See discussions, stats, and author profiles for this publication at: https://www.researchgate.

net/publication/333578113

DIABETES MELLITUS AND ITS RISK FACTORS

Article  in  Epitome : International Journal of Multidisciplinary Research · September 2018

CITATIONS READS

0 6,791

1 author:

Lashini Liyanage
University of Kelaniya
24 PUBLICATIONS   3 CITATIONS   

SEE PROFILE

Some of the authors of this publication are also working on these related projects:

Technology View project

Participation in Agriculture View project

All content following this page was uploaded by Lashini Liyanage on 03 June 2019.

The user has requested enhancement of the downloaded file.

 ISSN (Online) : 2455 - 3662
SJIF Impact Factor :4.924

EPRA International Journal of

Multidisciplinary
Research
Monthly Peer Reviewed & Indexed
International Online Journal

Volume: 4 Issue:9 September 2018

Published By :
EPRA Journals

CC License
Volume: 4 | Issue: 9 | September 2018 SJIF Impact Factor: 4.924 ISSN (Online): 2455-3662

EPRA International Journal of

Multidisciplinary Research (IJMR)

DIABETES MELLITUS AND ITS RISK FACTORS

ABSTRACT
Prevalence of diabetes mellitus has raised faster in low and
middle income countries than in high income country.
Diabetes Mellitus is a cardiovascular metabolic condition
with characteristics of chronic high blood glucose levels
and a high risk of difficulties like, eyes damage, kidneys
damage, nervous system damage, hearing deficiency,
Alzheimer and cardio vascular diseases. There were 1.16
million cases of diabetes in Sri Lanka in 2016. There are
L N Liyanage numerous risk factors of diabetes mellitus. But the majority
University of Kelaniya, of the humankind is unaware of the factors of the
Dalugama, Kelaniya, prevalence of this. Therefore the main purpose of this
study was to determine the factors effecting for diabetes
Sri Lanka mellitus. The data were obtained from a cross sectional
survey conducted through a structured questionnaire using
100 participants chose from cluster sampling and simple
random sampling. Descriptive statistics including mean,
standard deviation, frequency, proportion, and percentage
and inferential statistics comprising χ2 test, factor analysis,
and discriminant analysis were used to analyze the data
using SPSS and Excel. Prevalence of diabetes mellitus in
females was higher than in males. Higher educated
population had a less prevalence of the disease. Diabetes
mellitus showed a positive relationship with age, less
physical activity, and BMI value. Among these diabetic
patientss, 56.9% had family history of diabetes; and
47.10% were performance sedentary work. There was a
significant association between diabetic community and
BMI χ2 (3) = 31.041, p = .000. Therefore, measures must
be taken to implement health policies to aware the society
about the diabetes mellitus.
KEY WORDS: Diabetes Mellitus, Economic Burden,
Risk Factors

www.eprajournals.com Volume: 4 | Issue: 9 | September 2018

114
 EPRA International Journal of Multidisciplinary Research (IJMR) | ISSN (Online): 2455 -3662 | SJIF Impact Factor: 4.924

It represents all kinds of ethnicity groups,

I. INTRODUCTION religious groups, income groups and employment status.
According to Brunner et al. (2008), diabetes From that randomly, Mahara PS Division was selected.
mellitus influence on all kind of socio-economic countries And out of 92 GN Divisions, Kirillawala – West GN was
but the low-income countries are more influenced. In low selected randomly.
and middle-income countries, the number of diabetic Individuals with age of ≥18 years were included
patients in urban areas is 186.2 million while 126.7 million in the study, because the prevalence of Diabetes Mellitus
live in rural areas (International Diabetes Federation, in children is very low. According to the Medical
2015). Statistical Unit (2015), the incidence of Diabetes Mellitus
People tend to use more high sugar food and do under age 16 was 1.1%. So it is meaningless to add people
sedentary work with the changing lifestyles, as a result of who are under 16 years to the survey. And another reason
globalization and industrialization. With that Diabetes for selecting adults who are aged older than 18 is because
Mellitus has increased (Kolb & Mandrup-Poulsen, 2010). the sampling frame can only make with adults. The
Abegunde et al. (2007) mentioned that governments sampling frame for this research was the election registry.
should take actions to control Diabetes Mellitus in The Kirillawala – West GN Division has a
countries; specially the low and middle-income countries population of 2491 people. It has 1793 people who are
possess an enormous economic burden due to diabetes older than 18 years. So the population size of this study
mellitus. In the WHO South-East Asia Region, the number was 1793. Also, the study has used the "population
of diabetic patients has been increased from 17 million in proportion sample size" formula to choose the sample size
1980 to 96 million in 2014 (Ramachandran et al., 2010). (Israel, 2013). The sample size derived was 100 units.
According to them, lack of physical activity is the main Questionnaire was used as schedules to collect
reason for the rise of Diabetes Mellitus in the region. data from the participants. Illiterate participants were
Nearly 9% of the adult population of the WHO South-East explained regarding the study and essential details were
Asia Region has Diabetes Mellitus. It is the second highest collected from them. The parameters studied were
WHO Diabetes prevailing region, after the Eastern demographic features, and socioeconomic status. Body
Mediterranean Region (WHO, 2016). mass index of each participant was calculated and was
According to Begic et al. (2016), diabetes mellitus categorized into underweight, normal, overweight and
has some risk factors including hyperglycemia, irregular obese.
fat profiles, changes in seditious mediators and clotting. It Moreover, the data has been analyzed by SPSS
has been detected that type 2 diabetes mellitus is Version 21 Software and Ms. Excel 2010 Software.
matrimonial; there is a high chance that children will have Statistical tools such as descriptive statistics, chi-square
type 2 diabetes if both parents have it. A study done in test, were used to analyze the collected data.
India stated that hypertension, overweight, obesity, III. RESULTS
smoking, tobacco use, alcohol consumption, and exercise Among all the participants, 49% people who are
pattern are main risk factors of diabetes mellitus not suffering from diabetes mellitus and 51% people who
(Venugopal & Iyer, 2010). According to Hu et al. (2017), are suffering from diabetes mellitus were included in the
risk factors of diabetes are older age, lower educational study. Table 1 depicts the socio demographic
level, being married/live together, higher BMI, larger waist characteristics of the sample.
circumference, having an unhealthy diet and having more The study revealed that in the diabetic
comorbidities. A study done in Pakistan stated that there is community, out 51 participants, 61% were female and the
a high positive relationship between diabetes mellitus and rest 39% were male. On the contrary, in the non-diabetic
lack of exercise, diabetic family history, poor dietary community, among 49 participants, 53% were male and
pattern, unhealthy food supply, and television viewing the rest 47% female. In the diabetic community, the
(Shaikh et al., 2013). Many risk factors contribute to the majority (49%) of the participants were in the age group
pathogenesis of diabetes, including sedentary behaviour, 41-55 years. Factors like religion, occupation, monthly
diet, smoking and alcohol consumption (Bi et al., 2012). income was not directly affected to the prevalence of
In order to reduce the prevalence of diabetes diabetes mellitus. But overwhelming majority of the
mellitus, at first we should know about the risk factors of participants with negative family history did not suffer
it. There are only few amount of analyses carried out in Sri with diabetes mellitus, while those were positive with
Lanka on that topic. So this study is carried out to find the diabetes family history suffered from the disease.
risk factors of Diabetes Mellitus in Sri Lanka.
II. METHODOLOGY
A Cross-sectional study was conducted in
Kirillawala – West Grama Niladhari (GN) Division in
Mahara Divisional Secretary’s (DS) Division in Gampaha
District, Sri Lanka. In this study, multistage cluster
sampling method was used. A study done in Sri Lanka also
used the multistage cluster sampling method (Katulanda et
al., 2012). Gampaha District was selected because it is one
of the top 3 diabetes prevailing districts in Sri Lanka. As
well as it is the second highest population district. Not only
that Gampaha district is consisting with people from all
over Sri Lanka.

www.eprajournals.com Volume: 4 | Issue: 9 | September 2018

115
 EPRA International Journal of Multidisciplinary Research (IJMR) | ISSN (Online): 2455 -3662 | SJIF Impact Factor: 4.924

Alcoholism
Table 1: Demographic Characteristics
Never 27 52.90 35 71.40
Diabetic Non-diabetic
Former 3 5.90 4 8.20
N % N % Current 17 33.30 3 6.10
Gender Occasional 4 7.80 7 14.30
Male 20 39 26 53 Source : Survey (2017)
Female 31 61 23 47
There was a significant association between the
Age smoking and diabetes mellitus χ2 (3) = 11.418, p = .010.
18-25 1 1.9 5 10.2 As well as, there was a significant association between the
26-40 7 13.8 19 38.8 consumption of alcoholism and diabetes mellitus χ2 (3) =
11.758, p = .008
41-55 25 49.1 16 32.7 Among the diabetic community, the majority
56-70 9 17.6 7 14.2 (51%) was in overweight, followed by 29.40% normal
70< 9 17.6 2 4.1 weight and 7.80% were underweight. On the other side, in
the non-diabetic community, the majority (81.60%) was in
Religion average weight while both underweight and overweight
Buddhist 40 78.4 41 83.7 was 8.20%. There was a significant association between
Hindu 5 9.8 1 2 diabetic community and BMI χ2 (3) = 31.041, p = .000.
There was no any significant association between
Christian 2 3.9 3 6.1 diabetic community and intake of bread, fish, egg, fruit
Islam 4 7.8 4 8.2 juice, and milk. But there was a significant association
Occupation between diabetic community and fast food intake χ2 (1) =
4.137, p = .042. There was a significant association
Unemployed 16 31.4 11 22.4 between diabetic community and cake intake χ2 (1) =
Student 1 2 1 2 9.159, p = .002. There was a significant association
Businessman 4 7.8 3 6.1 between diabetic community and toffee intake χ2 (1) =
13.431, p = .000. There was a significant association
Housewife 17 33.3 10 20.4
between diabetic community and sugary food intake χ2 (1)
Clerk 1 2 0 0 = 25.130, p = .000.
Labourer 1 2 3 6.1 A principal component analysis (PCA) was
conducted with varimax rotation. The Kaiser Meyer Olkin
Mason 4 7.8 3 6.1
(KMO) measure tested the sampling adequacy for the
Other 7 13.7 18 36.7 analysis, KMO = .710. Bartlett’s test of sphericity χ² (45) =
Monthly Income 530.751, p =0.000, indicated that correlations between
(Rs.) items were sufficiently large for PCA. To sum up, the
Below 20,000 8 15.7 3 6.1 analyses revealed three primary scales in our study that
20,000 - 40,000 16 31.4 16 32.7 may relate to risk factors for diabetes mellitus. By
considering the variables, factors were given a name.
40,000 - 60,000 17 33.3 15 30.6 Factor one is the consumption of food; factor two is the
60,000 - 80,000 7 13.7 4 8.2 consumption of drug and factor three is the physical
80,000 - 100,000 1 2 5 10.2 relationship.
IV. DISCUSSION
Above 100,000 2 3.9 6 12.2
It has been observed though this research that,
Weight (kg) females have a highest prevailing rate of diabetes mellitus
40-60 18 35.3 25 51 than males. A study done in Sri Lanka, by
Ambepitiyawaduge et al. (2012) also found that prevalence
60-80 27 52.9 22 44.9
of diabetes mellitus in the female is higher. But it was not
80-100 6 11.8 2 4.1 statistically significant. But a study done in Pakistan
Height (cm) revealed that there’s no difference in prevalence of
diabetes mellitus with the gender (Shaikh et al., 2013). A
130-150 5 9.8 5 10.2
study done by Ambepitiyawaduge et al. (2012) showed
150-170 39 76.5 35 71.4 that highest diabetes current age group is between 55 to 59
170-190 7 13.7 9 18.4 years. In this study, the highest prevailing age group is
between 41 to 55 years. It seems to be that the onset of
Smoking
diabetes mellitus occurs early as stated by International
Never 29 56.90 37 75.50 Diabetes Federation (2015).
Former 4 7.80 6 12.20 When compared to the previous researchers,
Katulanda et al. (2012) found that Sri Lankan Tamils
Current 15 29.40 2 4.10
suffer from diabetes mellitus (58.8%) rather than Muslims
Occasional 3 5.90 4 8.20 (28.9%) or Sinhalese (15.8%). That result is different to

www.eprajournals.com Volume: 4 | Issue: 9 | September 2018

116
 EPRA International Journal of Multidisciplinary Research (IJMR) | ISSN (Online): 2455 -3662 | SJIF Impact Factor: 4.924

the results of this study. It may be due to the fact that this cross sectional descriptive study. International Journal for Equity in
precise research was conducted in defined GN Division Health, 11, 76. https://doi.org/10.1186/1475-9276-11-76
while the study of Katulanda et al. (2012) was carried out 3. Begic, E., Begic, E., Arnautovic, A., & Masic, I. (2016). Assessment
of Risk Factors for Diabetes Mellitus Type 2 Assesment Of Risk
countrywide with a larger sample.
Factors For Diabetes, (June), 1–5.
From this study we could conclude that BMI is https://doi.org/10.5455/msm.2016.28.187-190
truly a high factor that affects diabetes mellitus. Majority 4. Bi, Y., Wang, T., Xu, M., Xu, Y., Li, M., Lu, J., … Ning, G.
of the obsessed participants were suffered with diabetes (2012). Advanced research on risk factors of type 2 diabetes.
mellitus. A study done in Sri Lanka by Pinidiyapathirage et Diabetes/Metabolism Research and Reviews, 28, 32–39.
al. (2012), showed that there is a definite relationship https://doi.org/10.1002/dmrr.2352
between BMI and prevalence of diabetes mellitus. Another 5. Brunner, L. S., Suddarth, D. S., & Smeltzer, S. C. O. (2008).
study was done in Sri Lanka by Katulanda et al. (2012) Brunner &amp; Suddarth’s textbook of medical-surgical nursing.
proved that prevalence of diabetes mellitus was higher in Lippincott Williams & Wilkins.
provinces where the BMI value is higher when compared 6. Hu, M., Wan, Y., Yu, L., Yuan, J., Ma, Y., Hou, B., … Shang, L.
(2017). Prevalence, Awareness and Associated Risk Factors of
to the provinces with a lower BMI value. International
Diabetes among Adults in Xi’an, China. Scientific Reports, 7(1),
Diabetes Federation (2015) has stated that the obesity is a 10472. https://doi.org/10.1038/s41598-017-10797-x
major risk factor for diabetes and its prevalence. They have 7. International Diabetes Federation. (2015). IDF Diabetes Atlas.
further explained that obesity is becoming a major issue International Diabetes Federation.
especially in Low and Middle-Income Countries. https://doi.org/10.1289/image.ehp.v119.i03
When compared to the previous researchers, 8. Israel, G. D. (2013). Determining Sample Size. University of
studies showed that there is a positive relationship between Florida, IFAS Extension, PE0D6(April 2009), 1–5.
diabetic family history and prevalence of diabetes mellitus https://doi.org/10.4039/Ent85108-3
(Padaki et al., 2011; Pinidiyapathirage et al., 2012). A 9. Katulanda, P., Rathnapala, D., Sheriff, R., & Matthews, D.
study was done in Pakistan also stated that there is a high (2012). Province and ethnic specific prevalence of diabetes among Sri
Lankan adults. Sri Lanka Journal of Diabetes Endocrinology and
number of the patients (73%) in their study had a positive
Metabolism, 1(1), 2–7.
family history of diabetes (Shaikh et al., 2013). https://doi.org/10.4038/sjdem.v1i1.4180
From this study, it was revealed there is a positive 10. Kolb, H., & Mandrup-Poulsen, T. (2010). The global diabetes
relationship between diabetes mellitus and drug epidemic as a consequence of lifestyle-induced low-grade
consumption. But a study done in Sri Lanka by inflammation. Diabetologia, 53(1), 10–20.
Pinidiyapathirage et al. (2012), showed that there is a https://doi.org/10.1007/s00125-009-1573-7
negative relationship between smoking diabetes mellitus. 11. Medical Statistical Unit. (2015). Annual Health Bulletin.
Another study showed a positive relationship between 12. Padaki, S., Vijayakrishna, K., Dambal, A., Ankad, R., Manjula, R.,
diabetes mellitus and drug consumption (Bi et al., 2012). Surekharani, C., … Patil, S. (2011). Anthropometry and physical
fitness in individuals with family history of type-2 diabetes mellitus:
V. CONCLUSION A comparative study. Indian Journal of Endocrinology and
Prevalence of diabetes mellitus is increasing at a Metabolism, 15(4), 327–30. https://doi.org/10.4103/2230-
rapid pace in Sri Lanka. Many diabetic cases remain 8210.85595
undiagnosed as a result of lack of screening and adequate 13. Pinidiyapathirage, M. J., Kasturiratne, A., Ranawaka, U. K.,
diagnostic facilities in the country. Besides, diagnosed Gunasekara, D., Wijekoon, N., Medagoda, K., … Wickremasinghe,
diabetic patients suffer from severe complications of the A. R. (2012). Research : Epidemiology The burden of diabetes
diabetes mellitus due to unawareness of self-care, lack of mellitus and impaired fasting glucose in an urban population of Sri
financial comfort, regular checkup and facilities for Lanka. https://doi.org/10.1111/dme.12013
medical supervision. 14. Ramachandran, A., Ma, R. C. W., & Snehalatha, C. (2010).
The government should take measures to aware Diabetes in Asia. Lancet (London, England), 375(9712), 408–18.
the public about diabetes mellitus and its impact on the https://doi.org/10.1016/S0140-6736(09)60937-5
15. Shaikh, Z., Akhund, S., Ali, M., & Khan, M. (2013). Type 2
economy and the health (as a person and as a whole). As
diabetes, Effects of socio-demographic factors among patients.
well as government should aware the public about the Professional Med J, 20(2), 244–249.
correct managing styles diabetes mellitus such as self- 16. Venugopal, S., & Iyer, U. M. (2010). Risk factor analysis and trends
monitoring and periodic checkup for the disease. of dyslipidemia in type 2 diabetes mellitus subjects of an industrial
ACKNOWLEDGEMENT population. Biomedical Research, 21(4), 371–375. Retrieved from
The encouragement, commitment, guidance and https://www.scopus.com/inward/record.uri?eid=2-s2.0-
constructive comments of Senior Lecturer Mr. Namal 80051508015&partnerID=40&md5=90663be3cc20fe395d9391
Balasooriya, University of Kelaniya, is duly 82276d59d8
acknowledged. And I would like to express my gratitude to 17. WHO. (2016). Global Report On Diabetes.
everyone who participated in my survey by taking time to
answer my questionnaire.
REFERENCES
1. Abegunde, D. O., Mathers, C. D., Adam, T., Ortegon, M., & Strong,
K. (2007). The burden and costs of chronic diseases in low-income
and middle-income countries. The Lancet, 370(9603), 1929–1938.
https://doi.org/10.1016/S0140-6736(07)61696-1
2. Ambepitiyawaduge, P. D. S., Sudirikku Hennadige, P. D. S.,
Liyanage, I. K., Rajapakse, L. C., Jayasinghe, K. S. A., Katulanda,
P., Wijeratne, S. (2012). Social, cultural and economical
determinants of diabetes mellitus in Kalutara district, Sri Lanka: a

www.eprajournals.com Volume: 4 | Issue: 9 | September 2018

117
View publication stats