Skip to main content

Diabetes in Thailand: Status and Policy

Abstract

Like other countries in the Western Pacific region, Thailand is facing increasing numbers of patients with diabetes due to unhealthy diets, high obesity rates, and an aging society. Diabetes is a considerable burden for developing countries as it reduces quality of life, increases mortality, and drives up healthcare costs. The disease detection rate in Thailand has improved in recent years, but glycemic control remains suboptimal and significant numbers of patients suffer from complications. Universal healthcare coverage has increased access to care, but inequality exists between different health plans and non-medication diabetes supplies are not yet widely covered. Diabetes self-management education has not yet been standardized and a multidisciplinary team approach is not widely utilized. The Thai government recognizes the burden of diabetes and has launched nationwide programs of health promotion and disease prevention. In addition, local initiatives have targeted reductions in specific complications, including retinopathy and diabetic foot problems, which has resulted in better disease prevention and treatment. Along with strategic public health planning, increased collaboration between private and public sectors, enhanced professional training, increased use of technology and data management, and equitable distribution of care are all needed to improve outcomes of patients with diabetes in Thailand.

This is a preview of subscription content, access via your institution.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.

    The World Bank. Thailand. http://data.worldbank.org/country/thailand. Last updated 2015. Accessed 8-18-2015.

  2. 2.

    Porapakkham Y, Rao C, Pattaraarchachai J, Polprasert W, Vos T, Adair T. Estimated causes of death in Thailand, 2005: implications for health policy. Popul Health Metr. 2010;8:14.

    Article  PubMed  PubMed Central  Google Scholar 

  3. 3.••

    Deerochanawong C, Ferrario A. Diabetes management in Thailand: a literature review of the burden, costs, and outcomes. Global Health. 2013;9:11. A recent comprehensive review of diabetes status in Thailand.

    Article  PubMed  PubMed Central  Google Scholar 

  4. 4.

    Aekplakorn W, Stolk RP, Neal B, Suriyawongpaisal P, Chongsuvivatwong V, Cheepudomwit S, et al. The prevalence and management of diabetes in Thai adults: the international collaborative study of cardiovascular disease in Asia. Diabetes Care. 2003;26(10):2758–63.

    Article  PubMed  Google Scholar 

  5. 5.

    Aekplakorn W, Abbott-Klafter J, Premgamone A, Dhanamun B, Chaikittiporn C, Chongsuvivatwong V, et al. Prevalence and management of diabetes and associated risk factors by regions of Thailand: Third National Health Examination Survey 2004. Diabetes Care. 2007;30(8):2007–12.

    CAS  Article  PubMed  Google Scholar 

  6. 6.••

    Aekplakorn W, Chariyalertsak S, Kessomboon P, Sangthong R, Inthawong R, Putwatana P, et al. Prevalence and management of diabetes and metabolic risk factors in Thai adults: the Thai National Health Examination Survey IV, 2009. Diabetes Care. 2011;34(9):1980–5. The most recent National Health Examination Survey results on diabetes status in Thailand, 2009.

    Article  PubMed  PubMed Central  Google Scholar 

  7. 7.

    Likitmaskul S, Wacharasindhu S, Rawdaree P, Ngarmukos C, Deerochanawong C, Suwanwalaikorn S, et al. Thailand diabetes registry project: type of diabetes, glycemic control and prevalence of microvascular complications in children and adolescents with diabetes. J Med Assoc Thai. 2006;89 Suppl 1:S10–6.

    PubMed  Google Scholar 

  8. 8.•

    Rawdaree P, Ngarmukos C, Deerochanawong C, Suwanwalaikorn S, Chetthakul T, Krittiyawong S, et al. Thailand diabetes registry (TDR) project: clinical status and long term vascular complications in diabetic patients. J Med Assoc Thai. 2006;89 Suppl 1:S1–9. One of the larger diabetes registry conducted in 11 university medical centers.

    PubMed  Google Scholar 

  9. 9.

    Nitiyanant W, Chetthakul T, Sang A, Therakiatkumjorn C, Kunsuikmengrai K, Yeo JP. A survey study on diabetes management and complication status in primary care setting in Thailand. J Med Assoc Thai. 2007;90(1):65–71.

    PubMed  Google Scholar 

  10. 10.

    Likitmaskul S, Kiattisathavee P, Chaichanwatanakul K, Punnakanta L, Angsusingha K, Tuchinda C. Increasing prevalence of type 2 diabetes mellitus in Thai children and adolescents associated with increasing prevalence of obesity. J Pediatr Endocrinol Metab. 2003;16(1):71–7.

    CAS  Article  PubMed  Google Scholar 

  11. 11.

    Jiamjarasrangsi W, Aekplakorn W. Incidence and predictors of type 2 diabetes among professional and office workers in Bangkok, Thailand. J Med Assoc Thai. 2005;88(12):1896–904.

    PubMed  Google Scholar 

  12. 12.

    Aekplakorn W, Bunnag P, Woodward M, Sritara P, Cheepudomwit S, Yamwong S, et al. A risk score for predicting incident diabetes in the Thai population. Diabetes Care. 2006;29(8):1872–7.

    Article  PubMed  Google Scholar 

  13. 13.

    Jiamjarasrangsi W, Lohsoonthorn V, Lertmaharit S, Sangwatanaroj S. Incidence and predictors of abnormal fasting plasma glucose among the university hospital employees in Thailand. Diabetes Res Clin Pract. 2008;79(2):343–9.

    CAS  Article  PubMed  Google Scholar 

  14. 14.

    Tuchinda C, Angsusingha K, Chaichanwalanakul K, Likitmaskul S, Vannasaeng S. The epidemiology of insulin-dependent diabetes mellitus (IDDM): report from Thailand. J Med Assoc Thai. 1992;75(4):217–22.

    CAS  PubMed  Google Scholar 

  15. 15.

    Panamonta O, Laopaiboon M, Tuchinda C. Incidence of childhood type 1 (insulin dependent) diabetes mellitus in northeastern Thailand. J Med Assoc Thai. 2000;83(8):821–4.

    CAS  PubMed  Google Scholar 

  16. 16.

    Panamonta O, Thamjaroen J, Panamonta M, Panamonta N, Suesirisawat C. The rising incidence of type 1 diabetes in the northeastern part of Thailand. J Med Assoc Thai. 2011;94(12):1447–50.

    PubMed  Google Scholar 

  17. 17.

    Tuchinda C, Likitmaskul S, Unachak K, Panamonta O, Patarakijavanich N, Chetthakul T. The epidemiology of type 1 diabetes in Thai children. J Med Assoc Thai. 2002;85(6):648–52.

    PubMed  Google Scholar 

  18. 18.

    Lawrence JM, Imperatore G, Dabelea D, Mayer-Davis EJ, Linder B, Saydah S, et al. Trends in incidence of type 1 diabetes among non-Hispanic white youth in the U.S., 2002–2009. Diabetes. 2014;63(11):3938–45.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  19. 19.

    Harjutsalo V, Sjoberg L, Tuomilehto J. Time trends in the incidence of type 1 diabetes in Finnish children: a cohort study. Lancet. 2008;371(9626):1777–82.

    Article  PubMed  Google Scholar 

  20. 20.

    Kosachunhanun N, Benjasuratwong Y, Mongkolsomlit S, Rawdaree P, Plengvidhya N, Leelawatana R, et al. Thailand diabetes registry project: glycemic control in Thai type 2 diabetes and its relation to hypoglycemic agent usage. J Med Assoc Thai. 2006;89 Suppl 1:S66–71.

    PubMed  Google Scholar 

  21. 21.

    Chuang LM, Tsai ST, Huang BY, Tai TY. The status of diabetes control in Asia—a cross-sectional survey of 24 317 patients with diabetes mellitus in 1998. Diabet Med. 2002;19(12):978–85.

    CAS  Article  PubMed  Google Scholar 

  22. 22.•

    National Health Security Office T. Clinical care results for type 2 diabetes and hypertension from the Ministry of Public Health hospitals and Bangkok health centers 2014 https://thaimedresnet.org/. Last updated 2014. Accessed 8/15/2014. Recent outcome data on key performance indices of diabetes care for over 30,000 patients, collected by the National Health Security Office.

