For millions of South Africans living with diabetes, the condition is a daily negotiation between lifestyle, access to care and financial strain. Around 4.5 million people in the country have diabetes and many more remain undiagnosed. As the burden of chronic illness grows, it’s becoming clear that medical aids must go beyond paying for medicine to enabling holistic, continuous care that safeguards both health and dignity. ‘The typical approach for the treatment and management of diabetes comes down to managing glucose levels, but understanding the individual behind the condition, their habits, challenges and support structures, is just as crucial,’ says Dr Themba Hadebe, Clinical Executive at Bonitas Medical Fund. ‘Medical aids need to be active partners in helping members live well in a holistic manner, instead of simply focusing on managing the immediate and most obvious aspects of a disease.’ This shift in thinking is crucial, he adds, since diabetes doesn’t exist in isolation, with chronic conditions like hypertension and heart disease often accompanying it. The fragmented approach that focuses narrowly on funding prescriptions leaves patients unsupported in critical areas like nutrition, mental health and education. ‘If medical aids are to deliver meaningful health outcomes, they must replace fragmented care with coordinated, member-centred systems,’ he says. ‘Bonitas’ Diabetes Management Programme represents this evolution in action as a shift from transactional care to proactive, personalised support.’ Holistic diabetes care For medical aids to make a measurable impact on the country’s chronic disease burden, diabetes care must evolve from a benefits table to a coordinated ecosystem. The task is to integrate the many moving parts; the family doctor, pharmacist, dietician, care coordinator and the digital tools need to be part of one ecosystem that helps patients stay engaged. Several schemes are already adopting this approach. Bonitas, for example, offers a Diabetes Management Programme that has been structured around personalisation and continuity, with the treating doctor remaining central to care and supported by a wider clinical team. This allows members with multiple chronic conditions to receive consistent, informed treatment across disciplines. Care coordination is also becoming a cornerstone of effective managed care. Schemes can effectively close the gaps that often lead to disengagement among patients by giving members direct support from healthcare professionals who guide them through treatment plans, assist with lifestyle adjustments and connect them with specialists when needed. In addition, digital tools such as mobile apps, wellness questionnaires and feedback platforms make it easier to track health metrics and access educational resources that encourage members to take ownership of their wellbeing. When used effectively, these systems support the kind of proactive healthcare that prevents complications rather than reacting to them. ‘Diabetes often progresses silently, which makes annual screenings essential for identifying risk early and preventing long-term damage. When patients are diagnosed sooner and have the knowledge and tools to manage their condition, outcomes improve for both members and the medical schemes funding their care,’ says Hadebe. For South Africa to make meaningful progress against chronic diseases like diabetes, medical aids must continue to expand their scope beyond medicine and adopt a long-term, human-centred approach. The future of healthcare lies in understanding and in giving every person the chance to live well, not just live longer.