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The facts, figures, and reality of the diabetes epidemic in Sri Lanka: a systematic review

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Abstract

Prevalence of diabetes mellitus (DM) has reached epidemic proportions in Sri Lanka. We aim to systematically review the literature for studies on DM published by Sri Lankan authors and provide a comprehensive analysis of its prevalence, trends, and risk factors. Retrieval of diabetes-related research articles conducted in Sri Lanka was by a comprehensive systematic search of the literature in the following medical bibliographical databases: PubMed, Web of Science, SciVerse Scopus, CINAHL, and Cochrane Library. Studies published before January 6, 2012 was included. Search terms used were “Sri Lanka,” “Lanka,” “Ceylon,” “pre-diabetes,” “diabetes,” “type-2 diabetes,” “type-1 diabetes,” “diabetes mellitus,” “dysglycaemia,” and “glucose intolerance”. Studies not in English, conference proceedings, and abstracts were excluded. The number of studies included in the present systematic review is 96 (journal articles—82, dissertation—14). Our results based on the available latest national data (2005–2006) show that Sri Lanka is facing a significant burden of both diabetes (prevalence 10.3 %) and pre-diabetes (prevalence 11.5 %). Urban residency and familial inheritance appear to be important factors associated with diabetes in Sri Lanka. There were a number of ethno-medical studies done by Sri Lankan authors evaluating herbal products in diabetes treatment. DM is a major health problem in Sri Lanka, with an unprecedented current level of prevalence. Considering the gravity of the health issue and the economical burden, very little local research has been conducted to combat the epidemic. Future studies should be focused on the causes of this high prevalence, such as genetic characteristics, dietary habits, body composition, and level of physical activity.

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References

  1. Katulanda P, Sheriff MH, Matthews DR. The diabetes epidemic in Sri Lanka—a growing problem. Ceylon Med J. 2006;51:26–8.

    CAS  PubMed  Google Scholar 

  2. Illangasekera U, Nugegoda DB, Perera LS. Prevalence of diabetes mellitus and impaired glucose tolerance in a rural Sri Lankan community. Ceylon Med J. 1993;38:123–6.

    CAS  PubMed  Google Scholar 

  3. Fernando DJS, Siribaddana S, De Silva D. Impaired glucose tolerance and diabetes mellitus in a suburban Sri Lankan community. Postgrad Med J. 1994;70:347–9.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  4. Katulanda P, Constantine GR, Mahesh JG, Sheriff R, Seneviratne RDA, Wijeratne S, et al. Prevalence and projections of diabetes and pre-diabetes in adults in Sri Lanka—Sri Lanka Diabetes, Cardiovascular Study (SLDCS). Diabet Med. 2008;25:1062–9.

    Article  CAS  PubMed  Google Scholar 

  5. Wijewardene K, Mohideen MR, Mendis S, Fernando DS, Kulathilaka T, Weerasekara D, et al. Prevalence of hypertension, diabetes and obesity: baseline findings of a population based survey in four provinces in Sri Lanka. Ceylon Med J. 2005;50:62–70.

    CAS  PubMed  Google Scholar 

  6. Abeywardena MY. Dietary fats, carbohydrates and vascular disease: Sri Lankan perspectives. Atherosclerosis. 2003;171:157–61.

    Article  CAS  PubMed  Google Scholar 

  7. Hogan P, Dall T, Nikolov P. Economic costs of diabetes in the US in 2002. Diabetes Care. 2003;26:917–32.

    Article  PubMed  Google Scholar 

  8. Wijewardene K, Spohr M. An attempt to measure burden of disease using disability adjusted life years for Sri Lanka. Ceylon Med J. 2000;45:110–5.

    Article  CAS  PubMed  Google Scholar 

  9. Mather HM, Keen H, The Southall Diabetes Survey. Prevalence of known diabetes in Asians and Europeans. Br Med J (Clin Res Ed). 1985;291:1081–4.

    Article  CAS  Google Scholar 

  10. Health Survey for England. The health of minority ethnic groups ’99. In: The health of minority ethnic groups ’99 (Editor). City; 2001.

  11. Mukhopadhyay B, Forouhi NG, Fisher BM, Kesson CM, Sattar N. A comparison of glycaemic and metabolic control over time among South Asian and European patients with type 2 diabetes: results from follow-up in a routine diabetes clinic. Diabet Med. 2006;23:94–8.

    Article  CAS  PubMed  Google Scholar 

  12. Bhutta ZA. Why has so little changed in maternal and child health in South Asia? Br Med J. 2000;321:809–12.

    Article  CAS  Google Scholar 

  13. Ranasinghe P, Jayawardena R, Katulanda P. Sri Lanka in global medical research: a scientific analysis of the Sri Lankan research output during 2000-2009. BMC Res Notes. 2012;5:121.

    Article  PubMed Central  PubMed  Google Scholar 

  14. Abeysena C, Jayawardana P, Wickremasinghe R, Wickramasinghe U. Evidence-based medicine knowledge, attitudes, and practices among doctors in Sri Lanka. J Evid Based Med. 2010;3:83–7.

    Article  PubMed  Google Scholar 

  15. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ. 2009;339:b2535.

    Article  PubMed Central  PubMed  Google Scholar 

  16. Ranasinghe P, Perera YS, Abeygunasekara AM. The process and costs of publishing medical journals in Sri Lanka: an economic evaluation. BMJ Open. 2011;1:e000057.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  17. Sri Lanka Journals Online. SLJOL Newsletter. In Book SLJOL Newsletter (Editor ed.^eds.), vol. 6. City; 2011.

  18. Mohideen MR, Weerarathne TP. High prevalence of diabetes mellitus in an urban locality in Galle. Galle Med J. 1997;1:32–4.

    Google Scholar 

  19. Samarage SM. Some epidemiological aspects of non-insulin dependent diabetes mellitus in a defined population in the Kalutara district of Sri Lanka. MD. University of Colombo, Post Graduate Institute of Medicine; 1999.

  20. Illangasekera U. Impact of new diagnostic criteria for diabetes on its prevalence in a hospital population. Ceylon Med J. 2000;45:45–6.

    CAS  PubMed  Google Scholar 

  21. Beneragama APS. An epidemiological study of type II diabetes mellitus in Kalutara District in Sri Lanka. MD. University of Colombo, Post Graduate Institute of Medicine; 2002.

  22. Katulanda P, Rathnapala DAV, Sheriff MHR, Matthews DR. Province and ethnic specific prevalence of diabetes among Sri Lankan adults. Sri Lanka J Diabetes Endocrinol Metab. 2011;1:2–7.

    Google Scholar 

  23. Malavige GN, De Alwis NMW, Siribaddana SH, Weerasooriya N, Fernando DJS. Increasing diabetes and vascular risk factors in a sub-urban Sri Lankan population. Diabetes Res Clin Pract. 2002;57:143–5.

    Article  CAS  PubMed  Google Scholar 

  24. Illangasekera U, Rambodagalla S, Tennakoon S. Temporal trends in the prevalence of diabetes mellitus in a rural community in Sri Lanka. J R Soc Promot Health. 2004;124:92–4.

    Article  PubMed  Google Scholar 

  25. Dassanayake AS, Kasturiratne A, Niriella MA, Kalubovila U, Rajindrajith S, De Silva AP, Kato N, Wickremasinghe AR, De Silva HJ. Prevalence of Acanthosis nigricans in an urban population in Sri Lanka and its utility to detect metabolic syndrome. BMC Res Notes 2011;4.

  26. Hanwella R, De Silva V. Diabetes and impaired fasting glucose in Sri Lankan patients with schizophrenia. Sri Lanka J Psychiatry. 2010;1:56–9.

    Google Scholar 

  27. Katulanda P, Shine B, Katulanda GW, Silva A, Asfir EL, Sheriff R, et al. Diabetes mellitus among young adults in Sri Lanka—role of GAD antibodies in classification and treatment: the Sri Lanka Young Diabetes Study. Diabetologia. 2008;51:1368–74.

    Article  CAS  PubMed  Google Scholar 

  28. Katulanda P, Groves CJ, Barrett A, Sheriff R, Matthews DR, McCarthy MI, et al. Prevalence and clinical characteristics of maternally inherited diabetes and deafness caused by the mt3243A > G mutation in young adult diabetic subjects in Sri Lanka. Diabet Med. 2008;25:370–4.

