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EMPOWERING SOUTH AFRICANS TO MANAGE AND PREVENT DIABETES THROUGH INNOVATIVE HEALTH PROGRAMMES

Diabetes is a factor in the death of 118 people every day in South Africa, and it is now the leading cause of death in the country. To put this in perspective, diabetes now kills more people than HIV, tuberculosis (TB) and transport accidents , and more than four million people are living with the disease. These eye-opening statistics underscore the urgent need for awareness and proactive management of diabetes in our communities, where many people don’t know they have the disease until it is too late.

Taking on this challenge, diversified healthcare company AfroCentric is working through its Medscheme subsidiary to provide holistic preventive, screening and care solutions that preserve quality of life and curb avoidable deaths.

Ayesha Kriel, Functional Head of Disease and Medicine Management at Medscheme, explains: “Diabetes is a chronic condition that affects how your body processes blood sugar (glucose). It is a silent killer — you can have it for years before experiencing symptoms, and by then, it may have caused irreversible damage. More than 45% of people with diabetes are undiagnosed, so we encourage everyone to be proactive and have a blood glucose test at least once a year. Most medical aid schemes cover an annual blood glucose test as part of their health risk assessments.

There are two common types of diabetes mellitus, and they’re both linked to insulin, a hormone produced by the pancreas that regulates blood sugar levels. Type 1 diabetes is an autoimmune condition in which the body attacks insulin-producing cells in the pancreas, causing blood sugar levels to rise dangerously. Type 2 diabetes is by far the most common form of the disease and develops when the body becomes resistant to the effect of insulin or doesn’t produce enough insulin. It often develops in adults but is seen increasingly in children.

Regular screening facilitates early diagnosis and management of diabetes, reducing the risk of complications. If type 2 diabetes is caught early enough, it is possible to manage and even reverse the disease. Uncontrolled diabetes, in contrast, can lead to heart disease, stroke, kidney failure, amputations, blindness and eventually death.

Type 1 and type 2 diabetes are among the conditions that fall under the Prescribed Minimum Benefits (PMBs) that medical aid schemes must cover regardless of the benefit option a member has selected. Under the Medical Schemes Act, all medical aid schemes must cover the costs of diagnosis, treatment and care of PMB conditions. For medical aid members, this means your monthly medical aid premium may cover the cost of screening and treatment for diabetes. Contact your medical aid to confirm your benefits, as medicine formularies, networks, and other option/scheme/managed care rules may apply.

With the right support and personal commitment, people living with diabetes can live long, healthy and productive lives.

“At Medscheme, we take a personalised and patient-centred approach to managing diabetes. This includes providing access to a doctor, tests, treatment and chronic medicine, as well as educating members about their condition and empowering them to manage it. We also provide online tools, access to a care coordinator, access to specialised treatment, guidance and support. We consider all of a patient’s medical needs, including any other chronic conditions they may have, and work with their doctor to provide coordinated quality care,” Kriel explains.

The burden of diabetes

Medscheme is one of the largest medical aid administrators in South Africa, managing over four million lives. It has analysed data across the schemes it manages to shed light on the impact of diabetes, which are reflective of the healthcare system more broadly:

• The average age of diabetes patients is 59 years, and slightly more females have diabetes (56%).
• 64% of diabetes patients are older than 55 years.
• 70% of diabetes patients have type 2 diabetes.
• A 15.77% increase in type 2 diabetes in young adults (17 – 34 years) between 2018 and 2024 was higher than in any other age group.

• Reasons for the more significant increase in type 2 diabetes among young adults are speculated to relate to sedentary lifestyles, unhealthy diets and family history.

• Among adults over 55, the incidence of type 2 diabetes increased by 11.97% between 2018 and 2024.
• Members with diabetes cost their medical schemes about four times more to care for than those who do not.

• An average of 7% of scheme members are registered for chronic medicine for diabetes.

• 86% of members on diabetes medicine regularly claim their prescriptions.
• Among those with diabetes, about 42% also have hypertension, 9% have depression, 9% have asthma, and 6.3% are HIV-positive.

“These findings have far-reaching implications for our healthcare system and our members. We see that the prevalence of type 2 diabetes has climbed by more than one percentage point per year since 2018, and estimates suggest the number of cases will rise to 7.5 million by 2045. Considering the fact that diabetic patients cost four times more to care for than average members, and South Africans are already struggling to afford medical aid, we could be facing a sustainability crisis in the next few years — not only at Medscheme but across the entire healthcare system,” warns Kriel.

“The quality of life of members and the financial stability of our schemes will both improve if we can keep members healthy and out of hospital. That’s why we at AfroCentric and Medscheme continue our mission to innovate and integrate sustainable healthcare solutions that improve access to quality care,” she says.