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The poor quality of diabetes care in a cluster randomized community survey from Delhi (DEDICOM‐II): A crisis, an opportunity.
- Source :
- Diabetic Medicine; Sep2021, Vol. 38 Issue 9, p1-14, 14p
- Publication Year :
- 2021
-
Abstract
- Aims: To evaluate the quality of care in known diabetes patients of Delhi. Methods: A cross‐sectional survey was conducted using a two‐stage cluster design. In all, 30 of 150 wards were chosen in Stage 1 (using a random computer‐generated seed value and then selecting wards at a predefined sampling interval; Probability Proportionate to Size—Systematic) and one colony from each ward was selected randomly in Stage 2. The selected areas were surveyed house‐to‐house in one‐of‐four random directions to recruit a minimum of 25 subjects (known diabetes ≥1 year; 35–65 years of age) per area. Data were collected by interview, blood sampling and from medical records by specifically trained research staff. Results: A total of 843 subjects (of 1315 eligible) were enrolled from 11,490 houses. For the intermediate outcome measures, an estimated 33.5% (95% CI 27.3–40.2) had an HbA1c value >10%, 67.2% (95% CI 62.8–71.4) had an LDL cholesterol level >100 mg/dl and 57.3% (95% CI 50.4–63.9) had BP levels >140/90 mmHg. For the processes of care in the last 1 year, 25.6% (95% CI 19.7–32.6) of the patients had an HbA1c (A1c) estimation and 2.4% (95% CI 1.1–4.9) had a dilated eye examination and 4.1% (95% CI 2.6–6.2) had foot examination. Diabetes self‐management education was provided to only 11.3% (95% CI 8.6–14.7) while nutrition counselling was provided to 56.0% (95% CI 51.7–60.2). Conclusions: The glycaemic control, lipid control and BP management of known diabetes patients in Delhi are unacceptably poor and a wide gap exists between practice recommendations and delivery of diabetes care in Delhi. [ABSTRACT FROM AUTHOR]
- Subjects :
- MEDICAL quality control
CLUSTER sampling
GLYCOSYLATED hemoglobin
CONFIDENCE intervals
CROSS-sectional method
MEDICAL care
DIABETES
INTERVIEWING
BLOOD collection
LDL cholesterol
NUTRITION counseling
SURVEYS
MEDICAL records
DESCRIPTIVE statistics
STATISTICAL sampling
PATIENT education
PROBABILITY theory
EYE examination
Subjects
Details
- Language :
- English
- ISSN :
- 07423071
- Volume :
- 38
- Issue :
- 9
- Database :
- Complementary Index
- Journal :
- Diabetic Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 151932493
- Full Text :
- https://doi.org/10.1111/dme.14530