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Diabetes in Thailand : Lessons Learned from Policies of Developed Nations

ฉายศรี สุพรศิลป์ชัย; Chaisri Supornsilpchai; นิตยา จันทร์เรือง มหาผล; Nitaya Chanruang Mahabhol; อรพินท์ มุกดาดิลก; Orapin Mookdadilok;
Date: 2550
Abstract
The prevalence and burden of chronic diseases, particularly diabetes, are rapidly increasing in Thailand and worldwide. Yet in a national survey, it was reported that 41 percent of those diagnosed with the diabetes were unaware of the condition and only 26 percent had their blood glucose controlled effectively. The national health care cost for the 3 million cases is estimated to amount to 350-840 billion baht in 2007. Several studies have been reported that microvascular complications existed prior to the diagnosis of diabetes and later resulted in retinopathy (10-29%), proteinuria (10-36%) and neuropathy (9%). Furthermore, risk of macrovascular complications and their death rates of those with prediabetes were equal to those with diabetes and twice of those without. Studies showed that among those with high risk, the chance of developing to diabetes can be reduced by changing to of healthy life style - nutrition, physical activity, and weight reduction - which cut down the incidence of diabetes by 58 percent. It was reported that risk factors among Thais that might be related to diabetes were high blood pressure, over weight, high blood cholesterol, inadequate fruit and vegetables intakes, limited physical activity and malnutrition. In Thailand, among those with diabetes, the prevalence of diabetic complications were nephropathy 43.9%, cataract 42.8%, retinopathy 30.7%, ischemic heart disease 8.1% and stroke 4.4%. In Finland, the major causes of death among over half of cases with diabetes type 1 and 2, were myocardial infarction and ischemic heart disease. Review of national diabetes prevention and control programs of the United State of America, Canada, England, Finland and Australia shows that programs on prevention of diabetes type 2 by changing of life style were commonly endorsed. Advocacy on early diagnoses by screening service for high risk group and underserved population were clearly spelled out. However, the program in Finland used a screening questionnaire focusing on risk factors to identify those with high risk rather than depending alone on laboratory test. Similarities were reported on the efforts of the 5 developed nations to provide high quality service, continuing care and forming networks at all levels reaching communities in particular. Many of them underlined the essential of adequate information for general population in order to increase awareness and commitment in changing life style. Likewise diabetic patients need this continuing health information pertinent to their participation in treatment and self-care. The national health plans always underline strategies to strengthen infrastructure and capability of the health services and health manpower development. The prevalence and burden of chronic diseases, particularly diabetes, are rapidly increasing in Thailand and worldwide. Yet in a national survey, it was reported that 41 percent of those diagnosed with the diabetes were unaware of the condition and only 26 percent had their blood glucose controlled effectively. The national health care cost for the 3 million cases is estimated to amount to 350-840 billion baht in 2007. Several studies have been reported that microvascular complications existed prior to the diagnosis of diabetes and later resulted in retinopathy (10-29%), proteinuria (10-36%) and neuropathy (9%). Furthermore, risk of macrovascular complications and their death rates of those with prediabetes were equal to those with diabetes and twice of those without. Studies showed that among those with high risk, the chance of developing to diabetes can be reduced by changing to of healthy life style - nutrition, physical activity, and weight reduction - which cut down the incidence of diabetes by 58 percent. It was reported that risk factors among Thais that might be related to diabetes were high blood pressure, over weight, high blood cholesterol, inadequate fruit and vegetables intakes, limited physical activity and malnutrition. In Thailand, among those with diabetes, the prevalence of diabetic complications were nephropathy 43.9%, cataract 42.8%, retinopathy 30.7%, ischemic heart disease 8.1% and stroke 4.4%. In Finland, the major causes of death among over half of cases with diabetes type 1 and 2, were myocardial infarction and ischemic heart disease. Review of national diabetes prevention and control programs of the United State of America, Canada, England, Finland and Australia shows that programs on prevention of diabetes type 2 by changing of life style were commonly endorsed. Advocacy on early diagnoses by screening service for high risk group and underserved population were clearly spelled out. However, the program in Finland used a screening questionnaire focusing on risk factors to identify those with high risk rather than depending alone on laboratory test. Similarities were reported on the efforts of the 5 developed nations to provide high quality service, continuing care and forming networks at all levels reaching communities in particular. Many of them underlined the essential of adequate information for general population in order to increase awareness and commitment in changing life style. Likewise diabetic patients need this continuing health information pertinent to their participation in treatment and self-care. The national health plans always underline strategies to strengthen infrastructure and capability of the health services and health manpower development.
Copyright ผลงานวิชาการเหล่านี้เป็นลิขสิทธิ์ของสถาบันวิจัยระบบสาธารณสุข หากมีการนำไปใช้อ้างอิง โปรดอ้างถึงสถาบันวิจัยระบบสาธารณสุข ในฐานะเจ้าของลิขสิทธิ์ตามพระราชบัญญัติสงวนลิขสิทธิ์สำหรับการนำงานวิจัยไปใช้ประโยชน์ในเชิงพาณิชย์
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