Author(s): Katulanda P, Constantine GR, Mahesh JG, Sheriff R, Seneviratne RD,
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Abstract AIMS: To determine the prevalence of diabetes mellitus and pre-diabetes (impaired fasting glucose and impaired glucose tolerance) in adults in Sri Lanka. Projections for the year 2030 and factors associated with diabetes and pre-diabetes are also presented. METHODS: This cross-sectional study was conducted between 2005 and 2006. A nationally representative sample of 5000 adults aged >or= 18 years was selected by a multi-stage random cluster sampling technique. Fasting plasma glucose was tested in all participants and a 75-g oral glucose tolerance test was performed in non-diabetic subjects. Prevalence was estimated for those > 20 years of age. RESULTS: Response rate was 91\% (n = 4532), males 40\%, age 46.1 +/- 15.1 years (mean +/- standard deviation). The age-sex standardized prevalence (95\% confidence interval) of diabetes for Sri Lankans aged >or= 20 years was 10.3\% (9.4-11.2\%) [males 9.8\% (8.4-11.2\%), females 10.9\% (9.7-12.1\%), P = 0.129). Thirty-six per cent (31.9-40.1\%) of all diabetic subjects were previously undiagnosed. Diabetes prevalence was higher in the urban population compared with rural [16.4\% (13.8-19.0\%) vs. 8.7\% (7.8-9.6\%); P < 0.001]. The prevalence of overall, urban and rural pre-diabetes was 11.5\% (10.5-12.5\%), 13.6\% (11.2-16.0\%) and 11.0\% (10.0-12.0\%), respectively. Overall, 21.8\% (20.5-23.1\%) had some form of dysglycaemia. The projected diabetes prevalence for the year 2030 is 13.9\%. Those with diabetes and pre-diabetes compared with normal glucose tolerance were older, physically inactive, frequently lived in urban areas and had a family history of diabetes. They had higher body mass index, waist circumference, waist-hip ratio, systolic/diastolic blood pressure, low-density lipoprotein cholesterol and triglycerides. Insulin was prescribed to 4.4\% (2.7-6.1\%) of all diabetic subjects. CONCLUSIONS: One in five adults in Sri Lanka has either diabetes or pre-diabetes and one-third of those with diabetes are undiagnosed.
This article was published in Diabet Med
and referenced in Journal of Diabetes & Metabolism