ORCID Profile
0000-0003-4313-7528
Current Organisations
University of Oxford
,
University of Colombo
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Publisher: Wiley
Date: 05-02-2013
Abstract: Diabetes in South Asia represents a different disease entity in terms of its onset, progression, and complications. In the present study, we systematically analyzed the medical research output on diabetes in South Asia. The online SciVerse Scopus database was searched using the search terms "diabetes" and "diabetes mellitus" in the article Title, Abstract or Keywords fields, in conjunction with the names of each regional country in the Author Affiliation field. In total, 8478 research articles were identified. Most were from India (85.1%) and Pakistan (9.6%) and the contribution to the global diabetes research output was 2.1%. Publications from South Asia increased markedly after 2007, with 58.7% of papers published between 2000 and 2010 being published after 2007. Most papers were Research Articles (75.9%) and Reviews (12.9%), with only 90 (1.1%) clinical trials. Publications predominantly appeared in local national journals. Indian authors and institutions had the most number of articles and the highest h-index. There were 136 (1.6%) intraregional collaborative studies. Only 39 articles (0.46%) had >100 citations. Regional research output on diabetes mellitus is unsatisfactory, with only a minimal contribution to global diabetes research. Publications are not highly cited and only a few randomized controlled trials have been performed. In the coming decades, scientists in the region must collaborate and focus on practical and culturally acceptable interventional studies on diabetes mellitus.
Publisher: Wiley
Date: 03-01-2018
Abstract: This study evaluated the effects of zinc supplementation on glycemic control, other cardiometabolic and anthropometric parameters, and disease progression in prediabetes. A randomized double-blind placebo-controlled Phase 2 clinical trial was conducted over a 12-month period in 200 subjects (43% male mean [± SD] age 51.8 ± 7.3 years), randomly assigned (1: 1) to the treatment or control group. The treatment group received zinc (20 mg daily). Subjects were evaluated at baseline and at 1, 3, 6, and 12 months. The primary outcome was the change in glycemic control from baseline. Multiple regression analyses were performed, with change in outcome variables after intervention from baseline used as continuous dependent variables. In both groups, mean serum zinc concentrations prior to the trial were below normal (15.29-21.41 μmol/L). During the 12-month follow-up, a significantly higher percentage of participants developed type 2 diabetes in the control compared with zinc-treated group (25.0% vs 11.0% respectively P = 0.016). Fasting plasma glucose (FPG), 2-h glucose levels in the oral glucose tolerance test (OGTT), homeostasis model assessment of insulin resistance (HOMA-IR), total cholesterol (TC), and low-density lipoprotein cholesterol (LDL-C) were significantly lower in the treated group, with significant improvement in β-cell function. In all four regression models, the best predictor of the dependent variables (i.e. change in FPG, 2-h glucose in the OGTT, HOMA-IR, and homeostatic model assessment of β-cell function) was zinc treatment. Zinc supplementation reduced blood glucose and insulin resistance while improving β-cell function. Furthermore, supplementation reduced disease progression to diabetes and had beneficial effects on TC and LDL-C.
