60% not screened for diabetes complications in South Africa, new study finds

The world is experiencing a steep climb in the number of people living with diabetes, a chronic disease of significant public health concern. Many developing countries, such as South Africa, now bear the brunt.

Diabetes refers to high blood glucose levels. Several factors contribute to diabetes, but the main factors are obesity and an unhealthy lifestyle. It is an expensive disease, and it reduces Quality of life and life expectancy, especially if mismanaged.

Now eleven percent of South African adults living with diabetes, the highest prevalence in Africa. Most of them have poorly controlled diabetes. And many others are still undiagnosed. Many people are developing complications as a result of poorly controlled diabetes. These include eye problems, kidney diseases and cardiovascular disease. Some even develop wounds that do not heal, leading to limb amputation.

When people develop these complications, they spend more money on health care. And that puts a lot of strain on an already overburdened health care system. Some even lose their livelihoods, which in turn affects their families.

Were some research in South Africa looking at the level screening for complications for people living with diabetes. But there is very little attention to the primary level of health care. And some of these research were conducted many years ago, so the data may be invalid.

It is absolutely necessary to determine the situation, especially at the primary level of medical care. Our recent research focused on the Eastern Cape. It is one of the poorest provinces in South Africa with a high prevalence of poorly controlled diabetes.

We assessed the extent of screening for diabetes-related complications in primary care clinics in this province.

We found that the screening rate for these complications was very low. Our findings are similar research made in another rural province of the country. This points to the urgent need for measures to improve screening coverage of people with diabetes in South Africa. This will improve health outcomes and quality of life, and reduce the incidence of devastating complications of diabetes.

Check for complications

To keep blood glucose levels under control and avoid complications, diabetics need to carefully monitor their health. They must participate in their care, live a healthy lifestyleand undergo important tests and examinations that help quickly identify potential problems.

There is guiding principles for diabetes management and screening for complications in South Africa. Health professionals are also required to check that these people’s blood glucose levels are under control so that they do not develop complications that could shorten their lives or make them disabled.

Primary care clinics are entry points into the health care system. Most patients with diabetes are first treated in these institutions. This is where they get their medicine and have to check their blood glucose every time.

In addition, the first medical workers they should check patients’ eyes and kidney function when they are diagnosed and every year after that. Medical professionals should also examine patients’ feet at least once a year. Patients at higher risk of developing foot ulcers should be examined more often to prevent complications such as leg amputation.

Our research

We wanted to find out how people living with diabetes manage in some rural areas of the Eastern Cape, South Africa. We recruited participants with diabetes from six primary care settings. Asking them questions and looking at them medical documentationwe determined whether these measures and examinations were performed in these primary care clinics.

Our analysis showed that out of 372 people, only 71 (19%) of them had their blood glucose levels checked in the past year. Kidney function was checked in 60 (16%) of them, and blood cholesterol level in 33 (8.9%). Only 52 (14%) had an eye exam in the past year.

Only 9 (2.3%) performed a foot examination to help prevent leg amputation. More than half (60%) of these patients had not had any screening for these potential complications in the past year.

Not one of them passed all five of these important checks.

The way forward

Our research shows that without urgent intervention, many people with diabetes will soon develop complications that could have been prevented by proper screening. It will affect people, their families, jobs and even the overburdened health care system.

Prevention is cheaper than treatment. Understanding the possible causes of gaps in the diabetes mellitus management and finding effective solutions to improve screening coverage will be reduced health care costs, extend patients’ lives and allow them to lead quality lives.

There are several approaches that a country can take. For example mobile health technologies can be used as a tool to facilitate screening. A similar approach is used in developed countries. As a result, many of them were able to reduce their numbers complications related to diabetes.

Other countries have also adopted technological solutions train community health workers to perform some of these examinations under expert guidance.

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