Assessment of body composition in Sri Lankan adults: development and validation of bioelectrical impedance prediction equation.

Bioelectrical impedance analysis (BIA) is a simple and quick method used for assessment of body composition (BC). Present study aims to develop and validate a BIA prediction equation for Sri Lankan adults. Healthy adults (≥18 years) were randomly selected for development and validation of the equation. BIA was performed using the Inbody 230 multifrequency analyzer. BC analysis was also evaluated by deuterium oxide (D2O) dilution. Prediction equations for TBW/FFM were derived by linear-regression analysis. Study population included 170 adults, of which 32.9% were males. Mean age and BMI were 43.2 ± 12.6 years and 24.1 ± 4.5 kg/m2, respectively. Final equation for TBW (r = 0.915, p < 0.001) and FFM (r = 0.906, p < 0.001) correlated significantly with values obtained by D2O dilution. Therefore, this equation is suitable for estimation of BC parameters, such as TBW, FM, FFM, and %BF in Sri Lankan adults, and is possibly appropriate for use in other South Asian populations, including those living in Western countries.

Evaluation of the accuracy and precision of glucometers currently used in Sri Lanka.

AIMS: Life threatening macrovascular and microvascular complications of diabetes can be minimized by effective glycaemic control. Self monitoring of blood glucose with glucometers is recognized as a cost effective strategy to improve glycaemic control. However accuracy and precision of glucometers will determine the effectiveness of this strategy. We aimed to evaluate accuracy and precision of commonly used glucometers in Sri Lanka. MATERIALS AND METHODS: An observational study was conducted in a tertiary care setting including patients with diabetes and healthy volunteers. Eight commonly used glucometers were used. Blood glucose was measured in 50 participants (16 healthy volunteers, 34 patients with diabetes) in finger prick capillary blood using glucometers and venous blood using standard laboratory methods, and were compared to determine accuracy. Repeated measurements from same glucometer with a single finger prick were made and compared to determine precision. RESULTS: Only one glucometer showed insignificant difference to venous plasma glucose values. Only one glucometer met ADA recommended bias of <5%. None of the glucometers fell within the ISO recommendations for accuracy. CONCLUSION: Majority of commonly used glucometers in Sri Lanka do not meet the ADA recommendations and ISO standards for accuracy and precision. However their variations are unlikely to make significant adverse impact on patient management.

Hypoglycaemia in diabetes: do we think enough of the cause? An observational study on prevalence and causes of hypoglycaemia among patients with type 2 diabetes in an out-patient setting in Sri Lanka.

BACKGROUND: Hypoglycaemia is a feared experience for people with diabetes. We aimed to study the prevalence and causes of hypoglycaemia among Sri Lankans with diabetes. METHODS: One thousand patients with diabetes attending a private sector diabetic clinic were interviewed using a structured questionnaire. Hypoglycaemic episodes within the preceding month were inquired and severity was graded according to clinical features and/or capillary blood glucose levels. RESULTS: Mean age 55.0 years (± 12.5), 58.6% were males, mean diabetes duration 10.6 years (± 8.1), mean FPG 7.48 mmol/l (± 2.79) and mean HbA1c 7.82% (± 1.71) (62 mmol/mol). Of them, 26.1%. (mild 20.7%, moderate 3.9%, and severe 1.5%) experienced symptomatic hypoglycaemia. Sudden change diet (46.7%), unaccustomed exercise (15.7%) and increase in antihyperglycaemic therapy dosage (14.9%) were the recognized causes. Cause was not recognized by 16.3%. Non-prescribed native food items accounted for hypoglycaemia in 16.9% of patients (Momordica charantia 54.5%, Costus speciosus 52.3%, Salacia prinoides 11.4%, Coccinia grandis 6.8%, Adenanthera pavonina 4.5%). Severity of hypoglycaemia was positively correlated to age and duration of diabetes but not to HbA1C. CONCLUSION: Hypoglycaemia is common among patients with diabetes. Patients need advice on regular diet and exercise. Consumption of non-prescribed native foods should be considered as a possible cause.