  23. 23.••

    Trepatchayakorn S, Supornsilchai V, Wacharasindhu S, Aroonparkmongkol S, Sahakitrungruang T. Trends and characteristics of childhood diabetes in a tertiary care center in Thailand. Asian Biomedicine. 2014;8(6):707–15. Recent data on childhood diabetes status in a large university hospital.

    Google Scholar 

  24. 24.

    Santiprabhob J, Weerakulwattana P, Nunloi S, Kiattisakthavee P, Wongarn R, Wekawanich J, et al. Etiology and glycemic control among Thai children and adolescents with diabetes mellitus. J Med Assoc Thai. 2007;90(8):1608–15.

    PubMed  Google Scholar 

  25. 25.

    Chetthakul T, Likitmaskul S, Plengvidhya N, Suwanwalaikorn S, Kosachunhanun N, Deerochanawong C, et al. Thailand diabetes registry project: prevalence of diabetic retinopathy and associated factors in type 1 diabetes mellitus. J Med Assoc Thai. 2006;89 Suppl 1:S17–26.

    PubMed  Google Scholar 

  26. 26.

    Bunnag P, Plengvidhya N, Deerochanawong C, Suwanwalaikorn S, Kosachunhanun N, Benjasuratwong Y, et al. Thailand diabetes registry project: prevalence of hypertension, treatment and control of blood pressure in hypertensive adults with type 2 diabetes. J Med Assoc Thai. 2006;89 Suppl 1:S72–7.

    PubMed  Google Scholar 

  27. 27.

    Pratipanawatr T, Rawdaree P, Chetthakul T, Bunnag P, Ngarmukos C, Benjasuratwong Y, et al. Thailand diabetes registry project: current status of dyslipidemia in Thai diabetic patients. J Med Assoc Thai. 2006;89 Suppl 1:S60–5.

    PubMed  Google Scholar 

  28. 28.

    Sriwijitkamol A, Moungngern Y, Vannaseang S. Assessment and prevalences of diabetic complications in 722 Thai type 2 diabetes patients. J Med Assoc Thai. 2011;94 Suppl 1:S168–74.

    PubMed  Google Scholar 

  29. 29.

    Kosachunhanun N, Tongprasert S, Rerkasem K. Diabetic foot problems in tertiary care diabetic clinic in Thailand. Int J Low Extrem Wounds. 2012;11(2):124–7.

    Article  PubMed  Google Scholar 

  30. 30.

    Potisat S, Krairittichai U, Jongsareejit A, Sattaputh C, Arunratanachote W. A 4-year prospective study on long-term complications of type 2 diabetic patients: the Thai DMS diabetes complications (DD.Comp.) project. J Med Assoc Thai. 2013;96(6):637–43.

    PubMed  Google Scholar 

  31. 31.

    Krittiyawong S, Ngarmukos C, Benjasuratwong Y, Rawdaree P, Leelawatana R, Kosachunhanun N, et al. Thailand diabetes registry project: prevalence and risk factors associated with lower extremity amputation in Thai diabetics. J Med Assoc Thai. 2006;89 Suppl 1:S43–8.

    PubMed  Google Scholar 

  32. 32.

    Riewpaiboon A, Chatterjee S, Riewpaiboon W, Piyauthakit P. Disability and cost for diabetic patients at a public district hospital in Thailand. Int J Pharm Pract. 2011;19(2):84–93.

    Article  PubMed  Google Scholar 

  33. 33.

    Chaikledkaew U, Pongchareonsuk P, Chaiyakunapruk N, Ongphiphadhanakul B. Factors affecting health-care costs and hospitalizations among diabetic patients in Thai public hospitals. Value Health. 2008;11 Suppl 1:S69–74.

    Article  PubMed  Google Scholar 

  34. 34.

    Goldhaber-Fiebert JD, Li H, Ratanawijitrasin S, Vidyasagar S, Wang XY, Aljunid S, et al. Inpatient treatment of diabetic patients in Asia: evidence from India, China, Thailand and Malaysia. Diabet Med. 2010;27(1):101–8.