    Article  CAS  PubMed  Google Scholar 

  29. Premawardhana L, Wijeyaratne CN, Chen S, Wijesuriya M, Illangasekera U, Brooking H, et al. Islet cell, thyroid, adrenal and celiac disease related autoantibodies in patients with type 1 diabetes from Sri Lanka. J Endocrinol Investig. 2006;29:968–74.

    Article  CAS  Google Scholar 

  30. De Silva SNT, Weerasuriya N, De Alwis NMW, De Silva MWA, Fernando DJS. Excess maternal transmission and familial aggregation of type 2 diabetes in Sri Lanka. Diabetes Res Clin Pract. 2002;58:173–7.

    Article  PubMed  Google Scholar 

  31. Menik HL, Sammanthi JS, Priyantha WT, Wijewickrama GS, Shalika P, Kotapola I. Genetic association between insulin resistance and total cholesterol in type 2 diabetes mellitus—a preliminary observation. Online J Health Allied Sci 2005;4.

  32. Takeuchi F, Katsuya T, Chakrewarthy S, Yamamoto K, Fujioka A, Serizawa M, et al. Common variants at the GCK, GCKR, G6PC2-ABCB11 and MTNR1B loci are associated with fasting glucose in two Asian populations. Diabetologia. 2010;53:299–308.

    Article  CAS  PubMed  Google Scholar 

  33. Allender S, Wickramasinghe K, Goldacre M, Matthews D, Katulanda P. Quantifying urbanization as a risk factor for noncommunicable disease. J Urban Health Bull N Y Acad Med. 2011;88:906–18.

    Article  Google Scholar 

  34. Hettiaratchi UPK, Ekanayake S, Welihinda J. Do Sri Lankan meals help decrease blood glucose response? Ceylon Med J. 2009;54:39–43.

    Article  CAS  PubMed  Google Scholar 

  35. Hettiaratchi UPK, Ekanayake S, Welihinda J. Glycaemic indices of three Sri Lankan wheat bread varieties and a bread-lentil meal. Int J Food Sci Nutr. 2009;60:21–30.

    Article  CAS  PubMed  Google Scholar 

  36. Fernando DJ, Siribaddana S, De S, Subasinge Z. Prevalence of retinopathy in a Sri Lankan diabetes clinic. Ceylon Med J. 1993;38:120–3.

    CAS  PubMed  Google Scholar 

  37. Fernando DJS, Siribaddana S, Perera N, Perera S, de Silva D. The prevalence of macrovascular disease and lipid abnormalities amongst diabetic patients in Sri Lanka. Postgrad Med J. 1993;69:557–61.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  38. Fernando DJ. The prevalence of neuropathic foot ulceration in Sri Lankan diabetic patients. Ceylon Med J. 1996;41:96–8.

    CAS  PubMed  Google Scholar 

  39. Illangasekera U, Sivakanesan R. Frequency of microalbuminuria in patients with non-insulin dependent diabetes mellitus. Kandy Med J. 1997;6:12–5.

    Google Scholar 

  40. Weerasuriya N, Siribaddana S, Dissanayake A, Subasinghe Z, Wariyapola D, Fernando DJS. Long-term complications in newly diagnosed Sri Lankan patients with type 2 diabetes mellitus. QJM Mon J Assoc Physicians. 1998;91:439–43.

    Article  CAS  Google Scholar 

  41. Katulanda P, Ranasinghe P, Jayawardena R, Constantine GR, Sheriff MH, Matthews DR. The prevalence, patterns and predictors of diabetic peripheral neuropathy in a developing country. Diabetol Metab Syndr. 2012;4:21.

    Article  PubMed Central  PubMed  Google Scholar 

  42. Amarasinghe DACL, Fonseka P, Dalpatadu KCS, Unwin NC, Fernando DJS. Risk factors for long-term complications in patients with type 2 diabetes attending government institutions in the Western Province of Sri Lanka: a case control study. Diabetes Res Clin Pract. 2007;75:377–8.

    Article  CAS  PubMed  Google Scholar 

  43. Rajakumaraswamy N, Rajapakse IH, Fernando DJS. The frequency of cognitive dysfunction in elderly Sri Lankans with type 2 diabetes mellitus. Int J Geriatr Psychiatry. 2008;23:1205–6.

    Article  CAS  PubMed  Google Scholar 

  44. Preshaw PM, de Silva N, McCracken GI, Fernando DJS, Dalton CF, Steen ND, et al. Compromised periodontal status in an urban Sri Lankan population with type 2 diabetes. J Clin Periodontol. 2010;37:165–71.

    Article  PubMed  Google Scholar 

  45. Amarasena HDN: The prevalence of periodontal disease amongst diabetic patients attending the diabetic clinic, general hospital Colombo. Dissertation. University of Colombo, Post Graduate Institute of Medicine; 1992.

  46. De Silva NT, Preshaw PM, Taylor JJ, Jayaratne SD, Heasman PA, Fernando DJS. Periodontitis: a complication of type 2 diabetes in Sri Lankans. Diabetes Res Clin Pract. 2006;74:209–10.

    Article  PubMed  Google Scholar 

  47. Hettihewa LM, Gunasekara SW, Jayasinghe SS, Palangasinghe S, Weerarathna TP, Kotapola I. Lipid abnormalities in type 2 diabetes mellitus patients in Sri Lanka. Galle Med J. 2007;12:1–4.

    Google Scholar 

  48. Katulanda GW, Katulanda P, Adler AI, Peiris SR, Draisey I, Wijeratne S, et al. Apolipoproteins in diabetes dyslipidaemia in South Asians with young adult-onset diabetes: distribution, associations and patterns. Ann Clin Biochem. 2010;47:29–34.

    Article  CAS  PubMed  Google Scholar 

  49. Malavige LS, Jayaratne SD, Kathriarachchi ST, Sivayogan S, Fernando DJ, Levy JC. Erectile dysfunction among men with diabetes is strongly associated with premature ejaculation and reduced libido. J Sex Med. 2008;5:2125–34.

    PubMed  Google Scholar 

  50. Fernando DJS, Vernidharan J. Limited joint mobility in Sri Lankan patients with non-insulin-dependent diabetes. Br J Rheumatol. 1997;36:374–6.

    Article  CAS  PubMed  Google Scholar 

  51. Deen KI, Premaratna R, Fonseka MMD, De Silva HJ. The recto-anal inhibitory reflex: abnormal response in diabetics suggests an intrinsic neuroenteropathy. J Gastroenterol Hepatol. 1998;13:1107–10.

    Article  CAS  PubMed  Google Scholar 

  52. Siribaddana SH, Suranimala AC, Sheriff R, Fernando DJS. Heart rate variability in diabetic autonomic neuropathy. J Ceylon Coll Physicians. 1996;29:27–8.

    Google Scholar 

  53. Okosieme OE, Wijeyaratne CN, Lazarus JH, Premawardhana L. Restricted thyroglobulin antibody epitope specificities in subjects with type 1 diabetes mellitus. Eur J Endocrinol. 2009;161:489–93.

    Article  CAS  PubMed  Google Scholar 

  54. Arambewela LSR, Arawwawala LDAM, Ratnasooriya WD. Antidiabetic activities of aqueous and ethanolic extracts of Piper betle leaves in rats. J Ethnopharmacol. 2005;102:239–45.

    Article  CAS  PubMed  Google Scholar 

  55. Al-Logmani AS, Zari TA. Effects of Nigella sativa L. and Cinnamomum zeylanicum blume oils on some physiological parameters in streptozotocin-induced diabetic rats. Bol Latinoam Caribe Plant Med Aromat. 2009;8:86–96.

    Google Scholar 

  56. Chandrika UG, Wedage WS, Wickramasinghe SMDN, Fernando WS. Hypoglycaemic action of the flavonoid fraction of Artocarpus heterophyllus leaf. Afr J Tradit Complement Alternat Med. 2006;3:42–50.

    CAS  Google Scholar 

  57. Dayananda PD, Yapa WB, Ratnasooriya WD. The effect of the aqueous stem bark extract of Kokoona zeylanica Thw. on the blood glucose level of mice. Pharmacogn Mag. 2008;4:308–14.

    Google Scholar 

  58. Fernando MR, Wickramasinghe SMDN, Thabrew MI, Ariyananda PL, Karunanayake EH. Effect of Artocarpus heterophyllus and Asteracanthus longifolia on glucose tolerance in normal human subjects and in maturity-onset diabetic patients. J Ethnopharmacol. 1991;31:277–82.

    Article  CAS  PubMed  Google Scholar 

  59. Fernandopulle BMR, Karunanayake EH, Ratnasooriya WD. Oral hypoglycaemic effects of Momordica dioica in the rat. Med Sci Res. 1994;22:137–9.

    Google Scholar 

  60. Jayakody J, Ratnasooriya WD. Blood glucose level lowering activity of Sri Lankan black tea brew (Camellia sinensis) in rats. Pharmacogn Mag. 2008;4:341–9.

    Google Scholar 

  61. Jayawardena MHS, de Alwis NMW, Hettigoda V, Fernando DJS. Double blind randomised placebo controlled cross over study of a herbal preparation containing Salacia reticulata in the treatment of type 2 diabetes. J Ethnopharmacol. 2005;97:215–8.

    Article  CAS  PubMed  Google Scholar 

  62. Jeevathayaparan S. Effect of Momordica charantia on streptozotocin induced diabetes and an evaluation of toxic effects in normal animals. M.Sc. University of Colombo, 1988.

  63. Jeewathayaparan S. Oral hypoglycaemic activity of Momordica charantia: possible mechanisms of action and activity related fractionation. PhD. University of Colombo, 1999.

  64. Malalavidhane S, Wickramasinghe SMDN, Jansz ER. An aqueous extract of the green leafy vegetable Ipomoea aquatica is as effective as the oral hypoglycaemic drug tolbutamide in reducing the blood sugar levels of Wistar rats. Phytother Res. 2001;15:635–7.

    Article  CAS  PubMed  Google Scholar 

  65. Malalavidhane TS, Wickramasinghe SMDN, Perera MSA, Jansz ER. Oral hypoglycaemic activity of Ipomoea aquatica in streptozotocin-induced, diabetic Wistar rats and type II diabetics. Phytother Res. 2003;17:1098–100.

    Article  CAS  PubMed  Google Scholar 

  66. Ranasinghe P, Perera S, Gunatilake M, Abeywardene E, Gunapala N, Premakumara S, et al. Effects of Cinnamomum zeylanicum (Ceylon cinnamon) on blood glucose and lipids in a diabetic and healthy rat model. Pharmacogn Res. 2012;4:73–9.

    Article  Google Scholar 

  67. Ruvin Kumara NKVM, Pathirana RN, Pathirana C. Hypoglycemic activity of the root and stem of Salacia reticulata var. β-diandra in alloxan diabetic rats. Pharm Biol. 2005;43:219–25.

    Article  Google Scholar 

  68. Wanniarachchi KK, Peiris LDC, Ratnasooriya WD. Antihyperglycemic and hypoglycemic activities of Phyllanthus debilis aqueous plant extract in mice. Pharm Biol. 2009;47:260–5.

    Article  Google Scholar 

  69. Welihinda J. A Biochemical study of the oral hypoglycaemic activity of Momordica charantia. PhD. University of Colombo, 1985.

  70. Welihinda J, Karunanayake EH, Sheriff MHR, Jayasinghe KSA. Effect of Momordica charantia on the glucose tolerance in maturity onset diabetes. J Ethnopharmacol. 1986;17:277–82.

    Article  CAS  PubMed  Google Scholar 

  71. Siribaddana SH, Deshabandu R, Rajapakse D, Silva K, Fernando DJ. The prevalence of gestational diabetes in a Sri Lankan antenatal clinic. Ceylon Med J. 1998;43:88–91.

    CAS  PubMed  Google Scholar 

  72. Ginege PS. Prevalence and pregnancy outcomes of gestational diabetes mellitus (GDM) in Homagama D.D.H.S. area and validation of selected screening methods to detect GDM. M.Sc. University of Colombo, Post Graduate Institute of Medicine; 2004.

