Thursday, February 17, 2011

Sweet Living: Diabetes in Thailand

By: Lauren Nolan

Edited By: Dave Talmage

Imagine living day-to-day burdened with sensations of steady thirst, headaches, a continuous urgency to urinate, nausea and blurred vision. In addition to the discomfort these symptoms yield, many Thais cannot explain why they originated.

According to a study by the American Diabetes Association an estimated 10 percent of Thailand’s population suffer from these physical afflictions. Most Thais have no understanding of why they are suffering from these symptoms, but these numbers reflect direct cases of undiagnosed or poorly monitored diabetes.

Diabetes: Undiagnosed and Uneducated

The American Diabetes Association published a study in 2003 that concluded one-half of all diabetics in Thailand are undiagnosed. Many people native to Thailand say, education in big cities such as Bangkok and Pattaya-Chon Buri may be adequate, but education in rural Thailand is insufficient, particularly in regards to health. Henok Negash, a volunteer coordinator for the Peace Corps in Thailand said, “Health is not a factor taught in schools in rural Thailand.”

A Diabetes Friendly Climate

Yingrodge Kaetangkhuen, a Lieutenant Colonel in the Thai Army, knows first hand the hardships of living with diabetes. Both Kaetangkhuen’s mother and father were diagnosed with Type 2 diabetes. Tipsukou Kaetangkhuen, Yingrodge’s wife, suggests the cause for undiagnosed and poorly managed diabetes as a result of a variety of shifting cultural factors and lifestyle choices.

Thailand’s lack of education on the disease, a shift in eating habits, which now focuses around highly processed, starchy and sugary foods, as well as exercise, or lack thereof, could all be responsible. “(Thais) have really been embracing fast food culture,” said Tipsukou Kaetangkhuen. “It is probably because, now, Thailand always seems to be on the go, and (the fast food) is convenient for this new lifestyle.”

Lorraine Bergeron, a traveler and pad Thai enthusiast, has spent many months in Thailand over the past seven years. Bergeron says numerous street foods, specifically the wok’s, use heavy oils and sugars. “Most of the curries, even the really spicy ones, are very sweet, which is what is great—and awful about it, and why I love it,” she said.

Tipsukou Kaewtangkhuen was raised farming in Lopburi province, 180 km (112 miles) north of Bangkok. “My family grew the vegetables and fruit we ate,” she said. “We knew where our food came from, did physical work to grow it and cooked it (from its most basic form).”

“MSG is added to almost all Thai street food, as is sugar,” said Greg Jorgensen, a resident of Bankok. Home cooked meals are no exception in escaping added sugars. “Whenever my (Thai) girlfriend cooks for us at home I have to tell her, ‘Go easy on the sugar,’” he said. “(Thais) put (sugar and MSG) in everything: beef stew, soup, spicy salads, etcetera.”

It’s clear food consumption and production may be a big player in the onset of Type 2 diabetes among Thais, but a shift from demanding agricultural work to more desk jobs in cities may also be to blame.

Being Diagnosed: A Shift in Lifestyle

It’s unknown if Thais will decide to alter their lifestyles in order to prevent Type 2 diabetes. However, once diagnosed, frequent blood glucose testing might be most valuable in healthy monitoring of the disease.

While Thailand’s universal healthcare system covers the costs of insulin for Type 1 diabetics and monthly visits to doctors for both Type 1 and Type 2 diabetics, it does not cover the cost of testing meters or testing strips. Consequently, some diabetics are only checking their blood glucose once per month; when they visit their doctor.

“There are many (Thais) you hear about who go blind or lose a limb because of lack of treatment,” said Kaetangkhuen. Unlike most Thais, Kaetangkhuen’s parents receive blood glucose testing meters at zero cost because he and his father are government employees.

Though there is no single strategy for the frequency diabetics should be testing blood glucose, the American Diabetes Association recommends regularly testing 4-7 times each day. Without knowing the levels of glucose in their blood, diabetics cannot accurately determine how many carbohydrates they should ingest for a safe, balanced diet. If too many grams of carbohydrate are ingested, blood glucose increases.

When blood glucose levels are high, also known as hyperglycemia, the body wants to rid the system of the excess sugar via urine. This is the reason for the “sweet urine” that Thais associate with diabetes. When blood glucose is low—hypoglycemia—diabetics experience feelings of physical weakness, headaches, sweating and anxiety. Long-term consequences of instable blood glucose take their toll on the body through vision problems, blindness, and kidney and nerve damage.

Combating Diabetes

Henok Negash is currently working through the Peace Corps on “Fighting Diabetes.” The project is aimed to provide adequate health training and equipment to diabetics in the Thamanao district, a sub-district of Chaibadan, 210 km (130 miles) northeast of Bangkok.

“This project is important in Thailand because the majority of Thais don’t have the opportunity to check their blood sugar,” said Negash. “They also don’t know the consequences of not knowing their blood sugar.”

Negash conveys that the primary goal in his venture is to reach the point where all the diabetics in his village will have the opportunity to test their blood glucose once each day, instead of once each month.

The “Fighting Diabetes” project started after Negash came to Thamanao with the Peace Corps to develop sustainable projects and teach Thais the skills to continue the projects on their own. Thamanao has a population of about 3,500 and 85 of those have been diagnosed with diabetes. The 85 were shocked to learn Negash is also diabetic.

“(The locals) commented that they think I look healthy and they wanted me to help teach them some things so that they could properly manage their diabetes,” said Negash. “I figured that I had the knowledge (of diabetes management) and if they were excited to learn, I would be excited to help.”

Photos courtesy of natala007 on and

No comments: