Diabetes can affect almost any organ in the body. It is known to cause impaired vision and heart attacks, besides being responsible for a large number of amputations. That is why it is considered to be a serious illness. About 350 million people worldwide have diabetes and one-fifth of them live in South-East Asia Region. There had been 1.5 million deaths in the globe in 2012 directly due to diabetes. It is predicted to become the 7th leading cause of death in the world by the year 2030.

In a study done by Dr. Prasad Katulanda, consultant diabetologist and his team, it had been found that urban populations have a higher incidence (16.4%), over rural populations (8.7%). So, as expected, the Western Province has the highest incidence while the Uva Province, the lowest. Before a person develops diabetes, he usually has a condition called pre-diabetes, in which blood glucose levels are raised but not yet high enough to be labeled as diabetes. Some long-term damage to certain organs may already be occurring during pre-diabetes. But by early diagnosis and effective treatment of pre-diabetes, doctors can help patients to be free of diabetes. Therefore, regular estimation of blood sugar is important,

The Diabetes Association of Sri Lanka (DASL) statistics reveal that there are nearly four million diabetics in Sri Lanka and that one-third of those with diabetes are undiagnosed. The prevalence of diabetes in the country had increased from around 16% in 2009 to 20% in 2014. According to them, though the number of people affected by diabetes was ever-increasing, the country had not yet taken serious steps to reduce the risk of diabetes. The purpose of this letter is to show how certain parties, knowingly or unknowingly aggravate the situation in relation to ‘food habits’, and how the government can intervene. Overweight and lack of exercise are the main causes of diabetes among children, while family history, food habits and obesity are the main causes among adults.
It has been my experience that whenever I am offered a cup of tea at a friend’s place or an office, it is too sweet unless I get an opportunity to tell them beforehand to add only half a teaspoon of sugar. It is because the ‘tea maker’ is used to adding two to three spoons at home. This goes to show that the Sri Lankan population is used to taking a lot of sugar from early childhood. Actually, one can take tea even without any sugar at all. It is a matter of getting used to it, but half a teaspoon of sugar in a cup does no harm to the average person. I hope the readers would start using less sugar from now. It will help the body as well as the purse! Incidentally, raising the price of sugar would be a step in the right direction. If this is done, people do not have to spend more to buy sugar because they would be buying less sugar as they would be adding less sugar to their tea etc.

Let us now see what the sugar content is in the foods we buy. You would agree that almost all of them are too sweet. I cannot understand why the manufacturers add so much sugar. The food items I refer to are as follows. Iced coffee and fruit drinks we get at functions, drinking yoghurt and fruit drinks in packets and bottles, tea and Nescafe marketed in vending machines, different varieties of cakes and sweetmeats, puddings, ice cream, chocolates and ‘watalappan’ all have too much sugar. ‘Kimbula’ buns have a layer of sugar on top as well. When I eat cake, I remove the icing sugar from it. Butter cake and fruit cake have no icing sugar, but people like them. In my opinion, the person who invented and introduced icing sugar to cake makers has done the society a disfavor!
All would agree that the above foods need not have all that sugar. The sales would not come down if less sugar is added. Set yoghurt and natural fruit juices have low sugar content, but the sales are quite good. By adding less sugar to the list of foods mentioned in the earlier paragraph, the manufacturers could make a big saving, besides helping the people. That would also lower the import of sugar, saving foreign exchange. The readers would, no doubt, agree that reducing the sugar content in food by those who manufacture them has everything to gain. Everybody would be a winner.

I feel the Health Ministry should analyze the different food items in the market and lay down a ceiling for the sugar content for them. The DASL and the Sri Lanka Medical Association can get involved in this exercise. The DASL is a non-profit organization with its headquarters at National Diabetes Centre (NDC) 50, Sarana Mawatha, Rajagiriya. It is the only organization in Sri Lanka committed to serve the diabetic fraternity of the country through primary and secondary prevention, education, awareness and advocacy.

Dr Wijaya Godakumbura