Progression and management of diabetes in Indian settings with universal access to health care: Protocol and plans for CHIPS cohort study

There is a demand for more comprehensive studies related to diabetes management in Indian settings covering; incidence, multimorbidity and complications in diabetes patients, clinical progression, medication, and treatment-seeking patterns. CHIPS study aims to bridge this research gap through a systematic analysis of the medical records maintained under an employees contributory health services scheme (CHSS). The CHSS based in an urban metropolitan area has 89,204 beneficiaries. The hospital information management system (HIMS) has records of lab reports, clinical summaries, prescriptions, and drugs and other medical consumables, supplied for every interaction with CHSS. Firstly, a cohort of 835 patients newly diagnosed as diabetic in the year 2011-2012 was identified from the HIMS. Their 10-year (2011-2021) medical history after getting diagnosed as a diabetic patient was elicited from the HIMS in a retrospective manner. For comparison needs another cohort of 1670 age-sex matched non-diabetic beneficiaries was created and similar 10-year medical history was created. A total of 144,511 lab records and 247,473 drug records from the HIMS for the period 2010-2012 were scrutinized to identify newly diabetic patients and their non-diabetic counterparts. The reconstructed 10-year medical history of these two groups will be used to investigate the burden of diabetes in the community, transitions from a non-diabetic and pre-diabetic to a diabetic, excess morbidity in diabetic patients, seasonal variation in glycaemic levels, association between glycaemic control and frequency of health care utilization, and COVID-19-induced temporal changes in glycaemic control.