Abstract
BACKGROUND: Much of South East Asia is experiencing an epidemiological transition. In Thailand, chronic disease has emerged and the prevalence of diabetes has tripled. As part of a large cohort study of the Thai transition to chronic disease, we gathered data on self-reported diabetes. Epidemiological studies commonly ascertain such data by self-report but the validity of this method has not been assessed in Thailand. Therefore, we aimed to investigate the validity of self-reported type 2 diabetes (T2DM) in Thai adults participating in the Thai Cohort Study (TCS).METHODS: Data were collected by mailed questionnaire from adults involved in the TCS, a nationwide community-based longitudinal health study of distance learning adult students enrolled at Sukhothai Thammathirat Open University. Participants were surveyed in 2005, 2009 and 2013. We sampled all participants with self-reported T2DM status (878 cases) for telephone interview with our study physician along with a random selection of 650 participants who self-reported not having diabetes in all three TCS surveys. These physician telephone interviews allowed us to validate self-reported questionnaire responses.RESULTS: Questionnaire self-report of diabetes slightly over-estimated the incidence of T2DM in this cohort; the overall proportion of confirmed T2DM cases was 78%. Participants with a consistent pattern of diabetes reporting at the 2009 and 2013 questionnaire follow-ups had the highest validity of self-reported responses (96%; 95%CI 92.9-99.1).The lowest proportion of confirmed T2DM cases was recorded among participants who reported diabetes in 2009 and not in 2013 (32%)(95%CI 22.6-41.4), mostly young women with transient (gestational) diabetes.CONCLUSIONS: Our results, derived mainly from young, educated Thai adults nationwide, show that self-reported doctor diagnosed T2DM is a feasible and acceptable method for assessing diabetes in epidemiological studies.
Highlights
Many developing countries have undergone rapid economic growth over the past 50 years and this has transformed diets, behaviors and disease
Questionnaire self-report of diabetes slightly over-estimated the incidence of T2DM in this cohort; the overall proportion of confirmed T2DM cases was 78%
Participants with a consistent pattern of diabetes reporting at the 2009 and 2013 questionnaire follow-ups had the highest validity of self-reported responses (96%; 95%CI 92.9-99.1).The lowest proportion of confirmed T2DM cases was recorded among participants who reported diabetes in 2009 and not in 2013 (32%)(95%CI 22.6-41.4), mostly young women with transient diabetes
Summary
Many developing countries have undergone rapid economic growth over the past 50 years and this has transformed diets, behaviors and disease. There has been a widespread adoption of unhealthy behaviors (such as smoking and lack of exercise), along with a concomitant emergence of unhealthy environments (such as urban slums and air pollution), and a transformation of food systems and agrarian diets into modern supermarkets and industrialized food. These changes lead to the emergence of chronic and degenerative diseases. As part of a large cohort study of the Thai transition to chronic disease, we gathered data on self-reported diabetes. We aimed to investigate the validity of self-reported type 2 diabetes (T2DM) in Thai adults participating in the Thai Cohort Study (TCS)
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