Discovery Health launches new Diabetic Retinopathy Screening Benefit, enhanced by a cutting-edge artificial intelligence system and designed to detect the onset of diabetic retinopathy as early as possible.

People who live with diabetes (whether Type 1 or 2) are at heightened risk for several serious healthcare complications that affect various parts of the body. One of these complications is a condition known as diabetic retinopathy, and this can severely affect vision over time.

Persistently high blood glucose levels, which are typical of diabetes, cause damage to blood vessels throughout the body. This damage is more apparent in smaller blood vessels which are more vulnerable, like the tiny blood vessels at the back of the eyes. Diabetic retinopathy is a condition in which there is damage to the blood vessels of the light sensitive tissue at the back of the eye.

“This condition may present with only minor changes in our vision which may come and go, but it can also be entirely asymptomatic,” says CEO of Discovery Health, Dr Ryan Noach. “Of course, tight control of diabetes is key to preventing the start and progression of diabetic retinopathy. However, regularly undergoing screening for the early warning signs of diabetic retinopathy is equally important to nipping the condition in the bud and ensuring good eye health.”

Diabetic Retinopathy Screening Benefit

“This is why Discovery Health Medical Scheme (DHMS) has launched the new Diabetic Retinopathy Screening Benefit, designed to detect the onset of diabetic retinopathy as early as possible.”

“Through this benefit, we hope to increase the number of DHMS members who are screened for diabetic retinopathy. We take great pride in offering screening using the best available assessment tools and leading artificial intelligence technologies while we also have the great privilege of sending each member to our excellent network of participating optometrists, ophthalmologists, and GPs for their screening, broader assessment and clinical management.”

Less than one quarter of members living with diabetes were screened in 2020

“Our analysis of screening rates among DHMS members who are living with diabetes unfortunately shows low levels of adherence to important annual screening checks. In 2020, only 24% of DHMS members living with diabetes were screened for diabetic retinopathy,” explains Dr Noach.

“It’s understandable that one of the impacts of the COVID-19 pandemic and associated mitigation measures, has been a change to health-seeking behaviour, and a consequent marked reduction in care for non-COVID conditions. Preventative and screening healthcare interventions have declined markedly since the start of the pandemic. It’s critical that we reverse these trends to detect the onset of diabetic retinopathy as early as possible, even before symptoms appear.”

Available on all plans

“Discovery Health has always focused on incentivising, simplifying and enhancing member access to evidence-based preventative healthcare screening. The DHMS Diabetic Retinopathy Screening Benefit is fully aligned to this ethos. It gives members easy access to annual screening which is conducted using cutting-edge AI technology, followed up by a clear referral process, and supported by scheme benefits. We have also set up automated reminders that will prompt eligible scheme members to report for their annual screening check.”

“Regardless of which medical plan a member is on, they have access to screening that can prevent the significant reduction in their quality of life that advanced diabetic retinopathy brings.”

The Diabetic Retinopathy Screening Benefit follows a simple, three-level process:

1. Primary grading

Photography of the retina and assessment for signs of diabetic retinopathy

2. Secondary grading

Eye examination performed by an optometrist.

If signs of disease are detected by the AI system during primary grading, a full eye examination for secondary grading may occur at the same or subsequent appointment.

3. Tertiary grading

Diagnosis and treatment by an ophthalmologist. 

Following secondary grading, where necessary, scheme members will be referred to an ophthalmologist to confirm the diagnosis of retinopathy, and for long-term specialist care.

Benefits for scheme members and healthcare providers

“This simple yet highly comprehensive three-step process ensures that eligible scheme members benefit from the chance to utilise the highly-accessible services of optometrist practices for the necessary screening,” adds Dr Noach. “Furthermore, the primary and secondary grading levels require no member co-payments at all as these are funded from scheme benefits.”

“Diabetes care teams are enhanced by the inclusion of participating optometrists and GPs, who offer digital fundus camera photography analysed by an advanced AI system.”

EyeArt AI Eye Screening System

Frank Cheng, President of Eyenuk, developer of the EyeArt AI Eye Screening System, adds,“We applaud Discovery Health’s leadership for being the first payor to bring our EyeArt AI system to South Africa. The EyeArt AI system is the most extensively validated and adopted AI system for automated diabetic retinopathy detection in real-world settings. It has been cleared by regulatory authorities around the world, including the U.S. Food and Drug Administration (FDA), and is reimbursed by government and private payors in the U.S.”

Accessing the Diabetic Retinopathy Screening Benefit

The Diabetic Retinopathy Screening Benefit will be available to all patients who are registered on the Chronic Illness Benefit (CIB) for diabetes Type 1 or Type 2.

• The benefit covers one annual retinal screening each year for diabetic retinopathy (DR).
• Qualifying scheme members do not require pre-authorisations to access the necessary cover.

