Life style

Shifting paradigms in diabetes care

Published

4 years ago

2021/11/14

Today is World Diabetes Day

The prevalence of diabetes worldwide has nearly doubled since the 1980s. Globally about 422 million people have diabetes according to the World Health Organization and the majority of them live in low and middle-income countries. Around 1.5 million deaths are directly attributed to diabetes each year. A century after the discovery of insulin, millions of people with diabetes around the world still cannot access the care they need.

In this setting the theme for World Diabetes Day 2021-23 has been declared- ‘Access to Diabetes Care.’ The management of diabetes has today taken a shift involving a more holistic approach, points out Consultant Endocrinologist at the Sri Jayewardenepura General Hospital, Dr. Dimuthu Muthukuda. In an interview with the Sunday Island, she throws light on these shifting paradigms which are aimed at enhancing the quality of life of those with diabetes.

by Randima Attygalle

Q: How relevant is this year’s theme ‘Access to Diabetes care’ in a Sri Lankan context?

A: Since the discovery of insulin in 1921, there had been many strides forward in terms of the varieties of insulin – both oral and injectable. Today there are both national and international guidelines pertaining to diabetes care. Despite these, people with diabetes all over the world are challenged in accessing diabetic care. We are at a satisfactory level in delivering diabetic care within our freely accessible and well-structured health care system. Our limiting factor is the non-availability of the ideal device for insulin delivery which is the insulin pen. What we have in the state health sector for cost reasons is still the syringe and the needle. However, we are constantly improving our services for increased accessibility.

Q: What is the current ‘diabetes picture’ here at home?

A: In terms of the numbers, our situation is quite alarming. Recent studies show that the prevalence of diabetes in suburban areas of the island is about 20%. The situation in the rest of the South East Asian countries is no better. The major triggers of diabetes in our part of the world are obesity and being overweight. Today obesity has reached pandemic proportions and is as dangerous as COVID. Worse, there is a sizeable proportion of school children with diabetes.

The accumulation of fat in the abdomen which is called ‘abdominal or central obesity’ is common among South East Asians. This reflects the tendency for a person to develop diabetes. The other major risk factor is insulin resistance. This condition is closely linked to obesity and diabetes and this inter-connectivity leads to a very vicious cycle.

A few decades ago when we talked of a person with diabetes, it was a middle-aged or an older person that we visualized. This is no longer the case. Today many children, adolescents and young adults are diabetics.

Q: What are the most common types of diabetes?

A: Type 1, Type 2 and Gestational diabetes are the common types. In Type 1, the body does not produce any insulin and there is life-long insulin dependency. Very often children under 10 years develop this type although symptoms could occur in adolescence as well.

Type 2 is the most common, where the body does not use insulin which is produced by the pancreas effectively. This insulin resistance is also attributed to obesity where insulin is prevented from working well at tissue-level. Although Type 2 is called ‘adult-onset diabetes,’ today we see many young people developing it giving enough time to develop other complications. After about 10-15 years of having Type 2 Diabetes, the pancreas can get exhausted and it could stop producing insulin. Therefore initially although a person can manage Type 2 with drugs, later he/she may need insulin as well.

Diabetes during pregnancy is what is known as gestational diabetes. The long term consequences of this type could be serious. If a pregnant woman has gestational diabetes, there is a 50% chance of her children getting it. There is also the risk of children being obese. This is why we say that when we manage diabetes of an expectant mother, we also manage the condition in the next generation.

Q: Who are at high risk of developing diabetes?

A: Being a South Asian per se is a risk factor. Besides that, being overweight or obese, appearance of blackish velvety skin behind the neck, having a family history of diabetes (children whose both of whose parents have diabetes have more than 75% chances of developing the disease) and children of mothers with gestational diabetes and people who are on certain drugs such as steroids are at high risk.

Q: Can you throw light on the new interventions in managing diabetes?

A: Today the global trend is to look at the condition from a positive perspective. The traditional understanding was that the moment a person is diagnosed with diabetes, he/she becomes a ‘diabetic’ or a ‘diabetic patient’. Imagine a person being diagnosed at 15 or 20 with diabetes; are we going to call that person a ‘diabetic’ for the rest of his/her life? What will be his/her social and psychological well being in that case? Today diabetes is considered as a condition which you need to manage. Instead of calling ‘diabetics’ or a ‘diabetes patients’ we call them ‘individuals with diabetes’.