Publisher: Wiley
Date: 27-11-2014
DOI: 10.1111/DME.12591
Abstract: To describe the influence of family history on diabetes prevalence and associated metabolic risk factors in a nationally representative s le from Sri Lanka. A cross sectional national survey was conducted among 5000 adults in Sri Lanka. Family history was evaluated at three levels: (1) parents, (2) grandparents (paternal and maternal) and (3) siblings. A binary-logistic regression analysis controlling for confounders (age, gender, BMI and physical activity) was performed in all patients with 'presence of diabetes' as the dichotomous dependent variable and using family history in father, mother, maternal grandmother/grandfather, paternal grandmother/grandfather, siblings and children as binary independent variables. The s le size was 4485, mean age was 46.1 ± 15.1 years and 39.5% were males. In all adults, the prevalence of diabetes was significantly higher in patients with a family history (23.0%) than those without (8.2%) (P < 0.001). When family history was present in both parents, the prevalence of diabetes was 32.9%. Presence of a family history significantly increased the risk of diabetes [odds ratio (OR): 3.35, 95% confidence interval (CI): 2.78-4.03], obesity (OR: 2.45, 95% CI: 1.99-2.99), hypertension (OR: 1.25, 95% CI: 1.08-1.45) and metabolic syndrome (OR: 2.28, 95% CI: 1.97-2.63). In all adults, the presence of a family history of diabetes in a father (OR: 1.29, 95% CI: 1.02-1.63), mother (OR: 1.23, 95% CI: 1.11-1.36), paternal grandfather (OR: 1.27, 95% CI: 1.14-1.41), siblings (OR: 4.18, 95% CI: 3.34-5.22) and children (OR: 5.47, 95% CI: 2.93-10.19) was associated with a significantly increased risk of developing diabetes. Family history and diabetes had a graded association in the Sri Lankan population, because the prevalence increased with the increasing number of generations affected. Family history of diabetes was also associated with the prevalence of obesity, metabolic syndrome and hypertension. In iduals with a family history of diabetes form an easily identifiable group who may benefit from targeted interventions.
Publisher: SAGE Publications
Date: 27-11-2015
Publisher: Springer Science and Business Media LLC
Date: 31-08-2012
Publisher: Wiley
Date: 14-11-2012
DOI: 10.1111/J.1464-5491.2012.03718.X
Abstract: Diabetes is a leading cause of morbidity and mortality worldwide. Studies have frequently looked at dietary components beneficial in treatment and prevention. We aim to systematically evaluate the literature on the safety and efficacy of Cinnamomum zeylanicum on diabetes. A comprehensive search of the literature was conducted in the following databases PubMed, Web of Science, Biological Abstracts, SciVerse Scopus, SciVerse ScienceDierect, CINAHL and The Cochrane Library. A meta-analysis of studies examining the effect of C. zeylanicum extracts on clinical and biochemical parameters was conducted. Data were analysed using RevMan v5.1.2. The literature search identified 16 studies on C. zeylanicum (five in-vitro, six in-vivo and five in-vivo/in-vitro). However, there were no human studies. In-vitro C. zeylanicum demonstrated a potential for reducing post-prandial intestinal glucose absorption by inhibiting pancreatic α-amylase and α-glucosidase, stimulating cellular glucose uptake by membrane translocation of glucose transporter-4, stimulating glucose metabolism and glycogen synthesis, inhibiting gluconeogenesis and stimulating insulin release and potentiating insulin receptor activity. The beneficial effects of C. zeylanicum in animals include attenuation of diabetes associated weight loss, reduction of fasting blood glucose, LDL and HbA(1c) , increasing HDL cholesterol and increasing circulating insulin levels. Cinnamomum zeylanicum also significantly improved metabolic derangements associated with insulin resistance. It also showed beneficial effects against diabetic neuropathy and nephropathy, with no significant toxic effects on liver and kidney and a significantly high therapeutic window. Cinnamomum zeylanicum demonstrates numerous beneficial effects both in vitro and in vivo as a potential therapeutic agent for diabetes. However, further randomized clinical trials are required to establish therapeutic safety and efficacy.
Publisher: Springer Science and Business Media LLC
Date: 08-04-2013
Publisher: SAGE Publications
Date: 28-10-2015
Abstract: Metabolic syndrome (MetS) is a significant predictor of cardiovascular diseases (CVDs). A pretested questionnaire was used to assess knowledge, attitudes, and practice (KAP) of CVD and its risks among Sri Lankan urban adults (35-55 years) with MetS. KAP scores were predefined as high, moderate, and low. Of the participants (n = 423), 13% were males and 87% were females. Attitudes scores were high among this population, though their knowledge and practices scores on CVD risk factors were moderate. Participants with high mean knowledge scores had significantly lower waist circumference (WC) and showed a trend toward reduced fasting blood glucose levels. Participants with high practice scores had significantly lower BMI and WC, which signify that better knowledge and practices are associated with decrease in CVD risk markers in these patients. The study reveals that urban MetS patients have a moderate knowledge and practice score, though their attitude score is high regarding CVD risk factors.
Publisher: Springer Science and Business Media LLC
Date: 19-04-2012
Abstract: The number of people with diabetes and pre-diabetes are exponentially increasing. Studies on humans have shown the beneficial effects of Zinc supplementation in patients with diabetes. The present study aims to systematically evaluate the literature and meta-analyze the effects of Zinc supplementation on diabetes. A systematic review of published studies reporting the effects of Zinc supplementations on diabetes mellitus was undertaken. The literature search was conducted in the following databases PubMed, Web of Science and SciVerse Scopus. A meta-analysis of studies examining the effects of Zinc supplementation on clinical and biochemical parameters in patients with diabetes was performed. The total number of articles included in the present review is 25, which included 3 studies on type-1 diabetes and 22 studies on type-2 diabetes. There were 12 studies comparing the effects of Zinc supplementation on fasting blood glucose in patients with type-2 diabetes. The pooled mean difference in fasting blood glucose between Zinc supplemented and placebo groups was 18.13mg/dl (95%CI:33.85,2.41 p .05). 2-h post-prandial blood sugar also shows a similar distinct reduction in (34.87mg/dl [95%CI:75.44 5.69]) the Zinc treated group. The reduction in HbA1c was 0.54% (95%CI:0.86 .21) in the Zinc treated group. There were 8 studies comparing the effects of Zinc supplementation on lipid parameters in patients with type-2 diabetes. The pooled mean difference for total cholesterol between Zinc supplemented and placebo groups was 32.37mg/dl (95%CI:57.39,7.35 p .05). Low-density lipoprotein cholesterol also showed a similar distinct reduction in the Zinc treated group, the pooled mean difference from random effects analysis was 11.19mg/dl (95%CI:21.14,1.25 p .05). Studies have also shown a significant reduction in systolic and diastolic blood pressures after Zinc supplementation. This first comprehensive systematic review and meta-analysis on the effects of Zinc supplementation in patients with diabetes demonstrates that Zinc supplementation has beneficial effects on glycaemic control and promotes healthy lipid parameters. Further studies are required to identify the exact biological mechanisms responsible for these results.
Publisher: Elsevier BV
Date: 03-2013
DOI: 10.1016/J.DIABRES.2012.12.013
Abstract: Obesity associated metabolic diseases have reached epidemic levels in many South Asian countries. Conventional anthropometric indices have poor sensitivity and specificity for detecting people with increased metabolic risks. The aim of this study was to investigate and compare WHtR (Waist to Height Ratio) as a marker of diabetes and cardio-metabolic risks with existing classical anthropometric indices such as Body Mass Index (BMI), Waist Circumference (WC) and Waist to Hip Ratio (WHR) in a large sub-population of ethnic South Asians. A total of 5000 subjects recruited from a nationally representative community-based s le using multi-stage random cluster-s ling method. Anthropometric, biochemical and clinical parameters were measured. Receiver-operating characteristic (ROC) curves were performed and area under the curve (AUC) was calculated for each anthropometric index. S le size was 4485. The mean WHtR in all adults was 0.496 (±0.077), males (0.477±0.065) had a significant lower WHtR than females (0.508±0.081) (p<0.001). WHtR had the highest correlation with metabolic parameters. In all adults, males and females the AUC of WHtR was significantly higher than that of BMI, WC and WHR in diabetes mellitus, pre-diabetes, hypertension, metabolic syndrome and hypercholesterolemia. Mean age, fasting blood glucose, 2-h post prandial blood Glucose, total cholesterol, LDL cholesterol, triglycerides, systolic blood pressure and diastolic blood pressure were all significantly higher among all adults, males and females with WHtR≥0.5. WHtR is a simple and effective anthropometric index to identify obesity associated metabolic risks among Sri Lankan adults.
Publisher: Springer Science and Business Media LLC
Date: 04-08-2015
Publisher: American Diabetes Association
Date: 16-04-2013
DOI: 10.2337/DB12-1077
Abstract: We performed a genome-wide association study (GWAS) and a multistage meta-analysis of type 2 diabetes (T2D) in Punjabi Sikhs from India. Our discovery GWAS in 1,616 in iduals (842 case subjects) was followed by in silico replication of the top 513 independent single nucleotide polymorphisms (SNPs) (P & 10−3) in Punjabi Sikhs (n = 2,819 801 case subjects). We further replicated 66 SNPs (P & 10−4) through genotyping in a Punjabi Sikh s le (n = 2,894 1,711 case subjects). On combined meta-analysis in Sikh populations (n = 7,329 3,354 case subjects), we identified a novel locus in association with T2D at 13q12 represented by a directly genotyped intronic SNP (rs9552911, P = 1.82 × 10−8) in the SGCG gene. Next, we undertook in silico replication (stage 2b) of the top 513 signals (P & 10−3) in 29,157 non-Sikh South Asians (10,971 case subjects) and de novo genotyping of up to 31 top signals (P & 10−4) in 10,817 South Asians (5,157 case subjects) (stage 3b). In combined South Asian meta-analysis, we observed six suggestive associations (P & 10−5 to & 10−7), including SNPs at HMG1L1/CTCFL, PLXNA4, SCAP, and chr5p11. Further evaluation of 31 top SNPs in 33,707 East Asians (16,746 case subjects) (stage 3c) and 47,117 Europeans (8,130 case subjects) (stage 3d), and joint meta-analysis of 128,127 in iduals (44,358 case subjects) from 27 multiethnic studies, did not reveal any additional loci nor was there any evidence of replication for the new variant. Our findings provide new evidence on the presence of a population-specific signal in relation to T2D, which may provide additional insights into T2D pathogenesis.
Publisher: International Medical Publisher (Fundacion de Neurociencias)
Date: 2014
Publisher: Cambridge University Press (CUP)
Date: 17-12-2011
DOI: 10.1017/S0007114510004563
Abstract: Obesity is associated with increased cardiovascular risk. Anthropometric cut-off values derived for Caucasians may not be applicable to other populations. The main objective of the present study was to derive population-specific anthropometric cut-off values to define high CVD risk for Sri Lankan adults. A nationally representative s le of 4474 non-institutionalised adults aged ≥ 18 years was analysed. Cut-off values to provide optimum sensitivity and specificity were derived using receiver-operating characteristic curve analysis. BMI, waist circumference (WC), waist-to-hip ratio (WHR), blood pressure and overnight fasting venous blood s les were collected to measure glucose, HDL-cholesterol and TAG. An oral glucose tolerance test was also performed. The results suggested that the age-adjusted BMI, WC and WHR were significantly associated with all cardiovascular risk factors ( P 0·001). Cut-off values for BMI, WC and WHR for males were 20·7 kg/m 2 , 76·5 cm and 0·89, respectively. The respective values for females were 22·0 kg/m 2 , 76·3 cm and 0·85. The common cut-off value for BMI for males and females was 21·5 kg/m 2 . Similarly, WC and WHR cut-off values for both males and females were 76·3 cm and 0·87, respectively. The Asian and Caucasian anthropometric cut-off levels showed lower sensitivity and higher false negative percentage compared with newly derived cut-off levels. In conclusion, BMI, WC and WHR were all associated with increased CVD risk. We propose the following anthropometric cut-off points to determine high CVD risk level for Sri Lankan adults: BMI ≥ 21·5 kg/m 2 , WC ≥ 76 cm and WHR ≥ 0·85 (women) and 0·90 (men).
Publisher: S. Karger AG
Date: 2010
DOI: 10.1159/000315127
Publisher: International Medical Publisher (Fundacion de Neurociencias)
Date: 2014
Publisher: Informa UK Limited
Date: 16-01-2014
DOI: 10.3109/10641963.2013.863321
Abstract: We studied the community prevalence, patterns and predictors of hypertension in a large sub-population of South Asian adults with a view of identifying differential risk factors. Data were collected between years 2005-2006 and 5000 adults were invited for the study. The s le size was 4485, and about 39.5% were males. Mean systolic and diastolic blood pressures were 127.1 ± 19.8 mmHg and 75.4 ± 11.3 mmHg, respectively. Age-adjusted prevalence in all adults, males and females was 23.7%, 23.4% and 23.8%, respectively. Urban adults had a significantly higher prevalence of hypertension than rural adults. In the binary logistic-regression analysis, male gender (OR: 1.2), increasing age, Sri Lankan Moor ethnicity (OR: 1.6), physical inactivity (OR: 1.7), presence of diabetes (OR: 2.2) and central obesity (OR: 2.3) all were significantly associated with hypertension. In conclusion, nearly one-third of the Sri Lankan adult population is hypertensive. Hence, public health initiatives should encourage healthier lifestyles with emphasis on preventing obesity and increasing physical activity.
