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.

Decoding the Type 2 Diabetes Epidemic in Rural India

“…But we must eat it, because it is free” (Balagowramma, 69). The association of the consumption of sugar and polished white rice with increased risk of diabetes exists in both biomedical and folk models (Grams et al 1996; Greenhalgh et al 1998; Naemiratch and Manderson 2007; Poss and Jezewski 2002). A major oversight of the PDS is that it emphasizes caloric quantity rather than nutritional quality by distributing calorie-dense but nutritionally inferior food products (Deaton and Drèze 2009; Sen 2005).…”

'Normal, but...': living with type 2 diabetes in Bangkok, Thailand

“…13,14 Although in Buddhist theology kam is neutral, referring simply to cause and effect without moral judgement or implications of outcome, 13,15 in its lay use the term kam is always negative. Illnesses caused by kam indicate misdeeds in the past life of the individual or a parent, 16 reflecting adversely on his or her character and identity. [13][14][15][16][17] Common conditions such colds, fever and headache, which are selflimiting or curable and so enable the ill person to return to normal life, are assumed to have biophysiological causes.…”

“…Illnesses caused by kam indicate misdeeds in the past life of the individual or a parent, 16 reflecting adversely on his or her character and identity. [13][14][15][16][17] Common conditions such colds, fever and headache, which are selflimiting or curable and so enable the ill person to return to normal life, are assumed to have biophysiological causes. Serious conditions, resulting in hospitalization, confinement and convalescence before the ill person can resume normal activities, are believed to be due to kam.…”

From Jollibee to BeeBee: “Lifestyle” and Chronic Illness in Southeast Asia

“…We draw also on an ethnographic study conducted by the second author with adults with type 2 diabetes in inner metropolitan Bangkok from 2002 to 2004. 9,10…”