A few decades ago the most feared thought was going on a ‘diabetic diet’. Today we are talking of a healthy diet for everyone in the family; we are talking about giving advice to the whole family because it has to be essentially a family affair. For instance, you are going to cook a healthy meal for the entire family and not only for the member with diabetes.

The pharmacological management landscape of diabetes has also changed. Instead of the gluco centric approach which looked only at glycemic or sugar control, today a holistic approach is in place which is known as ‘cardio-renal’ approach. This looks at reducing cardio-renal complications (kidney and heart related complications). Although morbidity and mortality due to diabetes is largely heart attacks, the root cause is underestimated because the cause of death goes as ‘heart attack’ and most of these heart attacks can be prevented. To strengthen the cardio-renal management of people with diabetes, our health sector is trying its best to make the latest cardio-protective drugs available in government hospitals.

In diabetes management, we not only address sugar levels but the entire spectrum of micro vascular and macro vascular complications. When diabetes is mismanaged both small (micro) and big (macro) vessels can be damaged. While micro vascular damage will involve the retina of the eye, kidneys and nerves, macro vascular damage will lead to stroke, heart attack and peripheral vascular disease. As Endocrinologists, our ultimate goal is to prevent people from getting micro and macro vascular diseases. To realize this, we encourage people with diabetes to monitor their blood glucose levels at home using glucometers. It is imperative that they have good metabolic control and healthy cholesterol levels. Diseases such as ischemic heart disease and non-alcoholic fatty liver should also be kept at bay. Then only can we prevent amputations and even death. Today we look at the bigger picture.

Another new trend is what we call ‘diabetes remission’. New clinical trials have shown that in case of recent onset of diabetes, if a person is able to lose weight coupled with a healthy diet and exercise and also with the use of drugs such as Metformin, a person can go into a remission for a long period of time with a fully normalized blood sugar levels.

Q: What measures are in place to empower people with diabetes, so that they become independent and can improve their quality of life?

A: Sri Lanka College of Endocrinologists (SLCE) carries out many educational programmes including training of trainers and health care personnel. Guidelines are also developed by the SLCE.

Education and awareness is very much a part of Endocrinology Units of state hospitals today. We look at the entire metabolic picture and deliver a comprehensive diabetic care delivery through our clinics.

Q: What is the role of diet and exercise in preventing and managing diabetes?

A: Eating in moderation is the key and rather than what you eat, you need to be mindful of how you eat. Managing portions is crucial here. Our plate should ideally have 1/4^th of rice and the rest should be green leaves, fish, etc. People should also be more creative and intelligent in their food choices. Mixing food which contains more sugar with fibre-rich food for example, can be a smart way of eating. It is not realistic to stay away from delicacies during festive seasons, nor depriving a child of sweets; the key is enjoying what you like in moderation. Eating fruits in between meals is encouraged so that they serve the dual purpose of having a snack as well as fulfilling the daily fruit requirement. Processed food and fast food should be minimal.

In terms of exercise, we encourage at least half an hour of physical activity such as brisk walking, cycling, swimming or aerobics, at least five days a week. Exercising itself can help minimize insulin resistance.

Even people with disabilities are encouraged to exercise their muscles while being seated or lying down.

Q: What challenges do you see for people with diabetes during the pandemic and how can they be mitigated?

A: When a person has poorly controlled diabetes, his/her immunity is compromised and chances of catching infections are very high. So it is essential that people manage their diabetes and take their drugs diligently. Mismanaged diabetes can result in COVID pneumonia. Even during the lockdowns, we ensured that drugs reached people and most clinics operated uninterrupted in the best interest of the public.

We see more people becoming sedentary during the pandemic. Both children and adults are spending a considerable time before computer screens with little or no exercise. This could make them susceptible to obesity which is a precursor to diabetes. Hence, children should be encouraged to indulge in some kind of physical activity and even adults should regularly take breaks from their desks and take a short walk around.

Q: Finally, how important do you think it is to adopt a multidisciplinary approach to combat diabetes instead of making it the sole responsibility of the health sector?

