While COVID-19 dominated global headlines for years, another health crisis is quietly spreading across Sri Lanka,one that could soon surpass viral outbreaks in its impact: diabetes. Once seen as a disease of older adults, diabetes is increasingly affecting younger people, posing a serious threat to public health and placing an enormous strain on the country’s healthcare system. Research now warns that if immediate action is not taken, nearly half of Sri Lanka’s population could be living with diabetes in the near future.
A recent national survey paints a grim picture: 14% of Sri Lankans already have diabetes, while 30% are pre-diabetic—a condition that often develops into full-blown diabetes if untreated. Public awareness remains dangerously low, with many people unaware that even slightly elevated sugar levels can carry long-term health risks.
The urgency of the crisis is underscored in a study published in the British Medical Journal, one of the world’s most respected medical publications. The research, authored by a team including Professor Ranil Jayawardena of Colombo Medical College, Dr. Anoop Misra, Professor Naveed Sattar, Professor Amerta Ghosh, Dr. Mahmoud Nassar, and Senior Consultant Ritesh Gupta, brought together experts from Sri Lanka, India, and the United Kingdom.
Using extensive surveys across South Asia, the study offers the most detailed insights yet into why South Asians are particularly vulnerable to diabetes, predicting that 44% of Sri Lanka’s population could be affected in the coming years.
The findings identify a dangerous mix of genetic predisposition and lifestyle factors. South Asians tend to have lower muscle mass and higher abdominal fat, often around vital organs like the liver. This not only heightens the risk of diabetes but also increases vulnerability to fatty liver disease, heart disease, and strokes. Worryingly, these trends are already emerging among children in Sri Lanka, putting the next generation at risk.
Obesity remains underestimated. Many Sri Lankans fail to recognize even slight weight gain as a health concern. Unlike other ethnic groups, South Asians store fat mainly in the abdomen, and even their muscle tissue can accumulate unhealthy fat. When combined with sedentary lifestyles and diets high in rice, sweet tea, and fried snacks, these inherited traits accelerate the rise of diabetes and related metabolic disorders.
Urban lifestyles add to the challenge. In Colombo and other cities, long hours of desk work and limited physical activity worsen the problem. Even in schools, children participate in fewer sports and outdoor activities compared to peers in other developing nations, leaving fitness levels alarmingly low.
The study also highlights related health risks. Fat buildup in the liver increases the likelihood of fatty liver disease and cirrhosis, while abdominal fat elevates bad cholesterol, raising the risk of heart attacks and strokes. Diabetes is thus not an isolated disease but a gateway to multiple non-communicable illnesses that strain Sri Lanka’s health system.
Experts warn that urgent intervention is critical. Raising public awareness about pre-diabetes, promoting balanced diets, encouraging exercise, and expanding early screening programs could slow the crisis. Communities, schools, and workplaces must foster healthier habits—small changes like walking instead of driving, choosing fruit over processed snacks, or cutting down on fried foods can prevent countless future cases.
The diabetes crisis in Sri Lanka is a wake-up call. With genetics, modern lifestyles, and lack of awareness colliding, the country faces a public health emergency. The warning signs are already here, and unless Sri Lankans act swiftly, this silent epidemic could escalate beyond control.
Nuwan Senaratne
