Diabetes trends and determinants among Thai adults from 2004 to 2020

The global prevalence of diabetes is increasing rapidly, with particular concern for undiagnosed, uncontrolled, and untreated diabetes. This study used data from the Thai National Health Examination Surveys in 2004, 2009, 2014, and 2020 to estimate the overall prevalence and trends of diabetes, diagnosed, treated, and controlled diabetes. We also used multivariable logistic regression models to examine the factors related to the prevalence of diabetes, as well as diagnosed, treated, and controlled diabetes, in the 2020 survey cycle. Following the global trends, age- and sex-standardized prevalence of diabetes in Thailand increased from 7.5% (95%CI: 6.5, 8.5) in 2004 to 10.1% (95%CI: 9.0, 11.1) in 2020; only 62.8% (95%CI: 59.9, 65.8) were aware of their diagnosis, 42.9% (95%CI: 39.0, 46.9) were treated, and only 20.5% (95%CI: 17.8, 23.1) had controlled blood glucose levels. Individuals in younger age groups and lower socioeconomic status were more likely to be independently associated with unawareness, untreated, and uncontrolled diabetes. These findings underscore the importance of addressing the awareness, treatment, and control gaps in diabetes management in Thai adults. Strengthening diabetes prevention and management requires a comprehensive approach for individuals, communities, and the health system, including improved screening strategies, enhanced lifestyle modification, treatment practices, multidisciplinary collaboration, and resource allocation.