Diabetes and heart disease: Predictive analytics identify future risk to protect health and life span

This approach ensures investment into one's lifespan and health span. How is this being applied to tackling common noncommunicable diseases like diabetes and heart disease?

Predictive modelling changes the game

"We've introduced an innovative Disease Prevention Programme that uses advanced predictive modelling to identify Discovery Health Medical Scheme (DHMS) members who are at high risk of Type 2 diabetes or heart disease," explains Dr Noluthando Nematswerani, Chief Clinical Officer at Discovery Health.

"Diabetes and heart disease have a significant impact on life expectancy and health span (years spent in good health) which is why early intervention and the right short-and long-term support are so important. These are also two of the most prevalent diseases in the DHMS member base, and in South Africa and globally."

• According to the International Diabetes Federation, around 1 in 10 South Africans have diabetes, but about half of them don't know they have the disease. Diabetes is a leading cause of death among South African women, and the disease has tripled in prevalence since 2010. "Similarly, DHMS data show that there has been a 19% increase in members living with diabetes since 2018. And, 86% of DHMS members with diabetes also receive regular treatment for heart disease," says Dr Nematswerani.
• According to The Heart and Stroke Foundation, 225 South Africans are killed by heart diseases every day. Yet, 80% of heart disease and strokes can be prevented.

"Often these diseases are usually only picked up in the late stages, by which time more intensive treatment is required with significant impact on life expectancy," adds Dr Nematswerani. "Early intervention is fundamental to preventing long-term illness. The earlier we detect the onset of illness and put steps in place to reverse or halt disease progression, the better a person's health outcomes."

What happens once predictive modelling identifies someone at risk of diabetes or heart disease?

"People with persistently high blood pressure, elevated blood sugar, abnormal cholesterol, elevated blood triglycerides and high body mass index (BMI) - collectively known as cardiometabolic syndrome - are at a higher risk of developing Type 2 diabetes and heart disease. Cardiometabolic syndrome is recognized as a disease entity," adds Dr Nematswerani.

"That said, it's really quick and simple to pick up the early warning signs of these illnesses through a standard health check done at a General Practitioner (GP) or at a clinic, and testing for random or fasting blood glucose levels, blood pressure, cholesterol levels and so on."

"The advanced predictive modelling we use to identify DHMS members who are eligible for the Disease Prevention Programme analyses the member's health check results, claim patterns, family history of disease and other information that guides as to their risk of developing Type 2 diabetes or cardiovascular disease."

Once an eligible member has been identified, a Discovery Health Coach will contact the member informing them of eligibility for the programme. The member is asked to consult with their Premier Plus GP to confirm their disease risk and also to give consent to enrol them onto the Disease Prevention Programme.

"The goal of the programme is to reduce the member's risk of developing full-blown disease. In the case of Type 2 diabetes, this may be in the form of addressing high glucose levels with a combination of a healthy food plan, exercise, and medicine. During, or at the end of the programme, the member's Premier Plus GP will guide on the next steps to take, which may include continuing with the changes made to diet and exercise or continuing with the medicine prescribed."

Once enrolled on the programme, the member has access to:

• Two consultations with a Premier Plus GP
• Two dietician consultations
• Two fasting blood glucose tests
• One lipogram test
• One serum creatinine test (kidney function)
• Up to 12 coaching sessions delivered by the Discovery Health Care Services team

With the assistance of a Health Coach and Dietitian, the member sets lifestyle goals and works towards these goals, with ongoing support. Where required, the member will also have access to medicine for the clinical management of their cardiometabolic risk. After six months the Premier Plus GP reassesses the member's level of disease risk, repeating necessary tests and measurements.

"If a DHMS member is diagnosed with Type 2 diabetes during the programme, their Premier Plus GP will register the patient for Type 2 diabetes on the Chronic Illness Benefit and Diabetes Care Programme, which will give them access to benefits to manage their condition. The programme is designed to pick up the early signs of illness, allowing for a less intensive treatment plan - which may include continuing with lifestyle changes or oral medication. On the other hand, late-stage Type 2 diabetes may mean complications have developed or that medicine such as insulin is possibly required to control the condition," explains Dr Nematswerani.

• The DHMS Diabetes Care Programme helps patients actively manage their diabetes, with the aid of their Premier Plus GP. The programme gives the member and their Premier Plus GP access to various tools to monitor and manage their condition and to ensure that they get high quality, coordinated healthcare and the best outcomes. A member's progress can be tracked on a personalised dashboard displaying their unique Diabetes Management Score.

"Predictive modelling is such an important asset in supporting the early detection of disease. Early detection buys one time to halt or slow down the progress of disease, says Dr Nematswerani. "This means that we are able to live as many years as possible in better health and enjoy a better quality of life, so that we are not limited by poor health."

"I'd also really encourage everyone to go for a health check at least once a year to measure blood pressure, blood glucose and cholesterol levels, and calculate body mass index. Based on the results, your healthcare provider is able to guide you on whether you're at risk of developing any serious illness, so that you can take the necessary steps to take care of your health and wellbeing. An annual health check gives one an important baseline - a way to track how one is doing year-on-year, in staying healthy."