Type 2 diabetes mellitus in Thai traditional medicine: a cross-sectional survey of clinical practices and system-level challenges in Health Region 12

Abstract

This cross-sectional study investigates diagnostic approaches, therapeutic modalities, practitioner confidence, and systemic challenges regarding Traditional Thai Medicine (TTM) integration in Type 2 Diabetes Mellitus (T2DM) management. Data were collected via structured online questionnaires from 117 TTM practitioners across Sub-district Health Promoting Hospitals in Health Region 12. Statistical analyses included descriptive statistics, thematic analysis, and Chi-square tests. The participants, with an average professional experience of 6.3 years, managed approximately 24.6 diabetic cases per month. Within the TTM framework, T2DM was predominantly conceptualized as an imbalance of the Fire element, primarily attributed to improper dietary habits. Common clinical manifestations identified included peripheral numbness, delayed wound healing, excessive diaphoresis, and polydipsia. Notably, over half of the practitioners employed an integrated approach, combining TTM with conventional antidiabetic medications. While herbal compress and steam therapy were utilized more frequently than herbal prescriptions, the most commonly prescribed formulas were Benjakul, Triphala, and Momordica charantia L. Approximately 50% of practitioners reported high to very high confidence in TTM-based diabetes care. However, significant structural barriers were identified, specifically the shortage of standardized herbal medicines and inadequate TTM-related equipment. These findings underscore the urgent need for standardized yet flexible clinical practice guidelines that effectively integrate TTM with conventional medicine. Strengthening policy support and resource allocation is essential to ensure sustainable, holistic T2DM management within primary care settings.