Big Data and Diabetes: Seven-Year Data from Pakistan's Nation-Wide Laboratory Network

Introduction: Diabetes has become a prominent worldwide public health issue, with its prevalence notably higher in lower middle-income countries. Pakistan ranks third globally in terms of number of individuals diagnosed with Type 2 Diabetes Mellitus and have highest prevalence of diabetes throughout the world. The objective of current study was to assess the frequency of diabetes in relation to demographics utilizing laboratory data of individuals residing in Pakistan. Methods: Biochemical data of HbA1c, fasting and random plasma glucose, and oral glucose tolerance test were retrieved from Laboratory Information System analyzed in Pathology and Laboratory Medicine department from Jan 2016 to Dec 2022. Specimens were received from Aga Khan University laboratories’ network, which is spread over the country. For interpretation of biochemical tests’ values American Diabetes Association (ADA) criteria was applied. Results: After removal of duplicates and missing data, the final sample included 4,260,171 unique individuals. Diabetes was present in 35.9% of the overall population, with the highest incidence (55.6%) recorded in males aged 35 to 59 years. Diabetes was significantly associated with advancing age and gender (p<0.001). Individuals who had the fasting blood glucose ≥ 126 mg/dl were (n=372,050), HbA1c exceeding 6.5% were (n=762,940) the random blood glucose ≥ 200 mg/dl were (n=128,820), OGTT level ≥ 200 mg/dl were (n=487) and diabetes confirmed with more than one diagnostic test were (n=505,609). Conclusion: The study, based on dataset of around 4.2 million individuals, revealed an overall diabetes frequency of 35.9%, with highest prevalence in middle-aged group (55.6%), and significant associations with both advancing age and gender.