Prasad Katulanda

University of Colombo · Department of Clinical Medicine

Aims SGLT2 inhibitors provide cardiovascular and renal protection in people with type 2 diabetes (T2DM). Real-world data on their effect on improving glucose and cardiovascular risk factors, and adverse effects in South Asians are limited. Methods We retrospectively analyzed clinical, demographic, anthropometric and biochemical data among adults w...

Background: South Asians are at high risk of type 2 diabetes (T2D). Lifestyle modification is effective at preventing T2D amongst South Asians, but the approaches to screening and intervention are limited by high costs, poor scalability and thus low impact on T2D burden. An intensive family-based lifestyle modification programme for the prevention...

Background There is little data to accurate interpretation of spirometry data in South Asia, a major global region with high reported burden for chronic respiratory disease. Method We measured lung function in 7,453 healthy men and women aged over 18 years, from Bangladesh, North India, South India, Pakistan and Sri Lanka, as part of the South Asi...

Background: Most chronic liver diseases are subclinical until advanced, delaying their detection and management. Population screening should be guided by prevalence, which determines cost-effectiveness. Autopsy studies are a valuable source to estimate population prevalence and associated factors, particularly for conditions that need invasive scre...

Background The global epidemic of type 2 diabetes mellitus (T2DM) renders its prevention a major public health priority. A key risk factor of diabetes is obesity and poor diets. Food environments have been found to influence people’s diets and obesity, positing they may play a role in the prevalence of diabetes. Yet, there is scant evidence on the...

Introduction: In low-middle income countries (LMICs) the role of food environments on obesity has been understudied. We address this gap by 1) examining the effect of food environments on adults' body size (BMI, waist circumference) and obesity; 2) measuring the heterogeneity of such effects by income and sex. Methods: This cross-sectional study...

Abstract Background People from South Asia are at increased risk of type 2 diabetes (T2D). There is an urgent need to develop approaches for the prevention of T2D in South Asians that are cost-effective, generalisable and scalable across settings. Hypothesis Compared to usual care, the risk of T2D can be reduced amongst South Asians with central ob...

Purpose Vitamin D deficiency/insufficiency may increase the susceptibility to COVID-19. We aimed to determine the association between vitamin D deficiency/insufficiency and susceptibility to COVID-19, its severity, mortality and role of vitamin D in its treatment. Methods We searched CINHAL, Cochrane library, EMBASE, PubMED, Scopus, and Web of Sci...

Aims COVID-19 lockdown imposes many challenges to patients with diabetes. We aimed to assess the impact of COVID-19 lockdown on health-related behavior and disease control among patients with diabetes. Materials and methods A cross-sectional study was conducted among adults with diabetes attending a diabetes clinic in Colombo, Sri Lanka in June-Ju...

Introduction South Asians are at high risk of type 2 diabetes (T2D). We assessed whether intensive family-based lifestyle intervention leads to significant weight loss, improved glycaemia and blood pressure in adults at elevated risk for T2D. Methods This cluster randomised controlled trial (iHealth-T2D) was conducted at 120 locations across India...

Background: South Asia has become a major epicentre of the COVID-19 pandemic. Understanding South Asians' awareness, attitudes and experiences of early measures for the prevention of COVID-19 is key to improving the effectiveness and mitigating the social and economic impacts of pandemic responses at a critical time for the Region. Methods: We a...

Background and aims To examine the effects of aerobic training (AT) and resistance training (RT) compared to standard care on glycemic control in South Asian Sri Lankan adults with Type 2 Diabetes Mellitus (T2DM). Methods Randomized controlled trial (RCT) with parallel-group design recruited 86 sedentary Sri Lankans (aged 35–65 years) with T2DM in...

Objectives: The objective was to assess the effect of propranolol on oxidative stress and anti-oxidant potential in patients with resistant hypertension as a secondary analysis of the APPROPRIATE trial. This randomized double blinded clinical trial recruited patients with resistant hypertension and allocated forty patients to propranolol and place...