    CAS  Article  PubMed  Google Scholar 

  35. 35.•

    Chatterjee S, Riewpaiboon A, Piyauthakit P, Riewpaiboon W, Boupaijit K, Panpuwong N, et al. Cost of diabetes and its complications in Thailand: a complete picture of economic burden. Health Soc Care Community. 2011;19(3):289–98. A comprehensive calculation of direct and indirect care cost for diabetes patients.

    Article  PubMed  Google Scholar 

  36. 36.

    National Health Security Office. NHSO annnual report fiscal year 2013. http://www.nhso.go.th. Last updated 2015. Accessed 9-14-2015.

  37. 37.

    Faculty of Medicine Ramathibodi Hospital. Drug list, Faculty of Medicine Ramathibodi Hospital 2014. Published 2014.

  38. 38.

    Deebukkham P, Thavorncharoensap M, Kingkaew P, Teerawattananon Y. Cost-utility analysis of Self-monitoring blood glucose in diabetes mellitus type 1 and 2 who use insulin in Thailand. http://www.hitap.net/en/research/17715. Last updated 2-26-2012. Accessed 10-6-2015.

  39. 39.

    World Diabetes Foundation. Mobile eye care WDF08-395. http://www.worlddiabetesfoundation.org/projects/thailand-wdf08-395. Last updated 2012. Accessed 10-6-2015.

  40. 40.

    Thai Diabetes Society. Delivery of the best care for type 1 diabetes in the auspicious celebration of His Majesty The King’s 7th Cycle Birthday Anniversary, the 5th of December 2011. Bangkok: Srimaung Publishing; 2014.

    Google Scholar 

  41. 41.•

    World Diabetes Foundation. Foot care and footwear training WDF12-674. http://www.worlddiabetesfoundation.org/projects/thailand-wdf12-674. Last updated 2015. Accessed 10-6-2015. The first effort to improve foot care in Thailand through providing better care and educating health professionals, funded by the World Diabetes Foundation.

  42. 42.

    National Health Security Office. Clinical care results for type 2 diabetes and hypertension from the Ministry of Public Health hospitals and Bangkok health centers 2015. https://thaimedresnet.org/. Last updated 2015. Accessed 10-6-2015.

  43. 43.••

    Tantayotai V, Numsangkul S, Tinnaluck Y. Moving knowledge spiral toward a community-based lifestyle intervention program for people with prediabetes. World Diabetes Congress. 12-3-2013. The first Thai Diabetes Prevention Program, conducted with the funding from the International Diabetes Federation.

  44. 44.

    Galbally R, Fidler A, Chowdhuty M, Tang KC, Good S, Tantivess S. Ten year review of Thai Health Promotion Foundation, Nov 2001-Nov 2011. http://en.thaihealth.or.th/. Last updated 2012. Accessed 10-6-2015

  45. 45.••

    Ministry of Public Health. Thailand healthy lifestyle strategic plan (2011–2020). http://bps2.moph.go.th/content/thailand-healthy-lifestyle-strategic-plan-be-2554-2563-2011-2020. Last updated 2011. Accessed 9-30-2015. Lifestyle strategic plan specifically targeting non-communicable diseases, spanning 10 years, developed by the Ministry of Public Health in parallel with the 11th National Health Development Plan.

  46. 46.

    Satheannoppakao W, Aekplakorn W, Pradipasen M. Fruit and vegetable consumption and its recommended intake associated with sociodemographic factors: Thailand National Health Examination Survey III. Public Health Nutr. 2009;12(11):2192–8.

    Article  PubMed  Google Scholar 

  47. 47.

    Steering Committee on Formulation of 11th National Health Development Plan 2012–2016, Ministry of Public Health. The 11th National Health Development Plan under the National Economic and Social Development Plan (2012–2016). Published 10-2012.

  48. 48.

    Aekplakorn W, Inthawong R, Kessomboon P, Sangthong R, Chariyalertsak S, Putwatana P, et al. Prevalence and trends of obesity and association with socioeconomic status in Thai adults: National Health Examination Surveys, 1991–2009. J Obes. 2014;2014:410259.