Locating participating healthcare practitioners

• Find a provider who is part of our screening network by logging on to discovery.co.za > Medical aid > Find a doctor > Find a doctor close to you. Search for “Optometrists” in an area conveniently located for you. You can find providers who offer screening for diabetic retinopathy by filtering your search:

1. Select “COVER”
2. Deselect “Full network Cover” and choose “Additional/Other Cover” to select “Diabetic Retinopathy Screening”.

2021 DHMS cover for primary grading exams

DHMS pays for primary grading examinations from Scheme benefits.

If indicated following primary grading, secondary grading examinations are also paid from scheme benefits.  “This means that patients will not have out-of-pocket payments and that no claims will be deducted from their Medical Savings Account (MSA) balance,” says Dr Noach.

Participating healthcare providers may not charge extra fees for primary and secondary grading examinations.

We learn more about dry skin conditions that are characterised by dry skin, and how to manage dry skin.

The cause of dry skin

Dry skin is a very common condition and often results in visits to dermatologists. Symptoms vary according to the severity of dryness, but skin can be tight and rough and/or prone to itching, scaling, flakiness and redness. In extreme cases, skin is pathologically dry.

The main reason for skin dryness is an impaired skin barrier function which results from:

• A lack of lipids that help to protect skin from moisture loss.
• A deficit of urea and natural moisturising factors (NMFs) which bind moisture into the skin.

The skin is not only the body’s largest organ but also plays a vital role in regulating body temperature and acts as a barrier protecting the body against infection.

However, dry body skin that is cracked can lose its ability to perform these functions. A good skin care routine using products formulated specifically for rough and cracked skin, like Eucerin UreaRepair PLUS, can help to restore skin to a healthy state.

The causes of rough and cracked, dry skin vary from poor skin care and environmental factors to health-related conditions, such as atopic dermatitis (eczema) and diabetes.

Symptoms of dry skin

• Extreme tightness
• Extreme roughness
• Skin cracks or fissures
• Intense itching

Different types of dry skin conditions

Xerosis cutis is the medical term for abnormally dry skin. This name comes from the Greek word “xero” which means dry.

Psoriasis is a chronic, recurrent inflammatory skin disorder. The most common type is psoriasis vulgaris, characterised by slightly elevated reddish patches or papules covered with silvery white scales.

Ichthyosis vulgaris is a rare inherited skin condition that is characterised by extremely dry skin. It produces large scales in the skin that can resemble fish scales.

Keratosis pilaris is a common, harmless skin condition. It causes small, hard bumps that may make your skin feel like sandpaper. They usually appear on your upper arms, thighs, and buttocks, sometimes with redness or swelling

Diabetes

Diabetes mellitus is a chronic disease caused by inherited and/or acquired deficiency in production of insulin by the pancreas, or by the ineffectiveness of the insulin produced. It is very common for people living with diabetes to have dry skin.

The best way to treat dry skin

In 2018, a group of renowned physicians published a medical paper on the Diagnosis and Treatment of Xerosis cutis. The report summarises the latest research findings in the prevention, diagnosis and treatment of dry skin and gives doctors’ practical advice on how best to treat the condition.

The medical paper states that dry skin can, in principle, be treated effectively. The decisive factor in the effectiveness of dry skin treatment is choosing the appropriate care product.

Moisturising should involve a combination of hydrating and lipid-replenishing ingredients, formulated to restore the skin’s natural barrier function in the best possible way and prevent skin from drying out further.

Urea –  Gold standard treatment  

The paper explains that “based on the available scientific data, urea is the gold standard for the therapy of xerosis cutis.¹”

Urea has the advantage of being effective on two fronts; as a natural moisturising factor, it binds moisture into the outermost layers of skin. Plus, it also supports desquamation which is the natural process by which skin sheds dead skin cells. Healthy desquamation is linked to smooth skin.

The Diagnosis and Treatment of Xerosis cutis paper also explains that when urea is combined with other moisturising ingredients and lipids, the effect is even better. It states, “The combination of urea with ceramides, NMF and glycerol shows a significantly better effect than the effect of urea or the vehicle alone.²”

Eucerin UreaRepair PLUS

Eucerin scientists were the first to effectively include urea in a dermo-cosmetic product, and now have more than 25 years’ experience of maximising the benefits of urea in skincare formulas. Experience that includes more than 30 clinical and dermatological studies, involving 10 000 volunteers.

The lotions and creams in the Eucerin UreaRepair PLUS range offer people with dry skin exactly what the independent expert paper recommends.

The formulas include:

• Various concentrations of urea (ranging from 5% to 10%).
• Other natural moisturising factors (NMFs), ceramides and gluco-glycerol.
• The range is clinically and dermatologically proven to offer immediate and 48hour dry-skin relief.³

For more information please visit www.eucerin.co.za

References:

1. Augustin M et al., Diagnosis and Treatment of Xerosis Cutis. JDDG, July 2018: Suppl 4, Volume 16.
2. Weber TM et al., J Clin Aesthet Dermatol 2012, 5:29–39.
3. Beiersdorf. Data on file.