Worldwide, the prevalence of diabetes has been steadily increasing over the past few decades. An estimated 537 million adults aged 20–79 years globally (10.5% of all adults in this age group) have diabetes. In WHO South- East Asia region, 246 million people are living with this disease. Diabetes is responsible for 480 000 deaths annually in the region, with more than half occurring prematurely among less than 70-year-olds.
According to recent WHO estimates, the age-standardized prevalence of diabetes among individuals aged 30 and older in Sri Lanka was 31.2% in 2022. This equates to approximately 4.2 million people in the country living with diabetes. Of these, nearly 41%, or 2.4 million are not on any treatment. Noncommunicable disease survey in 2020 (STEPS) also suggested that a significant proportion of individuals are unaware of their hyperglycemia status and nearly half of the diagnosed are not on treatment.
The national datasets suggest that diabetes related premature deaths (35-70yrs) in Sri Lanka have doubled between 2000 and 2019.
Most of the burden of diabetes is attributable to lifestyle risk factors which include unhealthy diet, tobacco use, harmful use of alcohol, and insufficient physical activity. The rise in diabetes is driven by population growth and ageing and rising prevalence of overweight and obesity. Diabetes is associated with multiple morbidities including cardiovascular diseases, kidney failure, vision loss and lower limb amputations. Adults with diabetes have two-to-three-fold increased risk of heart attacks and stroke, often presenting earlier and in a more severe form.
Diabetes is one of the target diseases under the WHO Global Action Plan for Prevention and Control of Noncommunicable Diseases. There is a globally agreed target to halt any further rise in prevalence of diabetes and obesity by 2030.
Reducing risk factors as well as improving health systems response are crucial to tackle diabetes. Various resolutions and decisions by the World Health Assembly and South-East Asia Regional Committee have outlined actions for Member States to prevent and control diabetes. Recognizing the rising burden and premature mortality due to diabetes over the last two decades, the Seventy-fourth World Health Assembly in May 2021 (Resolution WHA 74.4) emphasized on the need for whole-of-government and whole-of-society approaches to prioritize diabetes prevention and control, including management of obesity, early diagnosis, treatment and management of complications.
In April 2021, WHO launched the Global Diabetes Compact (GDC) that focuses on reducing risks to diabetes and increasing access to diagnosis and medications. The compact requires stakeholders’ collective actions to tackle diabetes, with specific Key Asks—UNITE, INTEGRATE, INNOVATE, TREAT, TRACK, FUND, and EDUCATE—to prevent and manage diabetes.
To improve management of diabetes in the South-East Asia region, the Seventy-sixth Session of WHO Regional Committee endorsed SEAHEARTS: accelerating prevention and control of cardiovascular diseases in the South-East Asia Region (SEA/RC76/R5) that brings risk factor prevention and management of hypertension and diabetes on a single platform. The region committed to place 100 million people with hypertension and diabetes on protocol-based management by 2025, with additional targets to address risk factors.
On this World Diabetes Day, Sri Lanka has taken initiative to call upon all Member States in the region to develop a unified approach through a regional ‘Colombo Call to Action’ to improve prevention and management of diabetes. The Call to Action will reaffirm commitments to the Global Diabetes Compact's (GDC) Key Asks. The Member States will agree on actions to integrate Key Asks into national health agendas to support achieving targets of GDC.
Integrating prevention and management of diabetes is one of the priorities of the Ministry of Health in ongoing primary health care reforms for the coming decade. Sri Lanka has implemented population-based strategies to promote healthy diets and physical activities in schools, workplaces and through healthy lifestyle centres. Sri Lanka has adopted colour-code labelling regulations to improve public awareness on high sugar, fat and salty foods. Diabetes screening and management protocols have been updated and targeted capacity building programmes have been organized for health workers, including community nursing officers to improve screening and management of diabetes at primary health care levels and in communities.
WHO will continue to support implementation of Key Asks of GDC in Sri Lanka. Expanding community outreach activities and integrating diabetes prevention and management services at primary and community levels will be key areas of focus to reduce the treatment gap. WHO will also support expanding of health promotion interventions through the life-course approach.
WHO Sri Lanka is committed to support the national efforts in breaking the barriers and bridging gaps in diabetes prevention and management as a shared responsibility of governments, healthcare providers and communities in Sri Lanka.
Key Links:
- Urgent action needed as global diabetes cases increase four-fold over past decades
- World Diabetes Day 2024
- The WHO Global Diabetes Compact
- World Health Statistics – Sri Lanka https://data.who.int/countries/144
- Annual Health Bulletin – Sri Lanka https://www.health.gov.lk/annual-health-bulletin/
- Obesity and overweight (who.int) https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
- International Diabetes Federation – Diabetes Report- Sri Lanka diabetes report 2000 — 2045