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Prevalence and Management of Diabetes and Associated Risk Factors by Regions of Thailand

Third National Health Examination Survey 2004

¹ Community Medicine Center, Ramathibodi Hospital, Bangkok, Thailand
² Population Health, University of Queensland, Brisbane, Australia
³ Setting Priorities Using Information on Cost-Effectiveness (SPICE) Project, Ministry of Public Health, Bangkok, Thailand
⁴ Community Medicine, Khon Kaen University, Khon Kaen, Thailand
⁵ Preventive and Social Medicine, Chulalongkorn University, Bangkok, Thailand
⁶ Public Health, Mahidol University, Bangkok, Thailand
⁷ Epidemiology Unit, Prince of Songkla University, Hat Yai, Thailand
⁸ Nursing, Chiang Mai University, Chiang Mai, Thailand
⁹ Health System Research Institute, Bangkok, Thailand

Address correspondence and reprint requests to Dr. Wichai Aekplakorn, MD, PhD, Community Medicine Center, Ramathibodi Hospital, Rama 6 Road, Bangkok 10400 Thailand. E-mail: rawap{at}mahidol.ac.th

OBJECTIVE—The aim of this study was to determine the prevalence of diabetes and impaired fasting glucose (IFG) and their association with cardiovascular risk factors and to evaluate the management of blood glucose, blood pressure, and cholesterol in individuals with diabetes by geographical regions of Thailand.

RESEARCH DESIGN AND METHODS—With the use of a stratified, multistage sampling design, data from a nationally representative sample of 37,138 individuals aged 15 years were collected using questionnaires, physical examination, and blood samples.

RESULTS—The prevalence of diabetes and IFG weighted to the national 2004 population was 6.7% (6.0% in men and 7.4% in women) and 12.5% (14.7% in men and 10.4% in women), respectively. Diabetes was more common in urban than in rural men but otherwise prevalence was relatively uniform across geographical regions. In more than one-half of those with diabetes, the disease had not been previously diagnosed, although the majority of those with diabetes were treated with oral antiglycemic agents or insulin. The prevalence of associated risk factors was high among individuals with diabetes as well as those with IFG. Two-thirds of those with diabetes and concomitant high blood pressure (130/80 mmHg) were not aware that they had high blood pressure, and >70% of those with diabetes and concomitant high cholesterol (total cholesterol 6.2 mmol/l) were not aware that they had high cholesterol.

CONCLUSIONS—The prevalences of diabetes and IFG were uniformly high in all regions. Improvements in prevention, diagnosis, and treatment of diabetes and associated risk factors are required if the health burden of diabetes in Thailand is to be averted.

Abbreviations: FPG, fasting plasma glucose • IFG, impaired fasting glucose • NHESIII, Third National Health Examination Survey • PPS, probability proportional to size

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