Diabetes and its associated factors: A Retrospective cohort analysis of a large database at Indus Hospital Health Network

Objectives: This is a retrospective cohort analysis of diabetes and its associated factors from Electronic Medical Record (EMR) of 2020-2022 of Indus Hospital Health Network (IHHN), Korangi campus Karachi. Methods: Retrospective cohort study was conducted at Indus Hospital & Health Network (IHHN), Korangi Karachi. Out-patient records of adult patients of 2020-2022 were extracted from EMR of IHHN in March 2023. Descriptive statistics were presented as median (IQR) and frequency and percentage. Chi-square test determined association of risk-factors with diabetes and Wilcoxon-sign-rank test compared change in HbA1C from baseline. Results: Data of 460,799 adult patients were extracted and analyzed. Median age of patients was 38.71 (27.8752) years. Female preponderance was observed in our study. Out of 460,799, HbA1C was seen in 42,638 (9.25%) patients. Among these 29,596 (69.4%) had a HbA1C >= 6.5% while 13,042 (30.6%) had a HbA1C in the pre-diabetes range. Significant association was found between age, baseline creatinine, LDL and diabetes with no association depicted between gender, BMI, blood pressure, triglycerides, HDL and diabetes status. Patients in general had higher HbA1C at baseline as compared to last visit (p-value<0.001). Conclusion: High blood pressure, obesity, increased creatinine, micro albuminurea, high LDL and Triglycerides were important risk factors for diabetes. This study reports a snap shot of the status of diabetes and associated risk-factors in the Pakistani population. This was the first time that a large data was extracted and analyzed from a healthcare institution in Pakistan, which would guide physicians and public health practitioners to take evidence-based decisions for prevention and management of diabetes.