A simple screening tool to identify women with previously undiagnosed prediabetes and diabetes mellitus in the community

Background:In the current context of rising prevalence of non-communicable diseases, simple low-cost screening tools are essential for identifying individuals who have glucose dysregulationat its early stages. Therefore, we developed and validated a screening tool for dysglycemia (defined as HbA1c≥5.7%) with the potential to identify undiagnosed prediabetes and as well as diabetes mellitus.Methods:A sample of 2800 women representative ofColombo Municipal Council area was screened using fasting blood glucose for dysglycemia. All (n=272) newly diagnosed dysglycemics and a further 345 normoglycemics were recruited following confirmation of glycemic status by HbA1c, to enable ROC analysis. Apretested questionnaire and the International physical activity questionnaire validated for Sri Lanka were used to generate variables for the risk score.Results:A risk score for dysglycemia with a sensitivity of 87% and specificity of 87% and AUC of 0.941 was developed with two common symptoms of dysglycaemia, history of recent increase in frequency of passing urine and recent reduction in vision, one common food related practice, inability to resist sugary food and one indicator of sedentary behavior, TV viewing time and a single anthropometric measurement, waist circumference.Conclusions: A tool to identify prediabetesis currently unavailable and this new tool fills this gap. Further, the tool is designed to include women with previously undiagnosed diabetes mellitus. Inclusion of lifestyle parameters having a known association with dysglycemia increased the strength of the tool. Early identification will ensure targeting of interventions at the point of maximum effect.

School-based physical activity intervention in 11-13-year-olds: study protocol for cluster randomized controlled trial

Background:Targeted strategies to enhance regular physical activity appear to be promising to promote health and well-being of adolescents.This article reports the design of a cluster randomised controlled trial to evaluate the effectiveness of a school-based physical activity programme on the rate and duration of moderate-to-vigorous physical activity, sitting time including screen time, andhealth-related physical fitness parameters among 11-13 year-old adolescents.Methods:This is a cluster randomized controlled trial conducted in 360 adolescents fromgovernment schools in the Colombo Municipal Council area, Sri Lanka. An individual school wasconsidered as a unit of randomization and the 12 selected schools were randomly assigned to one of twogroups: control (sixschools) and intervention groups (sixschools). The intervention group follows aphysical activity programme for 30 minutes on threeschool days per week, for threeconsecutive months in addition to the standard practice. The primary outcomes are moderate-to-vigorous physical activity rate and duration and sitting time including screen time. Secondary outcomes are the health-related physical fitness parameters: cardiovascular fitness, muscle fitness and flexibility, and body composition. All the outcomes are measured at baseline and three-months following the intervention.Discussion:The outcomes of this study will be an evidence-based intervention programme with the potential to be incorporated into the national education system thus promoting health and well-being of adolescents in Sri Lanka. Trial Registration: Registered at the Sri Lanka Clinical Trials Registry (SLCTR/2018/028).