A: Although management of diabetes has to be customized, it is very crucial that we have a multi modal approach with the participation of schools, policy makers, employers and media to prevent the numbers from escalating. Today we have the traffic light system for certain foods, however there is still a question of consumer literacy. We also see children being the target of advertisers and there is a need for regulation here. Hence it is imperative that all stakeholders get together in preventing diabetes which could take a toll both on individual productivity as well as the health sector.

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Life style

From 1906 to today: Nestle’s 120-year journey in Sri Lanka

Published

6 days ago

2026/04/5

Thilina Walpola

Bernie Stefan - proud of Nestle’s 120 years jouney

Bernie Stefan is the Chairman and Managing Director of Nestlé Lanka Limited, overseeing Nestlé’s operations in Sri Lanka and the Maldives. He assumed this role in March 2023. Under his leadership, Nestlé has strengthened its footprint in Sri Lanka, touching individuals and families, communities and spearheading sustainable development.

Since taking charge in 2023, Stefan has brought with him over two decades of international experiences, steering the company with a clear focus on sustainability, innovation and long term growth.

Bernie describes the anniversary as a moment of pride and reflection on over a century of commitment to Sri Lanka and its people.

Under his leadership, Nestle has expanded its footprint while staying true to its mission: to improve lives by providing nutrition and wellness for all Sri Lankans. Beyond the commercial success, the company has focused on community impact – supporting local farmers. promoting sustainable practices and contributing to public health initiatives.

(Q) Nestlé has been part of Sri Lankan homes for 120 years. How has the brand evolved alongside the changing lifestyles of Sri Lankan families?

(A) We at Nestlé are extremely proud of our 120 year journey of enriching Sri Lankan lives. It has been a journey guided by purpose and working together for good – touching individuals and families, the community, and the planet. As lifestyles and needs have evolved, so, too, have our products – offering convenient, tasty and nutritious solutions that meet everyday moments, whether it’s energy on the go or a quick and tasty meal. A true symbol of this legacy is our flagship brand, Nestomalt – synonymous with power, strength and energy – which today is enjoyed as the first cup of the day by a majority of Sri Lankan households.

(Q) Many Sri Lankans have grown up with Nestlé products at their breakfast table or during tea time. How does the company stay emotionally connected with generations of consumers?

(A) Our product range caters to the nutritional needs of consumers from birth to old age. We always ensure that the consumer is at the centre of everything we do. This deep understanding of consumer preferences, ensures not only that our products deliver taste and nutrition but also our communication is in tune to the local context. Our brands have been deeply rooted in the lives of the Sri Lankan community over many decades – be it through Milo school sports programmes or Nestomalt marathons. Being an organisation that has been present in Sri Lanka for such a long time, it also means that consumers hold many nostalgic memories from their childhood with our products.

(Q) From childhood treats to everyday beverages, Nestlé products often carry nostalgic memories. How important is this sense of nostalgia to the brand’s identity?

(A) Brands need to evolve with time and remain relevant. Nostalgia does bring a deep bond and connect with consumers. However, through product and packaging renovations, we have successfully ensured that our brands remain relevant to consumers. One of our oldest Nestlé brands in Sri Lanka, Milkmaid , today, has an online recipe platform with over 300 recipes. This is another example where we have ensured that our brands are able to connect with today’s consumers.

(Q) Has Nestlé adapted its products to suit modern lifestyles while still respecting local tastes?

(A) Our ability to cater to local taste preferences has been a crucial factor to the success of our brands. With the setting up of our local manufacturing operations in 1984, we now manufacture over 90% of Nestlé products sold locally. The deep consumer understanding our teams possess, combined with our global R&D expertise in the food and beverage sector, have given us the ability to tailor make our products to cater to the Sri Lankan taste palette while offering convenience. This is evident in the success of our Nescafe and Nestea 3-in-1 variants and the Ready-to-drink beverage range of Milo and Nescafe, that deliver convenience and great taste.

(Q) How is Nestlé aligning its practices to sustainability and mindful living?

(A) We are committed to reaching net zero carbon emissions by 2050. Promoting circularity is also a focus area in this journey. We have plans to be 100% plastic neutral this year. Our sustainability initiatives cover the entire value chain, from farm to fork. In Sri Lanka, we are focusing a lot on increasing yield and promoting regenerative agricultural practices across our dairy and coconut value chains. In our manufacturing operations, we have continuously striving towards reducing water and energy usage. We have also implemented numerous initiatives to reduce our carbon footprint in logistics, such as the adoption of rail transportation. We also focus on fostering behavioural change on responsible waste disposal amongst the youth through our School Waste Management Programme.

