Long-term complications in newly diagnosed Sri Lankan patients with type 2 diabetes mellitus

We screened 597 newly-diagnosed diabetic patients (201 women) mean +/- SDage 42.3 +/- 6.2 years to determine the prevalence of diabeticcomplications; 22% presented because of symptoms of diabetes, 27% werediagnosed when hyperglycaemia was discovered at a health screening, and 36%were diagnosed while being treated for intercurrent illness. Neuropathy waspresent in 25.1%, nephropathy in 29%, retinopathy in 15%, coronary vasculardisease in 21%, stroke in 5.6%, peripheral vascular disease in 4.8%,hypertension in 23%, obesity in 16%, central obesity in 21.3%,hypercholesterolaemia in 11%, hypertriglyceridaemia in 14%, and lowhigh-density lipoprotein cholesterol in 12%. The prevalence of coronaryvascular disease, hypertension, stroke, neuropathy and retinopathy at thetime of diagnosis were higher in our patients than in Caucasian andIndo-Asian patients in the UK. Both a genetic predisposition to developcomplications, and exposure to a longer duration of asymptomatichyperglycaemia due to poor access to adequate health care, may contributeto the high frequency of complications at diagnosis. Since complicationsare already present at diagnosis, there is a case for implementing primaryprevention programmes combined with screening for diabetes in high-riskgroups.