UKZN’s Specialist Physician and PhD graduate, Dr Somasundran Pillay, has recently been  awarded the International Hospital Federation Global Excellence Award in Leadership and  Healthcare at the 41st World Hospital Congress held in Taipei, Taiwan.  This was in recognition of his PhD research work which resulted in a paper titled: Improving Diabetes Care In Resource-Limited Settings.

Pillay is not new to scooping awards.  He has also won the first Prize Gold Award in the category of Outstanding Achievement for innovation at the MASEA (Minister of Health Service Excellence Awards) this year. This particular accolade was for his PhD work on Improved Regional Diabetes Care.

A previous study conducted by Pillay demonstrated that the majority of patients with diabetes throughout the province of KwaZulu-Natal are diagnosed and have their therapy initiated at clinic level. This emphasised that much more effort needs to be placed on improving diabetes care from the clinic, district and regional level in order to decrease the burden of diabetes-related complications on the patient and economy of the country as a whole.

Under the supervision of Dr Colleen Aldous who is a Research Academic Leader in the School of Clinical Medicine at UKZN, Pillay designed a clinic system for diabetes care that gives the patient a complete service for all their diabetic care requirements.

Dr Pillay is a Specialist Physician and Head of Firm in Internal Medicine at Edendale Hospital and has successfully developed a blueprint for improving overall diabetes. The plan will be rolled out in all diabetes clinics both in KwaZulu-Natal and nationally.

‘This is the first paper to show how holistic treatment of a diabetic patients has been addressed at the clinic level and we hope that the system is applied across the country so that all South African diabetes patients will get better and more holistic care and treatment, seeing that diabetes is a growing problem across all socio-economic levels,’ said Aldous.

Published in the South African Journal of Diabetes and Vascular Diseases, this paper describes the development and implementation of the six steps as a holistic patient care package at a clinic.

Pillay conducted his study at the Edendale Hospital diabetes clinic, which is a busy regional clinic situated in Pietermaritzburg, KwaZulu-Natal. In order to improve diabetes care, the following integrated package of changes was made to this resource-limited clinic: (1) introduction of a fully operational multidisciplinary treatment team; (2) intensive nurse and clinician education on diabetes and its management according to local South African diabetes guidelines; (3) intensive patient education from all members of the team; (4) introduction of essential basic equipment into the clinic; (5) introduction of a patient clerking datasheet to ensure standardisation and comprehensive diabetes care for all patients visiting the clinic; and (6) development of a customised computer programme to audit and analyse data over time in order to identify areas of poor performance within the care of the patient, and to monitor patient progress.

Pillay’s research work concluded that diabetes care in this resource-limited clinic was inadequate, with large numbers of patients consulted by only a few rotating doctors. This scenario has now improved to include a multidisciplinary team (including increased numbers of doctors) coupled with a comprehensive and standardised approach to all patients consulted at this clinic. Based on the promising clinical outcomes shown by Pillay et al. in this clinic post implementation of the multifaceted approach, this model could serve as a possible blueprint and could easily be adapted to other clinics, and district and regional hospitals in South Africa and other developing countries. Data sheets could be completed in other regional or district hospital diabetes clinics in the province and sent to the central regional hospital for capturing into this specialised computer program. This process will provide extensive information on diabetic patients and their control within the province. Control of this “diabetes puzzle” need not be an insurmountable task if a multifaceted approach is attempted.

Words: Lihle Sosibo