clinical care and the research of diabetes, lipids, osteoporosis and other metabolic disorders.

Our nurse is a highly motivated and caring Registered Nurse and Certified Diabetes Educator who has demonstrated a high level of clinical expertise.

We have a Nutrition Educator who is a Registered Dietitian. She is a key team member supplying the knowledge and philosophy of the Diabetes Centre to patients when confronted with possible life style changes.

Under these key individuals' direction, we provide:

• comprehensive diabetes management services
• diagnosis, treatment and support for diabetes and related disorders
• clinical trials in the newest areas of diabetes treatment

Thyroid

Patients with thyroid disorders often have problem with energy levels, as well as muscle strength, emotions, weight control and hot/cold tolerance. Endocrinologists treat patients with too much or too little of the thyroid hormones by helping patients reach a hormonal balance.

Osteoporosis and Bone Disorders

Osteomalacia (which causes bones to soften) and osteoporosis (which causes bones to weaken) are often caused by a drop of the level of the hormones that protect bone tissue. Menopause, loss of testicle function and aging may create a risk for bone fractures.

Reproduction and Infertility

Endocrinologists diagnose and treat the precise hormone imbalance that causes infertility, and also assess and treat patients with reproductive problems based in glands. They treat patients who need hormone replacement, including those with menopause symptoms, irregular periods, endometriosis, polycystic ovary syndrome, premenstrual syndrome and impotence.

Obesity and Overweight

Endocrinologists treat patients who are overweight or obese, often because of metabolic and hormonal problems. Thyroid, adrenal, ovarian and pituitary disorders can cause obesity. Endocrinologists also identify factors linked with obesity such as insulin resistance and genetic problems.

Pituitary Gland Disorders

The pituitary is often called the master gland of the body because it controls other glands, and the pituitary makes several vital hormones. Over or under production of pituitary hormones can lead to infertility, menstrual disorders, growth disorders and overproduction of cortisol (Cushing's syndrome). Endocrinologists control these conditions with medications and refer patients who need surgery.

Growth Disorders

Adults with growth hormone deficiency can experience emotional and psychological distress as well as fatigue. Safe and effective growth hormone replacement therapy is available for people with abnormal growth.

Hypertension

About 11 percent of people with hypertension have too much aldosterone, a hormone produced in the adrenal glands. Approximately half of these cases are caused by growths that can be removed by surgery.

Lipid (cholesterol) Disorders

Patients with lipid disorders have trouble maintaining normal levels of fat in their blood. Hypertension is common in people with lipid disorders, which can put patients at higher risk for coronary heart disease. Endocrinologists are trained to detect factors that may be related to lipid disorders, such as hypothyroidism, steroid use, or genetic or metabolic conditions. Lipid disorders can be found in several conditions that require special management, including metabolic syndrome, polycystic ovary syndrome and obesity. Special diets, exercise and medications may be prescribed to manage lipid disorders.

Consultant Physicians:

Anothai Prukwattanasuk, M.D.
Suchitra Sukhavachana, M.D.
Supavadee Treesolrat, M.D.

Call Us (662) 910-1600 Ext.1080
E-Mail: diabetes@kasemrad.com