(Q) What moments or milestones best reflect its connection with everyday life in the country?

(A) Our ability to provide consumers with good food moments each and every day is something that I and the team are extremely passionate about. Also, the deep connect we have with the community, be it our dairy and coconut farmers, the numerous suppliers and trade partners, has been built on trust over the years. Today, we have farmers, suppliers and even employees from across generations and this speaks volumes about our business practices and the trust we have built in Sri Lanka for over a century.

(Q) Nestlé is known globally for innovation. How do you balance global expertise with the unique lifestyle and culinary culture of Sri Lanka?

(A) As I mentioned, understanding the taste palette, nutritional needs and the lifestyles of Sri Lankan consumers and ensuring our products fulfill these needs is key. Having access to one of the world’s leading R&D facilities gives us the unique ability to ensure our products deliver to these consumer needs and preferences. Further, it enhances our ability to ensure the freshness and bio-availability of certain nutrients contained in our products. We’ve also made significant strides in packaging innovation, where we use less plastic and materials that are better suited for recycling. The introduction of Coconut Milk Powder in 1986 was a first for Sri Lanka, and this is another great example of the deep understanding we have of local culinary culture.

(Q) How is the younger generation engaged with the brand today?

(A) Appealing to the discerning youth population will be key to ensuring the future success of our brands. Understanding the nuances of each generation is important. It is also evident that consumption patterns and lifestyles across generations are evolving rapidly. Staying abreast of these changes is something we are deeply committed to. In addition to delivering on taste and nutrition, being trendy and youthful – the purpose for which our brands stand for – is equally important. NESCAFÉ and MAGGI PAPARE BLAST are two brands that have developed a strong connect with Sri Lankan youth.

(Q) What vision do you have for the next chapter in Sri Lanka, especially in shaping lifestyle trends?

(A) Looking ahead, our vision is to continue enriching Sri Lankan lives by providing tasty and nutritious products and promoting healthier and active lifestyles. We will keep innovating to meet evolving consumer needs, while strengthening local sourcing and reducing our environmental impact. The next chapter is about deepening our positive impact – supporting communities, empowering youth and contributing to a resilient food system.

(Q) As the head of Nestlé Sri Lanka, what does celebrating 120 years personally mean to you?

(A) Celebrating 120 years in Sri Lanka is deeply meaningful to us, as it reflects the trust generations of Sri Lankan families have placed in Nestlé. This milestone is a testament to the dedication of our people and the strong partnerships we have built across the country. For me personally, it is both a moment of pride and a responsibility – to honour this legacy while continuing to work together for good, doing what is right for our consumers, our communities, and Sri Lanka.

By Zanita Careem

Life style

A hat-trick for knowledge: Saranga’s triple triumph at Raigam Tele’es

Published

6 days ago

2026/04/5

Thilina Walpola

K.C. Saranga

At a time when entertainment often overshadows education on television, K.C. Saranga has rewritten the script—securing a remarkable third consecutive win for Best Educational Programme at the Raigam Tele’es 2025.

His flagship programme, Jeevithayata Vidyawa (Science for Life), aired on Ada Derana, has not only dominated its category but also elevated the standards of educational broadcasting in Sri Lanka.

Reflecting on the milestone, Saranga described the win as more than a personal achievement. “Maintaining an award ceremony of this magnitude for 22 years is no small feat. Raigam Tele’es plays a pivotal role in uplifting the industry. By consistently recognising and rewarding Sri Lankan creators, it provides the necessary oxygen for television to evolve as a professional craft,” he said.

A veteran with over 25 years in the industry, Saranga—currently General Manager (News and Current Affairs) at TV Derana and Head of the Ada Derana News Channel—has seamlessly transitioned from hard news to impactful educational programming. His success underscores a broader vision: to harness television’s full potential as an audio-visual learning tool.

“There is a significant void in Sri Lankan television when it comes to high-quality educational productions,” he noted. “Television is an audio-visual medium; its true power lies in its ability to show, not just tell. We use multimedia elements—graphics, animation, and dynamic presentation—to grip the viewer’s attention.”

