Introduction GDM is a leading metabolic cause of morbidity to mother and offspring. Determining its prevalence is important for health planning and implementation.Objective Assess prevalence of GDM in the District of Gampaha.Method Community based cross-sectional study was conducted in women attending field-based ante-natal clinics in two Medical Officer of Health (MOH) areas between January 2014 to March 2015.Consecutive women were recruited by cluster sampling with probability proportionate to size using strict exclusion criteria. GDM diagnosis was based on fasting 75 g OGTT, WHO 1999. All responders underwent 2 hr PPBS in first trimester->200 mg/dl with symptoms identified as abnormal, probably diabetes in pregnancy (DIP); those >120 and <200 mg/dl proceeded to OGTT before 16 weeks POA; all negatives were tested by OGTT between 24-28 weeks. Negatives for GDM at 24-28 weeks underwent OGTT between 32-36 weeks; venous plasma glucose tested by accredited laboratory.Results Sample consistedof 160, non-response 4.2% (67); 1533 underwent 2 hr PPBS with 40 exceeding 120mg: 4 >200 mg diagnosed as GDM / DIP, 36 (PPBS >120 < 200 mg) underwent OGTT before 16 weeks with 15 GDM. One hundred and thirty four (8.38%) miscarried including one with early abnormal OGTT. Of 1381 eligible for OGTT (24-28 weeks) 150 had GDM (10.86%). Only 344 (27.94% of normal 1231) consented for third trimester OGTT, of whom 25 had GDM-yielding a total of 194 with GDM (13.9%). ConclusionThe current community prevalence of GDM in the suburban Gampaha District, Sri Lanka is high.
In Sri Lanka, a survey was conducted in 2018 to assess the levels of identified hazards in commonly consumed food items. Pesticide residue levels in vegetables, green-leaves and fruits, heavy metals in salt, mercury and formaldehyde in fish, artificial colouring in tea and rice, aflatoxins in chilli powder, peanut and coconut oil and microbiological quality of yoghurt were tested to assess the safety of such foods. 397 fruits, 199 vegetables and 85 green-leave samples were tested for pesticide residues and of them 10.08 % fruit samples, 11.56 % vegetable samples and 41.18 % green-leave samples were detected with the presence of pesticide residues exceeding Maximum Residue Limits (MRL). Among salt samples tested for lead, arsenic, cadmium and mercury, none of the samples exceeded Maximum Permissible Limits (MPL). About one fifth of red raw rice samples were detected with artificial colouring but none of the tea samples had added artificial colourings. Aflatoxin levels exceeding 10 ppm were detected in 8 (10 %) coconut oil, 9 (11.25 %) peanut and 15 (18.75 %) chilli powder samples. All the yoghurt brands tested complied with microbiological specifications given in SLS standard. This survey provides an overview of the level of contaminants and adulterants in commonly consumed food items in Sri Lanka. It is recommended to carry out regular surveillance to monitor food safety hazards.
Context: Gestational diabetes mellitus (GDM) is a recognized risk for abnormal glucose tolerance (AGT) long-term. Aims: The aim of this study is to determine the prevalence of postpartum diabetes and AGT and predictive factors among Sri Lankan women with GDM. Settings and Design: The follow-up study was conducted in Gampaha District, Sri Lanka. Materials and Methods: Pregnant women with GDM were identified by a community-based longitudinal study (n = 1200) by WHO 1999 criteria and followed up till 1 year postpartum. Study instruments were interviewer-administered questionnaire, anthropometric measurements, and fasting 75 gOGTT. Statistical Analysis Used: χ2 tests with P-values and odds ratios (ORs) with 95% confidence interval (CI) were used to assess the statistical significance and strength of the associations. Predictive factors of postpartum AGT were identified by the multivariate analysis. Results: Of those identified with GDM (194), 169 participated in postpartum follow-up at 2 months (87.1%). Of the 169, 59 participated at 1 year. At 2 months, 17/169 (10.1%) had diabetes and 55/169 (32.5%) had AGT (diabetes=17, impaired glucose tolerance= 36, impaired fasting glucose=2). At 1 year, 11/59 (18.6%) had diabetes and 28/59 (47.5%) had AGT. Predictive factors of postpartum AGT at 2 months were 2-h postprandial blood sugar (2-h PPBS) before 12 weeks ≥97.5 mg/dL (adjusted OR (aOR)=2.8; 95% CI=1.3–6.0), GDM diagnosis before 16 weeks (aOR=7.7; 95% CI=1.5–39.7), and 1-h oral glucose tolerance test (OGTT) ≥179 mg/dL (aOR=3.1; 95% CI=1.5–6.4). Predictive factors of postpartum AGT at 1 year were 2-h PPBS before 12 weeks ≥97.5 mg/dL (aOR=8.4; 95% CI=2.3–30.3) and physical activity (aOR= 0.2; 95% CI=0.1–0.8). Conclusion: Postpartum AGT following GDM is high among Sri Lankan women. Long-term follow-up is recommended.
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