Prevalence and projections of diabetes and pre-diabetes in adults in Sri Lanka—Sri Lanka Diabetes, Cardiovascular Study (SLDCS)
Article first published online: 28 JUN 2008
© 2008 The Authors. Journal compilation © 2008 Diabetes UK
Volume 25, Issue 9, pages 1062–1069, September 2008
How to Cite
Katulanda, P., Constantine, G. R., Mahesh, J. G., Sheriff, R., Seneviratne, R. D. A., Wijeratne, S., Wijesuriya, M., McCarthy, M. I., Adler, A. I. and Matthews, D. R. (2008), Prevalence and projections of diabetes and pre-diabetes in adults in Sri Lanka—Sri Lanka Diabetes, Cardiovascular Study (SLDCS). Diabetic Medicine, 25: 1062–1069. doi: 10.1111/j.1464-5491.2008.02523.x
- Issue published online: 29 AUG 2008
- Article first published online: 28 JUN 2008
- Accepted 6 June 2008
- South Asian;
- Sri Lanka
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 ≥ 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 ≥ 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.