    Article  PubMed  PubMed Central  Google Scholar 

  49. 49.

    Department of Medical Services, Ministry of Public Health. Thailand Medical Services Profile 2011–2014. http://www.dms.moph.go.th/ last updated 9-30-2014. Accessed 10-5-2015.

  50. 50.•

    Thailand Development Research Institute. Health outcomes and healthcare equality. http://tdri.or.th/ updated 12-2014. Accessed 10-5-2015. Recent publication demonstrating care inequality among health care scheme.

  51. 51.

    Ministry of Public Health. Strategies, key performance indices and data collection, fiscal year 2015. Last updated 2014. Accessed 10-6-2015

  52. 52.•

    Chetthakul T, Likitmaskul S, Plengvidhya N, Suwanwalaikorn S, Kosachunhanun N, Deerochanawong C et al. Thailand diabetes registry project: prevalence of diabetic retinopathy and associated factors in type 1 diabetes mellitus. J Med Assoc Thai. 2006; 89 Suppl 1: S17-S26. Data on glycemic control and complications among type 1 diabetes patients.

  53. 53.

    Jongsareejit A, Potisat S, Krairittichai U, Sattaputh C, Arunratanachote W. The Thai DMS Diabetes Complications (DD.Comp.) project: prevalence and risk factors of diabetic retinopathy in Thai patients with type 2 diabetes mellitus. J Med Assoc Thai. 2013;96(11):1476–82.

    PubMed  Google Scholar 

  54. 54.

    Krairittichai U, Potisat S, Jongsareejit A, Sattaputh C. Prevalence and risk factors of diabetic nephropathy among Thai patients with type 2 diabetes mellitus. J Med Assoc Thai. 2011;94 Suppl 2:S1–5.

    PubMed  Google Scholar 

  55. 55.

    Mayurasakorn K, Somthip N, Caengow S, Chulkarat N, Wanichsuwan M. Glycemic control and microvascular complications among type 2 diabetes at primary care units. J Med Assoc Thai. 2009;92(8):1094–101.

    PubMed  Google Scholar 

  56. 56.

    Phoksunthorn T, Thatsnarong D. Retinopathy and macro-albuminuria in type 2 diabetic patients. J Med Assoc Thai. 2007;90(4):684–7.

    PubMed  Google Scholar 

  57. 57.

    Supapluksakul S, Ruamviboonsuk P, Chaowakul W. The prevalence of diabetic retinopathy in Trang Province determined by retinal photography and comprehensive eye examination. J Med Assoc Thai. 2008;91(5):716–22.

    PubMed  Google Scholar 

  58. 58.

    Silpa-Archa S, Sukhawarn R. Prevalence and associated factors of diabetic retinopathy in Chandrubeksa Hospital, Directorate of Medical Services, Royal Thai Air Force. J Med Assoc Thai. 2012;95 Suppl 4:S43–9.

    PubMed  Google Scholar 

  59. 59.

    Jenchitr W, Samaiporn S, Lertmeemongkolchai P, Chongwiriyanurak T, Anujaree P, Chayaboon D. Prevalence of diabetic retinopathy in relation to duration of diabetes mellitus in community hospitals of Lampang. J Med Assoc Thai. 2004;87(11):1321–6.

    PubMed  Google Scholar 

  60. 60.

    Narenpitak S, Narenpitak A. Prevalence of chronic kidney disease in type 2 diabetes in primary health care unit of Udon Thani Province, Thailand. J Med Assoc Thai. 2008;91(10):1505–13.

    PubMed  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to Sirimon Reutrakul.

Ethics declarations

Conflict of Interest

Sirimon Reutrakul reports grants from Merck and personal fees from Sanofi and Medtronic. Chaicharn Deerochanawong declares that he has no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Economics and Policy in Diabetes

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Reutrakul, S., Deerochanawong, C. Diabetes in Thailand: Status and Policy. Curr Diab Rep 16, 28 (2016). https://doi.org/10.1007/s11892-016-0725-7

Download citation

Keywords

  • Diabetes
  • Thailand
  • Policy
  • Glycemic control
  • Complications
  • Healthcare cost