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

Abstract

Objectives: To explore how people in Bangkok, Thailand make sense of the challenges associated with living with type 2 diabetes. Methods: Ethnographic research was conducted for a period of 18 months, and included participant observation, documentary analysis, and interviews with health providers, family members and 33 adults with type 2 diabetes. Interviews and analyses were iterative, with longitudinal data drawing attention to shifts in meaning in relation to identity construction and the relevance of this to disease management. Results: People drew on cultural notions of social harmony and bodily imperfection, and ideas of the nature of diabetes as 'invisible' while blood sugar levels were controlled, to reconstruct their identity once diagnosed with diabetes. By maintaining their status as 'normal, but...', people could minimize disruptions in their everyday lives and in relation to others, due to both practices of management and their social effects. Their use of a qualification to their health status ( but) explicitly acknowledged certain behavioural and dietary modifications that were necessary to manage their diabetes, but also emphasized their role in self-management. Discussion: The diabetes qualification ('normal, but...') acted as a bridge between health and illness, enabling people to separate their physical health status, perceived as being particularly flawed by having diabetes, from their 'normal' social self. The sustained idea of the normality of the embodied and socially embedded self implied that the disease was under control, ensuring its minimal intrusion into social relationships and practical living.