Diagnosis and Treatment of Type 2 Diabetes Mellitus According to Thai Traditional Medicine Principles in Sub - district Health Promoting Hospitals Health Region 12

Abstract

Introduction and Objectives: Type 2 Diabetes Mellitus is an important public health issue impacting the quality of life of the population, particularly in Health Region 12 which possesses a unique socio–cultural context. This study aimed to explore patterns of diagnosis, treatment, herbal medicine selection, and Thai Traditional Medicine (TTM) procedures. It also examined problems and barriers to service provision by personnel in Subdistrict Health Promoting Hospitals (SHPHs) to utilize the data for developing the primary health service system.

Methodology: This study employed a survey research design, collecting data during 2025 using a structured online questionnaire that passed content validity verification by experts, yielding an Item–Objective Congruence (IOC) index between 0.67 and 1.00. The study population consisted of Thai traditional medicine practitioners and applied traditional Thai medicine practitioners working in subdistrict health promotion hospitals (SHPH) under the Ministry of Public Health in Health Region 12. They had at least three years of work experience and held a medical license. A sample size of 132 individuals was obtained. Descriptive statistics, including frequency, percentage, mean, and standard deviation, were used for quantitative data, while content analysis was employed for qualitative data. This research project received human research ethics approval from the Ethics Committee on Human Research in Thai Traditional and Alternative Medicine, Department of Thai Traditional and Alternative Medicine (Project Code FB 12–2568).

Results: The majority of the sample were female (77.30%), with an average age of 32.32 years and an average work experience of 5.31 years. Regarding diagnosis, an integrative pattern was found: 99.20% used laboratory results from modern medicine as the primary criteria for disease confirmation. However, in the dimension of disease etiology according to TTM theory, practitioners still adhered to the Four Elements principle, identifying Fire Element (81.06%) and Wind Element (74.21%) were identified as the main contributing factors to disease development. According to Thai traditional medicine principles, aggravation of the fire element is associated with excessive heat and abnormal metabolism, leading to symptoms such as excessive thirst and frequent urination, while imbalance of the wind element reflects disordered internal movement, which is consistent with overeating behaviors In terms of treatment patterns, lifestyle modification was emphasized (87.12%) combined with herbal medicine use (73.48%). The most popular herb used across all disease stages was Bitter Melon (Momordica charantia) (28.00 – 38.60%), followed by Wild Betel (Piper sarmentosum) and Triphala. Regarding therapeutic procedures, specific care was observed: patients with diabetic foot complications received Herbal Foot Soaks at a high rate of 86.40%. Meanwhile, patients with eye, kidney, and heart complications were referred to specialists at high rates (69.70 – 87.10%). These treatment methods demonstrated high safety, with side effects found to be less than 1.50%.

Discussion: The findings demonstrate that Thai traditional medicine services in subdistrict health promoting hospitals in Health Region 12 are characterized by an integrative care model, in which modern medical practices are used for screening and diagnostic confirmation, while Thai traditional medicine principles are applied to guide complementary care planning. The use of herbal medicines, such as bitter melon, and therapeutic procedures such as herbal foot soaking reflects an emphasis on restoring bodily balance and providing holistic care. Meanwhile, the high referral rates for patients with ocular, renal, and cardiac complications indicate appropriate role delineation and effective collaboration with multidisciplinary healthcare teams within the primary healthcare system.

Conclusion: Although the treatment patterns possess standards and safety, operations still face significant barriers, namely excessive workload (34.10%) and budgetary limitations (24.20%). Policy recommendations should focus on allocating manpower appropriate to the workload and supporting adequate budgets for medicines and medical supplies to sustainably enhance the quality of life for diabetic patients in the community.

Keywords: type 2 diabetes mellitus, Thai traditional medicine, subdistrict health promoting hospital (SHPH), health region 12