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Young-Onset Diabetes in Sri Lanka: Experience From the Developing World
Maulee Hiromi Arambewela1,2, Shani A D Mathara Diddhenipothage3, Chandrika Jayakanthi Subasinghe4
1Department of Physiology, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka.
Journal of Diabetes Research
|December 25, 2024
Summary
Young-onset diabetes (YOD) in Sri Lanka is most commonly Type 1 diabetes (T1D), but Type 2 diabetes (T2D) prevalence is concerning. The study highlights suboptimal glycemic control and high complication rates in young patients.
Area of Science:
- Endocrinology
- Public Health
- Epidemiology
Background:
- Young-onset diabetes (YOD) presents unique challenges, particularly in resource-limited settings like Sri Lanka.
- Understanding the prevalence and characteristics of YOD is crucial for effective management.
Purpose of the Study:
- To determine the prevalence, patterns, and characteristics of YOD in Sri Lanka.
- To assess the current state of care for YOD patients in the country.
Main Methods:
- A retrospective review of baseline data from 2531 patients across 28 centers in Sri Lanka.
- Data collected from the prospective multicenter Database for Young-Onset Diabetes, Sri Lanka (DYOD-SL) between April 2021 and April 2023.
Main Results:
- Type 1 diabetes (T1D) was the most common subtype (57.6%), followed by Type 2 diabetes (T2D) (34.3%).
- Younger age at onset, lower BMI, and diabetic ketoacidosis (DKA) at presentation were associated with T1D.
- Suboptimal glycemic control (median HbA1c 9.8%) and significant rates of complications (nephropathy 8.1%, retinopathy 6.6%) were observed.
- Insulin therapy predominantly involved premixed regimens via syringes, with limited use of advanced monitoring or delivery systems.
Conclusions:
- T1D is the predominant YOD subtype in Sri Lanka, but the high prevalence of T2D warrants significant attention.
- Suboptimal glycemic control, high complication rates, and inadequate treatment regimens characterize YOD care in Sri Lanka.
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