Publisher: Springer Science and Business Media LLC
Date: 2013
Publisher: Springer Science and Business Media LLC
Date: 28-08-2011
DOI: 10.1038/NG.921
Publisher: Springer Science and Business Media LLC
Date: 20-08-2014
Publisher: Springer Science and Business Media LLC
Date: 25-05-2012
Publisher: Wiley
Date: 17-03-2013
DOI: 10.1111/DME.12141
Publisher: Springer Science and Business Media LLC
Date: 23-11-2015
Publisher: Springer Science and Business Media LLC
Date: 29-09-2017
Publisher: Springer Science and Business Media LLC
Date: 24-02-2012
Publisher: Springer Science and Business Media LLC
Date: 31-05-2012
Publisher: S. Karger AG
Date: 2013
DOI: 10.1159/000355598
Abstract: b i Aim: /i /b Worldwide obesity levels have increased unprecedentedly over the past couple of decades. Although the prevalence, trends and associated socio-economic factors of the condition have been extensively reported in Western populations, less is known regarding South Asian populations. b i Methods: /i /b A review of articles using Medline with combinations of the MeSH terms: ‘Obesity', ‘Overweight' and ‘Abdominal Obesity' limiting to epidemiology and South Asian countries. b i Results: /i /b Despite methodological heterogeneity and variation according to country, area of residence and gender , the most recent nationally representative and large regional data demonstrates that without any doubt there is a epidemic of obesity, overweight and abdominal obesity in South Asian countries. Prevalence estimates of overweight and obesity (based on Asian cut-offs: overweight ≥ 23 kg/m sup /sup , obesity ≥ 25 kg/m sup /sup ) ranged from 3.5% in rural Bangladesh to over 65% in the Mal es. Abdominal obesity was more prevalent than general obesity in both sexes in this ethnic group. Countries with the lowest prevalence had the highest upward trend of obesity. Socio-economic factors associated with greater obesity in the region included female gender, middle age, urban residence, higher educational and economic status. b i Conclusion: /i /b South Asia is significantly affected by the obesity epidemic. Collaborative public health interventions to reverse these trends need to be mindful of many socio-economic constraints in order to provide long-term solutions.
Publisher: Springer Science and Business Media LLC
Date: 21-02-2015
Publisher: Springer Science and Business Media LLC
Date: 12-2017
Publisher: Springer Science and Business Media LLC
Date: 29-05-2012
Publisher: Springer Science and Business Media LLC
Date: 24-02-2016
Publisher: Cambridge University Press (CUP)
Date: 20-09-2012
DOI: 10.1017/S1368980012003990
Abstract: To evaluate patterns of physical activity (PA), the prevalence of physical inactivity and the relationships between PA and sociodemographic, clinical and biochemical parameters among Sri Lankan adults. Descriptive cross-sectional study. Nationally representative population-based survey conducted in Sri Lanka. Data on PA and associated details were obtained from 5000 adults. PA was assessed using the International Physical Activity Questionnaire (short-form). A binary logistic regression analysis was performed using the dichotomous variable ‘health-enhancing PA’ (0 = ‘active’, 1 = ‘inactive’). S le size was 4485. Mean age was 46·1 ( sd 15·1) years, 39·5 % were males. The mean weekly total MET (metabolic equivalents of task) minutes of PA among the study population was 4703 ( sd 4369). Males (5464 ( sd 5452)) had a significantly higher weekly total MET minutes than females (4205 ( sd 3394) P 0·001). Rural adults (5175 ( sd 4583)) were significantly more active than urban adults (2956 ( sd 2847) P 0·001). Tamils had the highest mean weekly total MET minutes among ethnicities. Those with tertiary education had lowest mean weekly total MET minutes. In all adults 60·0 % were in the ‘highly active’ category, while only 11·0 % were ‘inactive’ (males 14·6 %, females 8·7 % P 0·001). Of the ‘highly active’ adults, 85·8 % were residing in rural areas. Results of the binary logistic regression analysis indicated that female gender (OR = 2·1), age years (OR = 3·8), urban living (OR = 2·5), Muslim ethnicity (OR = 2·7), tertiary education (OR = 3·6), obesity (OR = 1·8), diabetes (OR = 1·6), hypertension (OR = 1·2) and metabolic syndrome (OR = 1·3) were all associated with significantly increased odds of being physically ‘inactive’. The majority of Sri Lankan adults were ‘highly active’ physically. Female gender, older age, urban living, Muslim ethnicity and tertiary education were all significant predictors of physical inactivity. Physical inactivity was associated with obesity, diabetes, hypertension and metabolic syndrome.
