A cross-sectional survey conducted by Sitaram Bhartia Institute of Science and Research among the population of Delhi has projected the possibility of 84,000 new cases of heart diseases and 34,000 cases of stroke in next 10 years in the city. The survey of Delhi Diabetes Community (DEDICOM), claimed to be the first of its kind in the country, has been accepted by American Diabetes Association for publication in its journal Diabetes.

According to Abhishek Bhartia, Director, Sitaram Bhartia , the survey evaluated the quality of care in known diabetes patients from the middle and high-income group populace of Delhi. "It highlights the wide gap between effective diabetes management practices and their implementation even among those from the higher income group", he said.

"Diabetes is a major public health problem in Delhi with about 15 per cent of the city's adult population affected by the disease. Our study shows that diabetes care is inadequate even among those from the higher income group. We advocate that all patients educate themselves about diabetes management and use a checklist to help ensure that they receive adequate care."

Of the current 600,000 (approx.) diabetes patients in Delhi, there is a risk of 84,000 (approx.) new cases of heart diseases and nearly 34,000 cases of stroke as well as an estimated 60, 000 deaths in the next 10 years, the DEDICOM suggested.

A cross-sectional survey was conducted using a probability proportionate to size (systematic) 2-stage cluster design. Thirty areas were selected for a house-to-house survey to recruit a minimum of 25 subjects per area. The inclusion criteria were known Type 2 Diabetes patients for one year, aged 35-65 years, family owned car and/or pucca house (house with brick-plaster walls and a concrete roof). Subjects were recruited from areas belonging to socioeconomic categories A, B, C or D. Data was collected by interview, blood sampling and from medical records. The patients were administered a standardized pre-tested proforma based on the National Diabetes Quality Improvement Alliance (NDQIA) measures for better comparability.

A total of 819 subjects (of 1,153 eligible) were enrolled from 20,666 houses. The study showed that known diabetes patients from the HIG populace of Delhi have poor glycemic, lipid and blood pressure control. Diabetes self-management education, nutrition counselling, exercise prescription and screening evaluations recommended for early detection of complications are infrequently advised and complied with, it said.

Notably, only 13per cent of the tested patients had HbA1c (Glycosylated Haemoglobin) tested even once a year as against the mandatory check-up of at least once a year. Only 16 per cent had gone for an eye check-up in the last one year (required at least once a year), just 3 per cent had a foot check up (required at least once a year) and a mere 32 per cent had a cholesterol and lipid profile examination in the last one year (required at least once a year) 63 per cent of the tested patients had an abnormally high Blood Pressure of 140/90 mmHg. The lipid profile was uncontrolled in over 74.5 per cent of the patients. Over 42 per cent of the patients had a HbA1C level of more than 8 as against the normal level of less than 6. Half of the patients had a routine urine examination in the last one-year (required yearly to look for traces of protein which indicate early kidney damage). One-fifth were taking aspirin, and 3.1per cent were taking lipid-lowering drugs. 92 per cent of the patents were visiting physicians but only 21.7 per cent of them had heard of the words " HB A1C," " glycosylated haemoglobin," or " any investigation estimating glycemic control over the past months." Awareness of the need for regular testing of blood glucose, eye examination and electrocardiogram was reported by 89.1 per cent, 61.1 per cent and 48.1 per cent respectively.

Sitaram Bhartia Institute of Science and Research is a 75-bed hospital and medical research center in South Delhi. It provides care in a wide range of medical specialties including medicine, obstetrics and gynecology, pediatrics, surgery, child and adolescent mental health, and diabetes. Sitaram Bhartia's research focuses on collecting health related data for our population, developing quality improvement interventions, and highlighting neglected aspects of medical care.