CDE takes on heart health
Out of the ten leading underlying natural causes of death reported by Statistics South Africa for 2013–2015, diabetes mellitus ranks second, cerebrovascular diseases rank third, other forms of heart disease rank fourth, hypertensive diseases rank seventh and ischaemic heart diseases rank tenth.
The increase in the prevalence of diabetes and associated cardiovascular risk conditions in South Africa over the last decade and their contribution to the overall burden of non-communicable diseases, has created an urgent need for improved diagnosis, treatment and control.
In a significant first for South Africa, The Council for Medical Schemes (CMS) has accordingly extended its accreditation for Centre for Diabetes and Endocrinology (CDE) as a Managed Care Organisation from management of diabetes alone to include the management of other cardiovascular disease risk factors – hypertension (high blood pressure), dyslipidaemia (disordered blood fats), obesity and chronic renal disease. CEO of the CDE, Grant Newton, says, “This is particularly welcomed as it provides an invaluable opportunity to bring together a host of specialist niche players to collaboratively address cardiovascular disease holistically.”
Dr Larry Distiller, Specialist Physician/Endocrinologist and Principal Physician, and Executive Chairman of the CDE says, “This will significantly empower the CDE to start addressing the need for holistic management of these common, largely asymptomatic and potentially devastating health conditions and risk factors for cardiovascular disease. This group of conditions are causally linked to strokes, myocardial infarction, end-stage renal disease, congestive heart failure, peripheral vascular disease and blindness. In recent years, there has been an alarming worldwide rise in their prevalence.”
In South Africa 4 out of 10 men and 7 out of 10 women are overweight or obese and this adds to the potential burden of cardiovascular risk, particularly amongst young people. Obese young adults are also more likely to have type 2 diabetes or ‘prediabetes’, both conditions being major risk factors for cardiovascular disease. “We know that diabetes, hypertension, dyslipidaemia and obesity are influenced by lifestyle behaviours like high-energy, low nutritional value processed foods, high salt intakes, excessive alcohol use, smoking and lack of physical activity,” says Distiller.
In addition, socioeconomic factors, such as poverty, unemployment, lack of schooling, dysfunctional family life and lack of support, lack of self-care capability all potentiate the massive rise in heart disease risk in South African adults.
He says management of cardiovascular risk is complex. Research and innovative practice reveal that apart from the necessary medical and pharmacological interventions, the successful management of most chronic conditions is dependent on patient-centred self-management, or self-care. Evidence shows that between 80–95% of chronic disease-related health outcomes are determined by patients’ health-related behaviours.
“Changing behaviour is a time-consuming and complex process often made difficult by the multitude of personal, societal and environmental influences. The key role in chronic disease management is to help patients to acquire tools and skills to care for themselves. Patients should not be passive recipients but rather empowered to be actively engaged in all aspects of their care, including identifying needs, setting goals and formulating a strategy to achieve these.”
“With a nearly 23-year history in the holistic, person-centred management of diabetes and related conditions, and the expanded CMS accreditation, CDE is well-placed to make a significant contribution to health care in South Africa” concludes Newton.
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