Publisher: Cambridge University Press (CUP)
Date: 12-07-2013
DOI: 10.1017/S1368980012003011
Abstract: The main aim of the present study was to identify food consumption in Sri Lankan adults based on serving characteristics. Cross-sectional study. Fruits, vegetables, starch, meat, pulses, dairy products and added sugars in the diet were assessed with portion sizes estimated using standard methods. Twelve randomly selected clusters from the Sri Lanka Diabetes and Cardiovascular Study. Six hundred non-institutionalized adults. The daily intake of fruit (0·43), vegetable (1·73) and dairy (0·39) portions were well below national recommendations. Only 3·5 % of adults consumed the recommended 5 portions of fruits and vegetables/d over a third of the population consumed no dairy products and fewer than 1 % of adults consumed 2 portions/d. In contrast, Sri Lankan adults consumed over 14 portions of starch and 3·5 portions of added sugars daily. Almost 70 % of those studied exceeded the upper limit of the recommendations for starch intake. The total daily number of meat and pulse portions was 2·78. Dietary guidelines emphasize the importance of a balanced and varied diet however, a substantial proportion of the Sri Lankan population studied failed to achieve such a recommendation. Nutrition-related diseases in the country may be closely correlated with unhealthy eating habits.
Publisher: Springer Science and Business Media LLC
Date: 09-02-2014
DOI: 10.1038/NG.2897
Publisher: Wiley
Date: 12-04-2010
Publisher: Springer Science and Business Media LLC
Date: 20-06-2015
Publisher: Elsevier BV
Date: 03-2014
DOI: 10.1016/J.ORCP.2013.05.003
Abstract: The purpose of the present study was to evaluate the association between self-perception of body weight, weight loss approaches and measured body mass index (BMI) and waist circumference (WC) among Sri Lankan adults. A nationally representative s le of 600 adults aged ≥18 years was selected using a multi-stage random cluster s ling technique. An interviewer-administrated questionnaire was used to assess demographic characteristics, body weight perception, abdominal obesity perception and details of weight losing practices. Weight, height and waist circumference (WC) were measured and Asian anthropometric cut-offs for BMI and WC were applied. Body weight mis-perception was common among Sri Lankan adults. Two-thirds of overweight males and 44.7% females considered themselves as ‘about right weight’, moreover, 4.1% and 7.6% overweight men and women reported themselves as being ‘underweight’. Over one third of both male and female obese subjects perceived themselves as ‘about right weight’ or ‘underweight’. Nearly 32% of centrally obese men and women perceived that their WC is about right. People who perceived themselves as overweight or very overweight (n = 154) only 63.6% tried to lose weight (n = 98), and one quarter of adults sought advice from professionals (n = 39). Body weight misperception was common among underweight, healthy weight, overweight, and obese adults in Sri Lanka. Over 2/3 of overweight and 1/3 of obese Sri Lankan adults believe they are in right weight category or are under weight.
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Prasad Katulanda.