Burden of Diabetes Mellitus in a Community Resident in an Area Designated as “High Risk” for Chronic Kidney Disease of Unknown Origin in Sri Lanka

Abstract

Chronic kidney disease (CKD) where etiology cannot be attributed to any known etiology is named CKD of uncertain etiology (CKDu). The main aims of this study were to assess the prevalence of diabetes mellitus (DM), treatment coverage, and glycemic control and its effect on renal function of patients with DM in a rural community affected by CKDu in Sri Lanka. A cross-sectional representative household survey (n = 4803) was conducted in Anuradhapura district. A random blood sugar (RBS), blood pressure, bio-impedance measurements, and renal profile were measured using standard instruments and protocols. Prevalence of DM based on self-reports verified by records was 7.9% (95% confidence interval [CI]: 7.1–8.7). Among the 4425 who did not give a history of being diagnosed ever as having DM, 2.1% (95% CI: 1.7–2.5) were classified as “possible diabetes” (RBS of more than 200 mg/dl with no history of DM). Although 76.2% were on treatment, glycemic control was poor in 40.2% (95% CI: 34.9–45.0). The presence of DM was associated with poor renal function. One in ten individuals in the rural district of Anuradhapura has possible DM. DM poses a significant burden to CKD even in populations affected by CKDu. Hence, public health initiatives should be implemented to control both CKDu and DM in these rural communities.