Browsing by Author "Somasundaram, N.P."

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High prevalence of Diabetes Mellitus in Sri Lankan urban population – Data from Colombo Urban Study
(Endocrine Society of Sri Lanka, 2019) Somasundaram, N.P.; Ranathunga, I.; Gunawardana, K.; Ediriweera, D.S.
BACKGROUND: In recent decades, Sri Lanka has experienced rapid urbanization, with approximately 30% of the population currently residing in urban areas. We report the age- and sex-specific prevalence of dysglycaemia in an urban population in Colombo, Sri Lanka. METHODS: Using a stratified random sampling method, 463 subjects (139 men; 324 women) aged 18 years and above were included. Physical activity was quantified using international physical activity questionnaire (IPAQ). Bio impedence was used to estimate body fat. Insulin sensitivity was estimated using the HOMA calculations. Prevalence was estimated using weighted age standardized calculations. Multiple logistic regression analyses were used to study associations to diabetes and prediabetes. RESULTS: There were 124 adults in the 18-40 age group (70% female), 209 adults in the 41-60 age group (73% female) and 130 adults in the > 60 age group (63% female). The overall prevalence of diabetes was 27.6% (95% CI: 23.7-31.4). The prevalence of diabetes in those aged 18-40 was 12.4% (95% CI: 6.4 -18.4), 36.1% (95% CI: 29.8 – 42.4) in those aged 41 – 60 and 48.3% (95% CI: 40.7 – 55.8) in those aged >60. Pre-diabetes was detected in 30.3% (95% CI 25.9-34.8) of the population (with either an HbA1c of 5.7-6.4%, FPG of 110-125 mg/dl or 2 Hr PPG of 140-199 mg/dl). Cumulative prevalence of diabetes and pre-diabetes in the population was 57.9%. CONCLUSIONS: This urban study demonstrates that along with the changes in the socio-demographic status, the metabolic profile of the Sri Lankan adult has transformed, with a high prevalence of dysglycaemia and obesity.
Prevalence of thyroid dysfunction among type 2 diabetic patients attending the Diabetes Clinic, National Hospital of Sri Lanka
(Endocrine Society of Sri Lanka, 2014) Kahandawa, S.; Somasundaram, N.P.; Ediriweera, D.S.; Kusumsiri, D.P.; Ellawala, S.; Chandrika, G.H.T.N.K.; Ransarini, K.G.H.
Objective: To determine the prevalence of thyroid dysfunction (TD) and to identify risk factors which are associated with TD in Type 2 Diabetic (T2DM) patients attending the Diabetes Clinic, National Hospital of Sri Lanka Method: A descriptive cross sectional study was carried out at the Diabetes Clinic, National Hospital of Sri Lanka. Study subjects were selected by simple random sampling method and data was collected using an interviewer administered data collection form. TD was assessed by performing 3rd generation TSH and when required FT4/FT3 levels were measured. Statistical analysis was done using Pearson’s Chi-square test, Fisher exact test, Mann Whitney U test and Wilcoxon Rank Sum test and P value < 0.05 was considered as significant. Results: TD was detected in 83 out of 393 T2DM subjects.The prevalence of TD among study subjects was 21.1% (95% CI:17.2-25.5%). The most common TD categories were subclinical hypothyroidism (9.4%, 95% CI:6.7-12.7%) and overt hypothyroidism (6.1%, 95% CI:3.9-8.9%). Subclinical hyperthyroidism and overt hyperthyroidism were detected only in 5.1% (95% CI:3.1-7.8%) and 0.5% (95% CI:0.1-1.8%) of cases respectively. The presence of TD was strongly associated with female sex (p<0.01) advancing age (p<0.01),the presence of goitre (p< 0.01) and a positive family history of thyroid disorder among 1st degree relatives (p=0.02).There was no association between the presence of TD and the duration of T2DM, presence of hypertension or chronic complications of DM, type of antidiabetic drugs used, current glycaemic control, body mass index (BMI) and total cholesterol level. Conclusion: The prevalence of TD was 21.1% and higher prevalence was seen in T2DM patients with female sex, advancing age, presence of goitre and positive family history of thyroid disorder among 1st degree relatives. DOI: http://dx.doi.org/10.4038/sjdem.v4i1.7254 Keywords: Thyroid dysfunction, type 2 diabetes
Prevalence of vitamin D deficiency/insufficiency and its metabolic associations in an urban setting in Sri Lanka: Data from Colombo Urban study
(Endocrine Society of Sri Lanka, 2019) Subasinghe, C. J.; Gunawardana, K.; Ediriweera, D.; Somasundaram, N.P.
INTRODUCTION: Vitamin D deficiency is a commonly prevalent, but less attended problem in Asia. Vit D status has many metabolic associations. We designed this community-based study to describe the prevalence of vitamin D deficiency/insufficiency and its metabolic associations in Sri Lankan population. METHODS: A representative sample aged 18 years and above was included. Demographic, anthropometric, and social details were recorded using a standard proforma. Blood analysis was done for vitamin D status, and other metabolic parameters. Prevalence was estimated using weighted age standardized calculations. Multiple logistic regression analyses were used to study associations to vitamin D status. RESULTS: Cumulative community prevalence of Vit D deficiency and insufficiency was 90.2%. Prevalence was highest among young and females. Obese had significantly lower vitamin D levels. According to the linear regression, Moors showed a significantly lower Vit D levels compared to Sinhalese while Triglyceride levels showed an inverse association with Vit D levels. Dysglycaemia was not associated with Vit D deficiency. DISCUSSION: Very high prevalence of Vit D problem was anticipated on clinical grounds and this is comparable with regional data. High prevalence among young needs early attention to avoid future poor bone health outcomes. Moor ethnicity shows high rates due to many known factors. Obesity is an emerging health problem in the country and co existent Vit D deficiency would increase its burden. CONCLUSION: Vitamin D deficiency and insufficiency and other metabolic problems are highly prevalent in this population. Causative factors and consequences of this problem should be further researched to plan strategies to replete the Vit D and prevent this problem.
Young male with heart failure and negative angiogram
(Endocrine Society of Sri Lanka, 2019) Liyanarachchi, K.D.; Kottachchi, D.C.; Somasundaram, N.P.
ABSTRACT: A young previously well male presented with features of acute coronary syndrome and heart failure. ECG showed inferior ST elevations but his cardiac markers and angiogram was negative. He was found to have a large abdominal paraganglioma with normal adrenal glands. He had a successful excision of the tumor and is now under life- long surveillance. He is awaiting genetic testing.