Temporal trends in the prevalence of diabetes mellitus in a rural community in Sri Lanka

Abstract

In developing countries the prevalence of diabetes mellitus is reported to be lower in rural areas compared to urban areas. This difference has been attributed to lifestyle factors associated with the higher socio-economic status of those living in urban areas. However, recent clinical observations indicate that the prevalence of diabetes is on the increase even in the rural sector. The aims of the present study were to objectively assess whether the prevalence of diabetes has increased in a named rural community in Sri Lanka during a period of ten years and whether there has been a change in the socio-economic status of the community during this period. The study was conducted on a sample of 220 subjects randomly selected from an adult population of 25,605 residents in a rural area in central Sri Lanka. Each of these subjects had the fasting blood sugar estimated and the height, weight, resting blood pressure and socio-economic parameters, such as the level of education, occupation and monthly income, recorded. These data were compared with those of a similar study conducted by the main author in the same community ten years ago. The results revealed that the age-standardised prevalence of diabetes had increased from 2.5% in 1990 to 8.5% in 2000 (p = 0.008) and that this was accompanied by an increase in the monthly income, level of education and body mass indices. Since nearly 70% of all Sri Lankans live in villages, continuation of the present trend would result in a dramatic increase in the number of patients with diabetes in the future. Suitable strategies should be implemented to arrest this trend and manage a large number of patients with diabetes in the future.

The diabetes epidemic in Sri Lanka – a growing problem

“…In a study published in 2002 [7] on a suburban population using fasting blood glucose according to the 1997 ADA criteria or established treatment for diabetes mellitus for diagnosis, a prevalence of 6.5% was reported. In the 2004 study [8] on a rural population similar to the population sampled in the 1990 study by the same authors, an increased prevalence of 8.5% was found. Results of a large study on the cardiovascular risk factors among adults between the ages of 30 and 65 carried out in four provinces in Sri Lanka was published in 2005 [9].…”

“…Several investigators have estimated the prevalence of diabetes mellitus in Sri Lanka over the last 15 years [4][5][6][7][8][9]. Most of the studies were on rural or suburban populations.…”

“…IDF and WHO estimates and projections for the two countries are shown in Table 3. [4] et al [5] et al [6] et al [7] et al [8] et al [9] Sample …”

Towards a cost-effective delivery of diabetes care in Sri Lanka

“…Diabetes mellitus, whilst reaching epidemic proportions in many parts of the world including Sri Lanka, affects in addition to the urban sector, an increasing number of rural communities (1). The rise in the prevalence of diabetes would correspondingly lead to an increase in number of patients seeking treatment in hospitals (2).…”

A traditional Asian diet modified to meet nutritional requirements of diabetes, has anything changed? A cross-sectional dietary survey

“…The current prevalence of diabetes is estimated to be 10.3% with a projected prevalence of 13.9% for the year 2025 [3]. The increase in prevalence is seen in both rural and urban areas [3,4].…”