VOLUME 7 NUMBER 3 • SEPTEMBER 2010
113
The ‘Changing Diabetes’ bus will now screen
for retinopathy and diabetic foot syndrome
A
fter three successful years of raising diabetes awareness among
the general population and healthcare professionals alike, the
Novo Nordisk’s ‘Changing Diabetes’ bus is expanding its services
to include screening for complications of diabetes such as retinopathy and
diabetic foot syndrome. These new services on board will facilitate the
early diagnosis of these common complications, with a view to optimising
current therapy and thus improving outcomes.
Eric Reurts, Novo Nordisk general manager for the southern African
region, explains further. ‘To date the bus has travelled all over southern
Africa and has evaluated more than 32 000 individuals, all of whom have
had their risk factors for diabetes assessed, for example, weight and blood
pressure. Our finding that many of the people we saw required further
investigation confirmed what we already knew – that diabetes is under-
diagnosed and often misdiagnosed. We wanted to make a difference in
respect of raising the profile of this condition, while at the same time
making government aware that this region has healthcare priorities other
than HIV/AIDS, which is where much of government’s attention is focused.
If everyone who has diabetes were diagnosed, the number of patients with
the condition would probably be higher than that of HIV sufferers.’
Foot amputations are common among diabetics, and add greatly to the
costs associated with the disease, hence Novo Nordisk’s upgrading of
the bus’s functions to include diabetic foot assessment. ‘We have all the
necessary testing equipment on board to assess nerve conduction to the
feet’, says Reurts. He also has high praise for the Podiatry Association of
South Africa’s support in this regard.
Retinopathy is another common complication of diabetes and Novo
Nordisk recently partnered with the University of Pretoria to help address
this. ‘The project is being piloted over a six-month period that commenced
on 28 June 2010. The bus now visits all the diabetic clinics that feed
into Pretoria Academic Hospital. We do a full screen for complications on
all patients, including a retinal examination. Staff from Pretoria Academic
Hospital undertake this, using the fundus camera that we purchased re-
cently and installed on the bus.’
‘We also have the facility to undertake laser treatment on those patients
who require it’, Reurts continued. ‘The camera screens patients on four
days of the week and the pictures are then analysed at the University of
Pretoria’s ophthalmology department. Thereafter, patients requiring treat-
ment are invited back to the bus to have their eyes lasered. Based on
an earlier initiative undertaken in a rural population with fundus cameras
donated by the World Diabetes Federation, we’re anticipating a referral
rate of around 30%.’
Reurts pointed out that while Novo Nordisk provides the infrastructure,
the multidisciplinary staff on board the bus (e.g. endocrinologists, podia-
trists, diabetes nurse educators) are all being provided by the University
of Pretoria. The intention is that they will also transfer their skills to clinic
staff. ‘Six months after completion of the project, we will assess its im-
pact’, Reurts concluded. ‘We hope ultimately to roll it out to other prov-
inces. Once again, we’ll provide, in the form of the bus, the environment
in which treatment can be optimised, while the provincial health depart-
ments provide the staff complement required.’
A new full retinopathy service and laser treatment is offered from
the bus.
The fully fledged laboratory has a dedicated team supporting this
massive education effort.
S Afr J Diabetes Vasc Dis 2010;
7
: 113
SA JOURNAL OF DIABETES & VASCULAR DISEASE
Community Initiative
