RT Journal Article
SR Electronic
T1 Prevalence of diabetes and pre-diabetes in Sri Lanka: a new global hotspot–estimates from the Sri Lanka Health and Ageing Survey 2018/2019
JF BMJ Open Diabetes Research & Care
JO BMJ Open Diab Res Care
FD American Diabetes Association
SP e003160
DO 10.1136/bmjdrc-2022-003160
VO 11
IS 1
A1 Rannan-Eliya, Ravindra Prasan
A1 Wijemunige, Nilmini
A1 Perera, Prasadini
A1 Kapuge, Yasodhara
A1 Gunawardana, Nishani
A1 Sigera, Chathurani
A1 Jayatissa, Renuka
A1 Herath, H M M
A1 Gamage, Anuji
A1 Weerawardena, Nethmi
A1 Sivagnanam, Ishwari
A1 Dalpatadu, Shanti
A1 Samarage, Sarath
A1 Samarakoon, Upeka
A1 Samaranayake, Navami
A1 Pullenayegam, Cheroni
A1 Perera, Bilesha
A1 
YR 2023
UL http://drc.bmj.com/content/11/1/e003160.abstract
AB Introduction This study’s objective was to produce robust, comparable estimates of the prevalence of diabetes and pre-diabetes in the Sri Lankan adult population, where previous studies suggest the highest prevalence in South Asia.Research design and methods We used data on 6661 adults from the nationally representative 2018/2019 first wave of the Sri Lanka Health and Ageing Study (SLHAS). We classified glycemic status based on previous diabetes diagnosis, and either fasting plasma glucose (FPG), or FPG and 2-hour plasma glucose (2-h PG). We estimated crude and age-standardized prevalence of pre-diabetes and diabetes and by major individual characteristics weighting the data to account for study design and subject participation.Results Crude prevalence of diabetes in adults was 23.0% (95% CI 21.2% to 24.7%) using both 2-h PG and FPG, and age-standardized prevalence was 21.8% (95% CI 20.1% to 23.5%). Using only FPG, prevalence was 18.5% (95% CI 7.1% to 19.8%). Previously diagnosed prevalence was 14.3% (95% CI 13.1% to 15.5%) of all adults. The prevalence of pre-diabetes was 30.5% (95% CI 28.2% to 32.7%). Diabetes prevalence increased with age until ages ≥70 years and was more prevalent in female, urban, more affluent, and Muslim adults. Diabetes and pre-diabetes prevalence increased with body mass index (BMI) but was as high as 21% and 29%, respectively, in those of normal weight.Conclusions Study limitations included using only a single visit to assess diabetes, relying on self-reported fasting times, and unavailability of glycated hemoglobin for most participants. Our results indicate that Sri Lanka has a very high diabetes prevalence, significantly higher than previous estimates of 8%–15% and higher than current global estimates for any other Asian country. Our results have implications for other populations of South Asian origin, and the high prevalence of diabetes and dysglycemia at normal body weight indicates the need for further research to understand the underlying drivers.Data are available on reasonable request. Data may be obtained from a third party and are not publicly available. The study data were provided by the SLHAS Consortium, which has adopted an Open Data policy which will provide access to SLHAS Wave 1 data from 2024, on application to the Consortium by interested researchers. The specific data file used for this paper can be shared on reasonable request to the corresponding author after then, and the underlying data will likely be included in the SLHAS Wave 1 public data release.