Background In South Africa, diabetes prevalence is expected to reach 5.4 million by 2030. In South Africa, diabetes-related complications severely impact not only patient health and quality of life but also the economy. Objective The Diabetes Nurse Educator (DNE) study assessed the benefit of adding the MyDiaCare program to standard of care for managing patients with type 1 and type 2 diabetes in South Africa. An economic study was also performed to estimate the budget impact of adding MyDiaCare to standard of care for patients with type 2 diabetes older than 19 years treated in the South African private health care sector. Methods The real-world DNE study was designed as an observational, retrospective, multicenter, single-group study. Eligible patients were older than 18 years and had at least 6 months of participation in the MyDiaCare program. The MyDiaCare program combines a patient mobile app and a health care professional platform with face-to-face visits with a DNE. The benefit of MyDiaCare was assessed by the changes in glycated hemoglobin (HbA1c) levels, the proportion of patients achieving clinical and biological targets, adherence to care plans, and satisfaction after 6 months of participating in the MyDiaCare program. A budget impact model was performed using data from the DNE study and another South African cohort of the DISCOVERY study to estimate the economic impact of MyDiaCare. Results Between November 25, 2019, and June 30, 2020, a total of 117 patients (8 with type 1 diabetes and 109 with type 2 diabetes) were enrolled in 2 centers. After 6 months of MyDiaCare, a clinically relevant decrease in mean HbA1c levels of 0.6% from 7.8% to 7.2% was observed. Furthermore, 54% (43/79) of patients reached or maintained their HbA1c targets at 6 months. Most patients achieved their targets for blood pressure (53/79, 67% for systolic and 70/79, 89% for diastolic blood pressure) and lipid parameters (49/71, 69% for low-density-lipoprotein [LDL] cholesterol, 41/71, 58% for high-density-lipoprotein [HDL] cholesterol, and 59/71, 83% for total cholesterol), but fewer patients achieved their targets for triglycerides (32/70, 46%), waist circumference (12/68, 18%), and body weight (13/76, 17%). The mean overall adherence to the MyDiaCare care plan was 93%. Most patients (87/117, 74%) were satisfied with the MyDiaCare program. The net budget impact per patient with type 2 diabetes, older than 19 years, treated in the private sector using MyDiaCare was estimated to be approximately South African Rands (ZAR) 71,023 (US $4089) during the first year of introducing MyDiaCare. Conclusions The results of using MyDiaCare program, which combines digital tools for patients and health care professionals with DNE support, suggest that it may be a clinically effective and cost-saving solution for diabetes management in the South African private health care sector.

BACKGROUND In South Africa, diabetes prevalence is expected to reach 5.4 million by 2030. Moreover, a large proportion of adults remain undiagnosed. In South Africa, diabetes-related complications not only severely impact patient health and quality of life, but also the economy. OBJECTIVE The Diabetes Nurse Educator (DNE) study assessed the benefit of adding the MyDiaCare program to standard of care for managing type 1 and 2 diabetes patients in South Africa. An economic study was also performed to assess the benefit of adding MyDiaCare to standard of care in type 2 diabetes patients, older than 19 years, treated in the South African private healthcare sector. METHODS The real-world DNE study was designed as an observational, retrospective, multicenter, single group study. Eligible patients were older than 18 years and with at least 6 months of participation in the MyDiaCare program. The MyDiaCare program combines patient mobile application and a healthcare professional platform with face-to face visits with a DNE. The benefit of MyDiaCare was assessed by the changes in HbA1c levels, the proportion of patient achieving clinical and biological targets, adherence to care plans, and satisfaction after 6 months of participating in the MyDiaCare program. A budget impact model was performed using data from the DNE study and another South African cohort to estimate the economic benefit of MyDiaCare. RESULTS Between 25 November 2019 and 30 June 2020, 117 patients (8 with type 1 diabetes and 109 with type 2) were enrolled in two centers. After 6 months of MyDiaCare, a clinically relevant decrease in mean glycated hemoglobin (HbA1c) levels by 0.6% from 7.8% to 7.2% was observed. Furthermore, 54% of patients reached or maintained their HbA1c targets at 6 months. Most patients achieved their targets for blood pressure (67% for systolic and 89% for diastolic blood pressure) and lipid parameters (69% for low-density lipoprotein (LDL) cholesterol, 58% for high-density lipoprotein (HDL) cholesterol, and 83% for total cholesterol, but fewer patients for triglycerides (46%), waist circumference (18%), and body weight (17%). The mean overall adherence to the MyDiaCare care plan was 93%. Most patients (74%) were satisfied with the MyDiaCare program. The economic study estimated that after 1 year of using the MyDiaCare program, the cost of type 2 diabetes management in the South African private healthcare sector would be reduced by 26 billion rands: from 117 billion rands with standard of care to 91 billion rands by adding MyDiaCare. CONCLUSIONS The MyDiaCare program, that combines digital tools for patients and healthcare professionals with DNE support, is a practical, clinically effective (lowering HbA1c levels and other cardiovascular risk factors), and cost-saving solution for diabetes management in the South African private healthcare sector. CLINICALTRIAL Not applicable.