Prevalence of Type 2 Diabetes Mellitus and Its Microvascular Complications in Sri Lanka: A Systematic Review and Meta-Analysis

Abstract

The burden of type II diabetes and microvascular complications is increasing around the globe, especially in low-and middle-income countries. We conducted a systematic review and a meta-analysis to estimate the prevalence of type II diabetes and its microvascular complications to determine the nature of diabetes and its complications in Sri Lanka. A systematic review and meta-analysis were conducted by searching PubMed, EMBASE, and CINAHL for studies published between 2014 and 2024 on the prevalence of type II diabetes mellitus and its microvascular complications in Sri Lanka. Titles, abstracts, and full texts were screened against predefined inclusion/exclusion criteria, and data were extracted from eligible studies. Pooled prevalence estimates were calculated using a random effects model, with 95% confidence intervals, and results were presented using forest plots. Analyses were performed using Stata version 18 (StataCorp LLC, College Station, Texas, USA). A total of 1400 articles underwent title, abstract or full text screening and only 11 (0.8%) articles were left for the analysis, which satisfied the inclusion/exclusion criteria; 15839 people with type II diabetes mellitus (mean sample size n=2263 (SD 2374), with a mean age of 48.6 years (SD 4.94)), were included. The estimated overall prevalence of type II diabetes, diabetic retinopathy and neuropathy was 17% (95% CI 17% to 18%), 13% (95% CI 13% to 14%) and 19% (95% CI 16% to 21%), respectively. The forest plots illustrated variation across individual studies but also showed a consistent upward trend in the prevalence of diabetes over time, with more recent studies reporting higher estimates. Further research into cost-effective methods for early identification and treatment of people with diabetes is needed to reduce the associated morbidity and mortality. Screening for complications at the time of diagnosis should become a routine practice to provide rapid intervention.