title: The burden of diabetes mellitus and impaired fasting glucose in an urban population of Sri Lanka.
abstract: OBJECTIVE
  To describe the burden of diabetes mellitus and impaired fasting glucose in middle-aged residents (35-64 years) in an urban area of Sri Lanka.
  
  
  METHODS
  A cross-sectional survey was conducted in the Ragama Medical Officer of Health area, from which 2986 participants (1349 men and 1637 women) were randomly selected from the electoral registry between January and December 2007. The participants underwent a physical examination and had their height, weight, waist and hip circumferences and blood pressure measured by trained personnel. Fasting blood samples were taken for measurement of glucose, HbA(1c)  and lipids. The prevalence of diabetes (fasting plasma glucose > 7 mmol/l) and impaired fasting glycaemia (fasting plasma glucose 5.6-6.9 mmol/l) and major predictors of diabetes in Sri Lanka were estimated from the population-based data.
  
  
  RESULTS
  Age-adjusted prevalence of diabetes mellitus in this urban population was 20.3% in men and 19.8% in women. Through the present screening, 263 patients with diabetes and 1262 with impaired fasting glucose levels were identified. The prevalence of newly detected diabetes was 35.7% of all patients with diabetes. Among patients with diabetes, only 23.8% were optimally controlled. In the regression models, high BMI, high waist circumference, high blood pressure and hypercholesterolaemia increased the fasting plasma glucose concentration, independent of age, sex and a family history of diabetes.
  
  
  CONCLUSIONS
  Our data demonstrate the heavy burden of diabetes in this urban population. Short- and long-term control strategies are required, not only for optimal therapy among those affected, but also for nationwide primary prevention of diabetes.
authors.affiliation: Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka. jananicm@yahoo.com
authors.forename: M J
authors.initials: MJ
authors.lastname: Pinidiyapathirage
authors.forename: A
authors.initials: A
authors.lastname: Kasturiratne
authors.forename: U K
authors.initials: UK
authors.lastname: Ranawaka
authors.forename: D
authors.initials: D
authors.lastname: Gunasekara
authors.forename: N
authors.initials: N
authors.lastname: Wijekoon
authors.forename: K
authors.initials: K
authors.lastname: Medagoda
authors.forename: S
authors.initials: S
authors.lastname: Perera
authors.forename: F
authors.initials: F
authors.lastname: Takeuchi
authors.forename: N
authors.initials: N
authors.lastname: Kato
authors.forename: T
authors.initials: T
authors.lastname: Warnakulasuriya
authors.forename: A R
authors.initials: AR
authors.lastname: Wickremasinghe
mesh_terms: D000328:Adult; D017677:Age Distribution; D001786:Blood Glucose / Q000378:metabolism; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000097:blood / Q000453:epidemiology*; D005215:Fasting / Q000097:blood; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007003:Hypoglycemia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012044:Regression Analysis; D012307:Risk Factors; D017678:Sex Distribution; D013188:Sri Lanka / Q000453:epidemiology; D014504:Urban Health / Q000706:statistics & numerical data
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin