Prevalence of Diabetes and Pre-Diabetes among Adults in the Western Province of Sri Lanka.

Abstract

Introduction: Previous Sri Lankan studies have shown an increase in diabetes and pre-diabetes prevalence. Therefore, we aimed to determine their prevalence and correlates among adults in the Western province.

Methods: Between 2018 and 2020, a cross-sectional sample of 1800 aged ≥20 years was recruited by a multi-stage stratified random cluster sampling technique. Fasting plasma glucose and HbA1C (in all participants) and a 75 g oral glucose tolerance test (in non-diabetic individuals) were used to categorise glycaemic status. Data are presented as % (95% CI).

Results: The response rate was 78.2% (n = 1408). Data from 1333 subjects were analysed, males = 36.4% and mean age = 49.8 (±14.9) years. The age-sex standardised prevalence of diabetes among adults in the Western Province was 27.8% (25.4%-30.3%) [males 29.9% (25.9%-33.9%) and females 25.8% (22.9%-28.8%)]. The highest prevalence was seen in the 60-69 age group (55.1%, 46.8%-63.4%) and the Colombo district (42.6%, 34.7%-50.5%). Those in urban areas had higher prevalence than those in rural areas [41.9% (33.3%-50.7%) vs 33.3% (28.6%-37.9%)]. Previously undiagnosed diabetes was present among 37.1% of diabetic individuals and in 13.4% (10.2%-16.5%) of the whole sample. The prevalence of isolated impaired glucose tolerance, isolated impaired fasting glucose, having both together, and overall pre-diabetes was 9.6% (7.3%-11.8%), 11.0% (8.7%-13.4%), 9.1% (5.6%-12.7%), and 35.6% (33.1%-38.2%), respectively. Those with diabetes and pre-diabetes compared with normoglycaemia were older, urban living, sedentary, and obese and had positive family history. They had higher blood pressure, triglycerides, serum transaminases, and urine albumin-creatinine ratio.

Conclusions: Among adults in the Western Province, more than 70% had diabetes or pre-diabetes with over one-third of those with diabetes being undiagnosed.