Endocrine Abstracts

Background and Objectives: The prevalence of pre-diabetes and diabetes has risen exponentially in the recent past. Though the symptomatic patients frequently undergo testing for the diagnosis of the disease, asymptomatic individuals are not routinely subjected to diagnostic testing. Thus, data on asymptomatic people are still lacking. We have studied the prevalence of pre-diabetes and diabetes in asymptomatic subjects attending the Endocrinology clinic in a tertiary care institute in Sri Lanka.

Methods: A descriptive cross sectional study was conducted from January to August 2020 at the Endocrinology Unit of the National Hospital of Sri Lanka. Systematic sampling was done recruiting non diabetic patients aged more than 40 years, attending the clinic for other endocrine diseases. After obtaining informed written consent, the data was collected using an interviewer administered questionnaire. Pre-diabetes or diabetes was diagnosed according to the ADA-2020 diagnostic criteria.

Results: The study enrolled hundred and nine patients. The mean age was 53.9 years (range 40-76) and 90.8% were females. The mean weight was 62.1 (SD=11.3) kg and BMI was 26.6 (SD=4.6) kg/m^-2. Forty six percent had a family history of first degree relative being affected with type 2 diabetes. All the patients were asymptomatic of classic symptoms of hyperglycemia. Patients were evaluated with fasting blood glucose levels and HbA1c values. Forty nine patients (45%) were diagnosed with diabetes or pre-diabetes with either one or both values being impaired range. Out of that, six patients (5.5%) were diagnosed with type 2 diabetes and 43 patients (39.4%) were diagnosed with pre-diabetes. Out of the patients diagnosed with pre-diabetes and diabetes (n=49), sixty four percent did not had a family history of first degree relative being affected with type 2 diabetes. Out of the pre-diabetes and diabetes patients 32% had their BMI < 25 kgm^-2.

Conclusions: The prevalence of pre-diabetes and diabetes are much higher than expected in asymptomatic individuals. Hence, the likely patients should be regularly screened to diagnose asymptomatic phase of the disease. This is important as the prevalence has escalated in the immediate past, and diagnosing and treating early will improve long term outcome of the disease. Further large scale studies including community studies are needed to recognize the current prevalence and the rising trend both in urban and rural regions.