Saranga emphasised that his goal was to match global benchmarks. “If world-class science documentaries are available in English, our mission was to bring that same global standard to the Sinhala-speaking audience,” he said.

Through Jeevithayata Vidyawa, complex scientific concepts—from aerodynamics to cyclones—are presented in a manner that is both accessible and engaging, redefining the notion of “edutainment” in local television.

Expressing gratitude, Saranga credited his team and network for the continued success.

“This achievement is a result of a shared vision. My deepest gratitude goes to the management of Ada Derana. In an industry often driven by conventional ratings, they have consistently provided a sanctuary for creative freedom, allowing ‘out-of-the-box’ ideas to flourish,” he said.

He added: “To my incredible production team—this trophy belongs to you. Your technical skill and commitment have transformed simple ideas into a national standard. Finally, thank you to our viewers; your curiosity is our ultimate motivation. We will continue to prove that learning is an inspiring journey.”

Saranga’s hat-trick stands as a testament to the power of innovation in educational broadcasting—proving that knowledge, when presented with creativity and purpose, can captivate audiences just as effectively as mainstream entertainment.

By Ifham Nizam

Life style

‘Style Surge’ blends glamour with a cause

Published

6 days ago

2026/04/5

Thilina Walpola

Lighting up the evening with effortless charm

The event “Style Surge,” organised by the Lions Club Elevate, was an evening filled with glamour, leadership and purpose collided in a spectacular fusion. The grand Ballroom at Galle Face Hotel became a canvas of fashion; every detail, from the floral centrepiece to the curated lighting, whispered elegance, while glamour set the stage, purpose was the back bone.

The show featured a curated selection of Sri Lankan designers, each bringing their signature styles to the stage.

The designers captivated the audience with bold, contemporary silhouettes that fused modern trends with traditional influence, creating pieces that were both sophisticated and wearable.

The batik ensembles by doyen of Batiks, Eric Suriyasena, were masterpieces, demonstrating the designer’s mastery in balancing artistry and practicality. Each piece told a story, highlighting the cultural nuances of Sri Lanka, while contributing to the glamour of the event.

The hair and make up for the models were curated by Salon Avra by Thushari de Silva and was nothing short of perfection,

From sleek, modern looks to elegant textured styles, Salon Avra ensured every model complemented the designer’s vision, highlighting the intricate details of each ensemble. The artistry on stage reflected a seamless collaboration between fashion beauty and presentation.

Style Surge unfolded an evening of elegance, creativity and purpose. It brought together Colombo style conscious crowd, social leaders and fashion enthusiasts and transformed the venue into a vibrant celebration of couture and compassion.

As the lights dimmed,the runaway came alive with a striking showcase of designs, ranging from contemporary chic to timeless sophistication, by designers like Eric Suriyasena, Anushko, Azeena Sulaiman and Jaywanthi Panibharatha. Leading fashion brands showcased were Aluminium, Disala, Eriq and Elegant Closet, and they presented a blend of contemporary and traditional fashion. Jewellery for the show was designed and sponsored by Blue Majestara Ceylon, . The Chief Guest was District Governor Lion Mahesh Borolugoda and his wife Lion Lady Sunethra Borolugoda.

Beyond glamour, this event, Style Surge, carried a meaningful mission to help rennovate two schools and improve educational facilities for future students

Lions Club of Colombo Elevate district 306D6, the organisers of this event, have been long synonymous with community development .The event underscores the power of fashion as a force of good.

Proceeds and awareness generated though the evening will be directed towards the clubs ongoing humanitarian initiatives, reinforcing its commitment to uplifting communities while engaging the public in an inspiring way.

In every sense, the event was more than a fashion show, it was a statement. This event reaffirms that glamour can also carry a purpose, creativity can spark compassion, and a runaway that can become a powerful platform for social change. This fashion show was graced by distinguished guests of honour , including designers Aseka Wijewardena, Michael Wijesuriya, Yolande Aluwihare, and Shyara Mendis

This event was organised by Lion Diana Nilanthi, Shen, Lion Thushari de Silva and Lion Shashika Hettiarachchi, whose commitment to creativity and attention to detail transformed the event into a truly memorable evening. They were the driving force that brought the vision of the show to life. Their meticulous planning, conceptualising the theme, coordinating the designers ensured the show ran seamlessly, from start to finish Pix by Thushara Attapathu

By Zanita Careem