  73. Jasinliyanage IPK: Screening for gestational diabetes mellitus: should it be risk factor based or universal? MD. University of Colombo, Post Graduate Institute of Medicine; 2004.

  74. Illangasekera U, Senaratne G. Screening for diabetes mellitus in pregnancy. Ceylon Med J. 2002;47:38–9.

    PubMed  Google Scholar 

  75. Dahanayaka NJ, Agampodi SB, Ranasinghe ORJC, Jayaweera PMED, Fernando S. Screening for gestational diabetes mellitus in Anuradhapura district. Ceylon Med J. 2011;56:128–9.

    Article  CAS  PubMed  Google Scholar 

  76. Nanayakkara K. Managing gestational diabetes—a two year study of 200 patients. Sri Lanka J Obstet Gynaecol. 2011;33:45–50.

    Google Scholar 

  77. Peiris H, Weerasekara DS. Glycosylated haemoglobin (HbA)—is it a useful screening test for gestational diabetes mellitus? Ceylon J Med Sci. 2000;43:7–10.

    Google Scholar 

  78. Weerasekera DS, Peiris H. The value of serum fructosamine in comparison with oral glucose tolerance test (OGTT) as a screening test for detection of gestational diabetes mellitus. J Obstet Gynaecol. 2000;20:136–8.

    Article  CAS  PubMed  Google Scholar 

  79. Senanayake H, Ariyaratne H, Wijeratne S. Is there a place for a single value oral glucose tolerance test for the diagnosis of gestational diabetes mellitus? Ceylon Med J. 2004;49:136–6.

  80. Jayathilaka KGH, Dahanayake S, Abewardhana R, Ranaweera AKP, Rishard MRM, Wijeyaratne CN. Diabetes in pregnancy among Sri Lankan women: gestational or pre-gestational? Sri Lanka J Diabetes Endocrinol Metab. 2011;1:8–13.

    Google Scholar 

  81. Senanayake H, Seneviratne S, Ariyaratne H, Wijeratne S. Screening for gestational diabetes mellitus in southern Asian women. J Obstet Gynaecol Res. 2006;32:286–91.

    Article  CAS  PubMed  Google Scholar 

  82. Wijeyaratne CN, Ginige S, Arasalingam A, Egodage C, Wijewardhena K. Screening for gestational diabetes mellitus: the Sri Lankan experience. Ceylon Med J. 2006;51:53–8.

    CAS  PubMed  Google Scholar 

  83. Silva NY, Tennekoon KH, Senanayake L, Karunanayake EH. Cord blood leptin levels in normal pregnancies, pregnancy induced hypertension and gestational diabetes mellitus. Ceylon Med J. 2008;53:79–82.

    CAS  PubMed  Google Scholar 

  84. Fernando D. Glucose tolerance after gestational diabetes mellitus. Kandy Med J. 1996;5:13–5.

    Google Scholar 

  85. Senanayake MP, Gunawardena MKS. Neonatal morbidity control of maternal diabetes with human insulin. Sri Lanka J Child Health. 2000;29:11–4.

    Google Scholar 

  86. Chang AA, De Abrew K, Fernando DJ. An audit of structure, process and outcome of care of the diabetic clinic, National Hospital of Sri Lanka. Ceylon Med J. 1997;42:133–6.

    CAS  PubMed  Google Scholar 

  87. Jayawardena MHDS, Idampitiya C, Jayawarna C, Wanigasuriya K, Thomson GA, Fernando DJS. An audit of standards of care at a Sri Lankan diabetic clinic. Diabetes Res Clin Pract. 2007;75:249–51.

    Article  PubMed  Google Scholar 

  88. Mulgirigama A, Illangasekera U. Study of the quality of care at a diabetic clinic in Sri Lanka. J R Soc Promot Health. 2000;120:164–9.

    Article  CAS  PubMed  Google Scholar 

  89. Ranasinghe CC, Rodrigo PC, Premaratne S, Adikari AMMC, Rajapakse S. An audit on the care of patients with type 2 diabetes mellitus in a tertiary care medical clinic in Sri Lanka. Int J Diabetes Dev Countries. 2010;30:174.

