Background: Diabetes is one of the most common chronic diseases with a high rate of impaired quality of life. Patients with diabetes experience significant symptoms but symptoms management typically consider secondary to risk factor control. Objective: The study purpose is to describe symptom burden and association of symptoms and association between symptoms and biological variables among Thai persons with diabetes. Methods: The study recruited Thai persons 21 years old or older with diabetes from two diabetic clinics in Chiang Mai Thailand. During their single visit, participants completed symptoms experience and quality of life (SF-12) questionnaires. Patients’ medical records were reviewed for laboratory results. Data analysis was done using SPSS software version 22. Results: One hundred and twenty five Thai patients with diabetes age ranged from 39–75 years old were included in this analysis. The majority was female (n = 86, 69%) and was married (n = 103, 82%). Their fasting blood glucoseranged from 70 to 329. The top two most often reported symptoms were pain (75%) with mean severity of 3.26 (SD = 2.83) and fatigue (64%) with mean severity of 2.64 (SD = 2.70). Patients with high fasting blood sugar reported high pain (r = 0.295, p = 0.001), high fatigue (r = 0.216, p = 0.02) and difficult breathing (r = 0.260, p = 0.005). Older patients had lower fasting blood glucose than younger patients (r = −0.221, p = 0.018). Both high pain and fatigue significantly associated with poor quality of life. No significant association found between age and symptoms and blood cell counts and symptoms. Conclusion: These results confirm the association between symptom burden and quality of life and suggested the association of high fasting blood glucose level with severity of symptoms. To effectively manage symptoms and prevent diabetic associated chronic diseases, determination of the causal relationship between fasting blood glucose and symptoms is needed. Further longitudinal study is recommended.