Background Suboptimal diet is the leading cause of global morbidity and mortality. Addressing this problem requires context-specific solutions informed by context-specific data collected by context-specific tools. This study aimed to assess the relative validity of a newly developed brief dietary survey to estimate food intake and adherence to the...

Background South Asians are at high risk of type 2 diabetes (T2D). Lifestyle modification is effective at preventing T2D amongst South Asians, but the approaches to screening and intervention are limited by high-costs, poor scalability and thus low impact on T2D burden. An intensive family-based lifestyle modification programme for prevention of T2...

Background People from South Asia are at increased risk of type 2 diabetes (T2D). There is an urgent need to develop approaches for prevention of T2D in South Asians, that are cost-effective, generalisable and scalable across settings. Hypothesis Compared to usual care, risk of T2D can be reduced amongst South Asians with central obesity or raised...

Background South Asia has become a major epicentre of the COVID-19 pandemic. Understanding South Asians’ awareness, attitudes and experiences of early measures for the prevention of COVID-19 is key to improving the effectiveness and mitigating the social and economic impacts of pandemic responses at a critical time for the Region. Methods We asses...

Introduction: Establishing the burden of undiagnosed CVD risk factors is critical to monitoring public health efforts related to screening and diagnosis. Objective: To assess the proportion and determinants of undiagnosed diabetes, hypertension, and hypercholesterolaemia, among overweight or obese adults. Methods: A sample of 1200 participants...

Background and aims: This paper describes the data resource profile of South Asia Biobank (SAB), which was set up in South Asia from November 2018 to March 2020, to identify the risk factors and their complex interactions underlying the development of type-2 diabetes mellitus, cardiovascular disease and other chronic diseases in South Asians. Data...

The coronavirus disease 2019 (COVID-19) pandemic has emerged as one of the greatest challenges faced by humankind in the recent past. People with diabetes and related comorbidities are at increased risk of its complications and of COVID-19-related death. Older age, multi-morbidity, hyperglycaemia, cardiac injury and severe inflammatory response are...

SARS-CoV-2 virus has spread across the globe rapidly causing an unprecedented pandemic. Due to the novelty of the disease, the possible impact on endocrine system is not clear. In order to compile a mini-review describing possible endocrine consequences of SARS-CoV-2 infection we performed a literature survey using the key words Covid-19, Coronavir...

There is an increasing prevalence of diabetes mellitus (DM) and diabetic peripheral neuropathy (DPN) in older people in many countries across the world. Older adults with type 2 DM have a significantly higher incidence of falls compared with their counterparts without DM. This review synthesize published findings on sensorimotor, cognitive, balance...

Background: The indigenous population in Sri Lanka called “Veddas” estimated to be around 0.05% of the total population in the island. This population is unique that they used to live mostly in jungles with primitive lifestyles. The objective was to study the cardiovascular risk factors in this indigenous (Vadda) community. Methods: A descriptive c...

Mobile phone-based health interventions (mHealth) are viewed as an attractive approach to foster behaviour change, and found to be effective in promoting physical activity and healthy diets. The present study aims to investigate whether mHealth with advice for dietary and lifestyle modifications would reduce 10-year cardio vascular disease (CVD) ri...

Background Older adults with type 2 diabetes mellitus (DM) have high incidence of falls. The aim of this study was to compare sensorimotor functions, balance, mobility, fear of falling, and fall history in older people with DM (with and without neuropathy) and non-diabetic healthy controls.Methods We enrolled 153 participants aged 50–70 years: 51 p...

Aims To identify risk factors for falls in older people with diabetes mellitus (DM) and to develop a low-cost fall risk screening tool. Methods Older adults with DM (n = 103; age = 61.6 + 6.0 years) were recruited from diabetic clinics. Demographic, DM specific factors, lower limb strength and sensation, cognition, fear of falling, hand reaction t...

Background: The Timed up and Go Test (TUG) is often used as a mobility measure in older people. However, it is unclear whether the TUG is useful for identifying fall risk in people with diabetes mellitus (DM) and which physical and cognitive/psychological factors influence the performance of this test. Objectives: To investigate whether slow TUG ti...

Introduction: Sri Lanka has a predominantly rural population. However, there is a dearth of research on health and socioeconomic issues in this group. Objective: To describe basic socioeconomic characteristics and health profile in a rural population. Methods: A descriptive cross-sectional household survey was conducted in 1950 households in t...

Mobile phone-based health interventions (mHealth) are viewed as an attractive approach to foster behaviour change, and found to be effective in promoting physical activity and healthy diets. The present study aims to investigate whether mHealth with advice for dietary and lifestyle modifications would reduce 10-year cardio vascular disease (CVD) ri...

The advent of incretin mimetics such as glucagon-like peptide-1 receptor agonists (GLP-1 RAs) has enriched the armamentarium for diabetes management owing to their glycaemic as well as extra-glycaemic benefits. The approval status and availability of this class of drugs vary widely across the globe. Being a relatively newer class of drug with numer...

Objective: The current paper describes methods of evaluating dietary habits of Sri Lankan adolescents based on the Diet Quality Index-International (DQI-I), which has been used in multiple international studies to describe dietary variety, moderation, adequacy and balance. The paper describes the method for calculating DQI-I scores and examines as...

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....

Background: The determination of behaviours that lead to noncommunicable diseases (NCDs), such as high dietary salt intake, are multifactorial. The prevention of NCDs, including the promotion of healthy dietary choice, including low salt intake, therefore requires multisectoral working. Although the need of a multisectoral approach to risk factor...

Background Fasting plasma glucose (FPG) is the most commonly used screening tool for diabetes in Sri Lanka. Cut-off values from American Diabetes Association recommendations are adopted in the absence of local data. We aimed to establish FPG cut offs for Sri Lankans to screen for diabetes and pre-diabetes. Methods Data on FPG and diabetes/pre-diab...

Aims: Metabolic syndrome (MetS) is a risk factor for cardiovascular disease (CVD). Apolipoproteins are emerging as powerful predictors of CVD. We aimed to study associations of metabolic syndrome and apoB, apoAI, apoB/AI ratio in young Sri Lankans with type 2 diabetes. Materials & methods: Blood samples were available from 690 patients with type...

Background. Adherence to long-term therapy for diabetes remains low. Accurately measuring adherence is the primary step in improving adherence. We translated and validated the Sinhalese version of the Brief Medication Questionnaire (BMQ) in patients with diabetes. Methods. The study was conducted at the National Hospital of Sri Lanka between April...

Annexure 1: Sinhalese translation of the Brief Medication Questionnaire used for validation.

Background: Explorations into quantifying the inequalities for diabetes mellitus (DM) and its risk factors are scarce in low and lower middle income countries (LICs/LMICs). The aims of this study were to assess the inequalities of DM and its risk factors in a suburban district of Sri Lanka. Methods: A sample of 1300 participants, (aged 35-64 yea...

Background: The prevalence of type 2 diabetes mellitus (T2DM) and cardiovascular diseases (CVD) is rising globally. T2DM is particularly problematic in South Asia with an estimated 10-15% of Sri Lankans diagnosed with the disease. Exercise is known to improve blood glucose, lipid profiles, blood pressure and adiposity, key goals in the management...

BACKGROUND: Dyslipidemia is a major risk factor for cardiovascular disease. Prevalence patterns and determinants of dyslipidemia in Sri Lanka are unkown. OBJECTIVES: We aimed to determine the prevalence and correlates of dyslipidemia among Sri Lan-kan adults. METHODS: A nationally representative sample was recruited by multistage random cluster sam...

Abstract Background Cinnamon is considered as a treatment for many ailments in native medicine. Evidence suggests that Cinnamomum zeylanicum (CZ) has anti-microbial, anti-parasitic, anti-oxidant, blood glucose lowering properties and beneficial cardiovascular effects. The present study aims to evaluate Pharmacodynamic properties and safety of CZ in...

Background: To evaluate the effects of Zinc supplementation on glycaemic control, other cadio-metabolic/anthropometric parameters and progression of disease in pre-diabetes. Methods: The clinical trial was conducted as a randomized, double-blind, placebo-controlled Phase II clinical trial for a period of 12 months. The treatment group received Z...