    Article  Google Scholar 

  90. Samarage SM. A Study on the utilization of patient care services of a general hospital by diabetics. M.Sc. University of Colombo, Post Graduate Institute of Medicine; 1992.

  91. Wijeweera S, Hettige C, Ragunathan MK. Diabetic care provided at a diabetic clinic at the largest tertiary care hospital in Southern Sri Lanka: an audit. Galle Med J. 2009;14:45–7.

    Google Scholar 

  92. De Abrew K, Galappatthy P, Weerasuriya K. Metformin in diabetes mellitus: are we choosing the right patients? Ceylon Med J. 2000;45:43–3.

  93. Fernando DJ. Symptomatic hypoglycaemia in elderly diabetic patients. Ceylon Med J. 1994;39:110–1.

    CAS  PubMed  Google Scholar 

  94. Fernando DJ. Knowledge about diabetes and metabolic control in diabetic patients. Ceylon Med J. 1993;38:18–21.

    CAS  PubMed  Google Scholar 

  95. Fernando DJ, Perera SD. The work of a diabetes clinic: an audit. Ceylon Med J. 1994;39:138–9.

    CAS  PubMed  Google Scholar 

  96. Idampitiya C, Lenora D, Lau S, Thomson GA, Fernando DJS. Improving the quality of diabetes care in a Sri Lankan diabetes clinic through a diabetes nurse educator. Diabetes Res Clin Pract. 2008;80:e25–6.

    Article  CAS  PubMed  Google Scholar 

  97. Chang AA, Fernando DJ, de Abrew K, Sheriff MH. Knowledge about diabetes among final year medical students, non-specialist hospital doctors and general practitioners. Ceylon Med J. 1998;43:51–2.

    CAS  PubMed  Google Scholar 

  98. Katulanda P, Constantine GR, Weerakkody MI, Perera YS, Jayawardena MG, Wijegoonawardena P, Matthews DR, Sheriff MH. Can we bridge the gap? Knowledge and practices related to diabetes mellitus among general practitioners in a developing country: a cross sectional study. Asia Pac Fam Med 2011;10.

  99. Gunathilake W, Kulasinghe R, Siriwardana A, Hettiarchchi K, Thomson GA, Fernando DJS. Engaging the media in diabetes prevention in Sri Lanka. Pract Diabetes Int. 2006;23:335–7.

    Article  Google Scholar 

  100. Fernando D. Costs of insulin injection. Ceylon Med J. 1996;41:29–30.

    CAS  PubMed  Google Scholar 

  101. Lanerolle RD, de Abrew K, Fernando DJ, Sheriff MH. Patient mixed biphasic insulin in a diabetic clinic. Ceylon Med J. 1997;42:137–8.

    CAS  PubMed  Google Scholar 

  102. Weerarathna TP, Dissanayake AS. Value of assessing post prandial blood glucose as a surrogate for fasting blood glucose in an outpatient medical clinic: a descriptive study. Galle Med J. 2006;11:6–10.

    Google Scholar 

  103. Malavige GN, Weerasooriya N, de Alwis NMW, Fernando DJS. The validity of fasting blood glucose and post-prandial blood glucose measurement as an index of glycaemic control in Sri Lankan patients with type 2 diabetes. Ceylon Med J. 2006;51:40–1.

    CAS  PubMed  Google Scholar 

  104. Gunasekara P, Hettiarachchi M, Liyanage C, Lekamwasam S. Effects of zinc and multimineral vitamin supplementation on glycemic and lipid control in adult diabetes. Diabetes Metab Syndr Obes Targets Ther. 2011;4:53–60.

    CAS  Google Scholar 

  105. Jayaratne SA. Effect of chromium supplementation on glycemic status and serum lipid concentrations in type 2 diabetes mellitus. M.Phil. University of Sri Jayawardenepura, 2005.

  106. Hettihewa L, Jayasinghe S, Imendra K, Weerarathna T. Correlation between changes of blood pressure with insulin resistance in type 2 diabetes mellitus with 4 weeks of pioglitazone therapy. Int J Diabetes Dev Countries. 2008;28:26–30.

