The University of Pretoria’s (UP) Diabetes Research Centre, in conjunction with health tech company Aviro Health, recently launched the Aviro Pocket Clinic app for diabetes which allows for patient registration, guided clinic and home visits for insulin initiation for people with type 2 diabetes as well as lifestyle counselling, among other features.

“An individual cannot make major changes, but joining hands with industries and companies, and looking at innovation can make a difference. Collaborations and partnerships are important,” said Professor Tiaan de Jager, Dean of the Faculty of Health Sciences at UP.

According Dr Patrick Ngassa Piotie, senior programme manager at the University’s Diabetes Research Centre, diabetes is the leading cause of death among South African women and the second-biggest cause of death among men and women combined. He says that almost one in two South Africans living with diabetes is undiagnosed.

During the launch and demonstration, Aviro product manager Soraiya Verjee said that diabetes is a global health emergency, adding that about 24 million African adults are living with the condition and that the number is expected to rise to at least 33 million by 2030 and 55 million by 2045.

“In 2021, diabetes was responsible for 416 000 deaths,” she said. “We must urgently find ways to implement and scale effective, efficient and empathetic diabetes care, made by and for Africans.”

Verjee indicated that the app aims to assist healthcare providers to deliver high-quality and consistent care and counselling; empower patients to better understand and manage their condition; and improve physician support through calculated and recommended titrations.

“Because of loadshedding and power problems, the app is designed in such a way that it works even in offline mode,” she added.

UP began the implementation of the Tshwane Insulin Project (TIP) in 2019 after receiving a grant from the Lilly Global Health Partnership. The TIP intervention was then developed to facilitate the transition of people living with type 2 diabetes from oral drugs to insulin. With this intervention, the TIP team tested a decentralised model of diabetes care that included nurse-led initiation of insulin at clinics and proactive follow-ups, and insulin titration at the patient home, facilitated by ward-based outreach teams and supported remotely by a physician.

In 2021, UP’s business incubator TuksNovation introduced the TIP team to Aviro Health, and they have been working together since to improve the TIP intervention and migrate from a paper-based system to a digital one. The app includes digital diabetes education material in video and PDF format, which are easily accessible for healthcare workers.

Addressing attendees and delegates from the national Department of Health and the City of Tshwane, Professor Paul Rheeder, Director of UP’s Diabetes Research Centre, said TIP was launched to address critical health issues.

“The major issue is that in the Tshwane district and other districts, clinics do not have enough doctors to start patients on insulin, and very few patients were successfully started on insulin at primary care level,” he said. “Home visits by a dedicated team of community health workers (CHWs) is the critical component of our intervention. A team leader, who is a registered nurse, goes with the CHWs who visit patients at their homes. The patient’s glucose values are communicated to the doctor remotely and the doctor instructs the CHWs to adjust the patient’s insulin dose. We are collecting information via the digital tool as opposed to a paper-based method.”

During the launch, Lucas Mahamba, a community healthcare worker based at Eersterust Clinic in Hammanskraal, said he was delighted to have received training to operate the app.

“The training improved my knowledge about how to capture data on the app while assisting patients with diabetes,” he said. “This method will prevent the misplacement of patient information, which often happens with paper-based methods; everything will be on the cloud and can be retrieved at any given moment.” 

“It is through initiatives and partnerships such as with Aviro Health that UP is able to lead and perform well in terms of Sustainable Development Goal 3 – Good Health and Well-being,” Prof De Jager said. “This, on its own, is proof enough that we are serious about making an impact on society.”