Background Previous studies have explored the anti-diabetic effects of Cinnamomum cassia extract in vivo and in vitro. However, there are no studies at present exploring the effects of the indigenous species of Sri Lankan cinnamon (Cinnamomum zeylanicum) in patients with diabetes mellitus. The present study aims to evaluate the potential effects of...

Abstract Purpose: In-vitro and in-vivo studies in animals suggests that Ceylon Cinnamon has anti-microbial, anti-parasitic, anti-oxidant and free radical scavenging properties. This article summarizes the study protocol for a Phase-I clinical trial in humans. Methods: The study will be conducted as a phase-I clinical trial for a period of 3 months...

Background: Resistant hypertension is defined as an uncontrolled blood pressure despite treatment at best-tolerated doses with at least three antihypertensive agents including a diuretic. It is an emerging public health problem. At present clinical trial data on management of resistant hypertension is limited. Management is largely based on observ...

Sri Lanka is undergoing nutritional transition and diet-related chronic diseases are emerging as an important health problem. Currently, no validated food frequency questionnaire (FFQ) exists to measure habitual dietary intake of Sri Lankan adults. The purpose of the study is to assess the validity of a semi-quantitative FFQ and 7-day weighed-intak...

Sub-Theme: Physical Activity Epidemiology and Health Benefits Across the Life Course Key words: Monitoring, Policy, Surveillance, Physical Activity Methods: Standardized methodology was used by the GoPA to collect sociodemographic, surveillance, policy, and research data for each country around the world. A country representative, reviewed data acc...

Background Screening for undiagnosed diabetes is not widely undertaken due to the high costs and invasiveness of blood sampling. Simple non-invasive tools to identify high risk individuals can facilitate screening. The main objectives of this study are to develop and validate a risk score for screening undiagnosed diabetes among Sri Lankan adults a...

Background Information on socioeconomic determinants in the management of diabetes mellitus is scarce in lower middle income countries. The aim of this study is to describe the socioeconomic determinants of management and complications of diabetes mellitus in a lower middle income setting. Methods Cross sectional descriptive study on a stratified r...

Background Computer vision syndrome (CVS) is a group of visual symptoms experienced in relation to the use of computers. Nearly 60 million people suffer from CVS globally, resulting in reduced productivity at work and reduced quality of life of the computer worker. The present study aims to describe the prevalence of CVS and its associated factors...

Dengue fever is the most rapidly spreading mosquito-borne viral disease in the world. Haemophilia A is the commonest inherited bleeding disorder. There is little data on the incidence and outcome of dengue in patients with haemophila. We report a case of a patient with severe haemophila A, presenting with dengue fever, managed at a tertiary care ho...

Background: Diabetes mellitus (DM) is a rapidly growing health concern in Sri Lanka. Diet and physical activity are important modifiable risk factors affecting the incidence, severity and management of DM. The present study aims to evaluate the knowledge and perceptions about dietary patterns and physical activity among a group of adults with DM i...

Prevalence of diabetes mellitus (DM) has reached epidemic proportions in Sri Lanka. We aim to systematically review the literature for studies on DM published by Sri Lankan authors and provide a comprehensive analysis of its prevalence, trends, and risk factors. Retrieval of diabetes-related research articles conducted in Sri Lanka was by a compreh...

Introduction Acromegaly is an endocrine disorder arising from excessive serum growth hormone levels in adulthood and is characterized by progressive somatic enlargement. Biochemical confirmation is achieved by demonstration of elevated baseline serum growth hormone levels which are not suppressed during an oral glucose tolerance test, and by increa...

Background: Diabetes mellitus is a leading cause of morbidity and mortality worldwide. Studies have shown that Zinc has numerous beneficial effects in both type-1 and type-2 diabetes. We aim to evaluate the literature on the mechanisms and molecular level effects of Zinc on glycaemic control, β-cell function, pathogenesis of diabetes and its compl...