    Article  CAS  Google Scholar 

  107. Hettihewa LM, Dharmasiri LP, Ariyaratne CD, Jayasinghe SS, Weerarathna TP, Kotapola IG. Significant correlation between BMI/BW with insulin resistance by McAuley, HOMA and QUICKI indices after 3 months of pioglitazone in diabetic population. Int J Diabetes Dev Countries. 2007;27:87–92.

    Article  Google Scholar 

  108. Jayasinghe SS, Hettihewa LM, Gunasekara SW, Palangasinghe S, Imendra KG, Weerarathna TP. Remission of diabetes mellitus after treatment with pioglitazone. Galle Med J. 2006;11:54–6.

    Google Scholar 

  109. Hettihewa LM, Palangasinghe S, Jayasinghe SS, Gunasekara SW, Weerarathna TP. Comparison of insulin resistance by indirect methods—HOMA, QUICKI and McAuley—with fasting insulin in patients with type 2 diabetes in Galle, Sri Lanka: a pilot study. Online J Health Allied Sci 2006;5.

  110. Warusawithana AK, Fernando ADA, Guruparan K, Athukorala TJ, Goonaratna C. Double blind placebo controlled crossover clinical trial of sildenafil citrate in patients with diabetes mellitus and erectile dysfunction. J Ceylon Coll Phys. 2010;41:72–5.

    Google Scholar 

  111. Wijesuriya M, Gulliford M, Vasantharajah L, Viberti G, Gnudi L, Karalliedde J. DIABRISK-SL prevention of cardio-metabolic disease with life style modification in young urban Sri Lankan's—study protocol for a randomized controlled trial. Trials 2011, 12.

  112. Fernando D. Preventing diabetes mellitus; the epidemiological basis. Ceylon Med J. 1995;40:136–8.

    CAS  PubMed  Google Scholar 

  113. Jayawardena R, Ranasinghe P, Byrne NM, Soares MJ, Katulanda P, Hills AP. Prevalence and trends of the diabetes epidemic in South Asia: a systematic review and meta-analysis. BMC Public Health. 2012;12:380.

    Article  PubMed Central  PubMed  Google Scholar 

  114. International Diabetes Federation. IDF diabetes atlas. (Editor ed.^eds.), vol. 2012, 5th edition. City: International Diabetes Federation 2011.

  115. Mohan V, Shanthirani CS, Deepa R. Glucose intolerance (diabetes and IGT) in a selected South Indian population with special reference to family history, obesity and lifestyle factors–the Chennai Urban Population Study (CUPS 14). J Assoc Physicians India. 2003;51:771–7.

    CAS  PubMed  Google Scholar 

  116. Jayawardena R, Bryne MN, Soares MJ, Katulanda P, Hills AP. Consumption of Sri Lankan adults: an appraisal of serving characteristics. Public Health Nutrition 2012, In press.

  117. Katulanda P, Jayawardena MA, Sheriff MH, Constantine GR, Matthews DR. Prevalence of overweight and obesity in Sri Lankan adults. Obes Rev. 2010;11:751–6.

    Article  CAS  PubMed  Google Scholar 

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Conflict of interest

The authors declare that they have no competing interests.

Authors’ contributions

PR, RJ, and PK made substantial contribution to conception and study design. PR and RJ were involved in data collection. PR, RJ, and PK were involved in refining the study design, statistical analysis, and drafting the manuscript. PR and RJ critically revised the manuscript. All authors read and approved the final manuscript.

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Authors and Affiliations

  1. Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka

    P. Ranasinghe

  2. Diabetes Research Unit, Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka

    P. Ranasinghe, R. Jayawardena & P. Katulanda

  3. Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia

    R. Jayawardena

Authors
  1. P. Ranasinghe
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  2. R. Jayawardena
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  3. P. Katulanda
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Corresponding author

Correspondence to P. Ranasinghe.

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Ranasinghe, P., Jayawardena, R. & Katulanda, P. The facts, figures, and reality of the diabetes epidemic in Sri Lanka: a systematic review. Int J Diabetes Dev Ctries 35, 501–513 (2015). https://doi.org/10.1007/s13410-015-0326-z

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