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Keywords:

  • diabetes;
  • pre-diabetes;
  • prevalence;
  • South Asian;
  • Sri Lanka

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 ≥ 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.