Lay Explanations of Type 2 Diabetes in Bangkok, Thailand

Abstract

The increasing incidence of and mortality associated with type 2 diabetes in Thailand, and the lack of knowledge of lay understandings of diabetes, are the starting points of this paper. Ethnographic research was undertaken in an inner zone district of Bangkok, with participant observation, interviews and case studies conducted with individuals who had lived with type 2 diabetes for at least three years. Culturally specific explanations exist for the aetiology, pathology and course of illness, and responses to biomedical treatment. The notion of kam—the negative effects of past behaviour—underpinned participants’ explanations of the cause of diabetes. The presentation and development of the disease derive from Thai traditional medical theory, but its management, aimed at controlling blood glucose levels and preventing complications, involves both cosmopolitan and traditional medicines. This syncretic approach to cause, diagnosis and management suggests the value of a more comprehensive approach in health education, diagnosis and treatment.