The DIAbetes MANagement and Treatment (DIAMANT) Cohort

Jetty A Overbeek,1– 3 Karin MA Swart,1– 3 Emma YM van der Pal,2,3 Marieke T Blom,2,3 Joline WJ Beulens,3– 5 Giel Nijpels,2,3 Petra JM Elders,2,3 Ron MC Herings1,3,4 1Department Research, PHARMO Institute for Drug Outcomes Research, Utrecht, Netherlands; 2Department of General Practice, Amsterdam UMC - Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands; 3Health Behaviors & Chronic Diseases, Amsterdam Public Health, Amsterdam, Netherlands; 4Department of Epidemiology and Data Science, Amsterdam UMC - Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands; 5Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, NetherlandsCorrespondence: Jetty A Overbeek, Department Research, PHARMO Institute for Drug Outcomes Research, Van Deventerlaan 30-40, Utrecht, 3528 AE, Netherlands, Tel +3130 7440 800, Email jetty.overbeek@pharmo.nlIntroduction: The increasing number of people with diabetes and the unclear long-term safety and effectiveness of newer and older blood-glucose-lowering treatments emphasize the need for more pharmaco-epidemiological studies in this field. A prospective, regularly updated cohort of people with diabetes would provide quick and up-to-date information regarding prevalence, treatment, safety and effectiveness. The current aim was to describe the design of the DIAbetes MANagement and Treatment (DIAMANT) cohort.Methods: The DIAMANT cohort is a population-based, dynamic, prospective cohort of persons with diabetes. It contains real-world data (RWD) from general practitioners (GP), including diagnoses, symptoms, examinations, communication to/from specialists and medication. Diabetes is defined as a recorded diabetes diagnosis or a prescription of drugs used in diabetes. The cohort is part of the national infrastructure of “Stichting Informatievoorziening voor Zorg en Onderzoek” (STIZON) and is linked to other data sources.Results: Currently, the cohort enables access to information of 89,883 patients in 2004 to 344,914 in 2020 (6% T1D, 84% T2D and 10% unclassified type of diabetes), with 193,931 participants still registered as being present in the GP practice (active) in 2020. The frequency of follow-up of persons with diabetes is practice dependent. The Dutch guidelines advise 2– 4 contacts per year with a more extensive yearly check-up. The DIAMANT cohort is updated several times a year. Anonymised data from the DIAMANT cohort are available to researchers.Discussion: The DIAMANT cohort provides the opportunity to gain RWD insights into the treatment and outcomes among people with diabetes in daily general practice. The data can be enriched by established linkages to other data sources (eg, hospital data, the Perinatal Registry, the Cancer Registry). The DIAMANT cohort serves as a start of a national infrastructure to study, manage and provide personalised care in order to ultimately improve care and outcomes for people with diabetes.Keywords: diabetes, type 2 diabetes, epidemiology, follow-up, prospective cohort, real-world data