SA’s diabetes disaster is getting even bigger

With more than 4.5 million people living with diabetes, South Africa is in the top 10 countries with increasing diabetes prevalence, according to the International Diabetes Federation’s (IDF) latest Diabetes Atlas.

Diabetes is among the top 10 causes of death, with up to half of deaths occurring in people under the age of 60 and over two million of the 4.5 million people who are undiagnosed, putting them at greater risk of developing complications.

“Diabetes is a serious threat to global health that respects neither socioeconomic status nor national boundaries,” said Groote Schuur Hospital’s Dr Naomi Levitt, a member of the Diabetes Atlas committee.

The increasing prevalence of diabetes in South Africa was a wake-up call and much could be done to reduce its impact.

“We have evidence that type 2 diabetes can often be prevented, while early diagnosis and access to appropriate care for all types of diabetes can avoid or delay complications in people living with the condition,” said Levitt. “Therefore, we must do more to prevent type 2 diabetes, diagnose all forms of diabetes early and prevent complications.”

According to Diabetes Atlas, the rise in the number of people with type 2 diabetes is driven by a complex interplay of socioeconomic, demographic, environmental and genetic factors.

Key contributing factors include urbanisation, an ageing population, decreasing levels of physical activity and increasing levels of people becoming overweight and obese.

November is World Diabetes Month, a global reminder to increase awareness of diabetes.

This year’s theme, “family and diabetes”, focuses on raising awareness of the impact that diabetes has on families. It promotes the role of the family in management, care, prevention and education about the condition.

According to the World Health Organisation (WHO), the number of people with diabetes has risen from 108 million in 1980 to 422 million in 2014. In 2016, an estimated 1.6 million deaths were directly caused by diabetes and the WHO estimated that diabetes was the seventh-leading cause of death.

“Diabetes is a chronic and progressive disease. However, people with diabetes can live long, healthy lives with good disease management. It requires not only management of blood glucose (glycaemia) levels, but also risk factors for complications such as high blood pressure and high cholesterol, which can be controlled with a healthy diet, regular physical activity and the correct use of medication as prescribed by a health provider,” said Sibonile Dube, head of communications and public affairs at pharmaceutical company Novartis.

When diabetes is undetected or when a person suffering from it is inadequately supported, they are at risk of serious and life – threatening complications, such as heart attacks, strokes, kidney failure, blindness and lower-limb amputation.

Type 1 diabetes is usually caused by an autoimmune reaction in which the body’s defence system attacks the cells that produce insulin. People with type 1 diabetes produce very little or no insulin.

The disease may affect people of any age, but usually develops in children or young adults.

People with this form of diabetes need injections of insulin to control the levels of glucose in the blood. Access to insulin is therefore absolutely crucial for people with type 1 diabetes.

The symptoms include unplanned weight loss, nausea and vomiting.

Type 2 diabetes, formerly called non-insulin dependent diabetes or adult-onset diabetes, accounts for at least 90% of all cases. The diagnosis of type 2 diabetes can occur at any age and may remain undetected for many years.

The diagnosis is often made when a complication appears, or when a routine blood or urine glucose test is done.

It is often, but not always, associated with being overweight or obese, which itself can contribute to insulin resistance and lead to high blood glucose levels.

People with type 2 diabetes can often initially manage their condition through exercise and diet. However, over time, most people will require oral medication and/ or insulin.

Type 2 diabetes is frequently not associated with any symptoms, but some patients may experience increased thirst, frequent urination, hunger, fatigue or blurred vision.

Gestational diabetes is a form of diabetes characterised by high blood glucose levels during pregnancy. It develops in one in 25 pregnancies worldwide and is associated with complications to both mother and baby.

Gestational diabetes usually disappears after pregnancy, but women with it and their children are at an increased risk of developing type 2 diabetes later in life.

Approximately half of women with a history of gestational diabetes go on to develop type 2 diabetes within five to 10 years after delivery.

Symptoms of gestational diabetes include high blood sugar during pregnancy. An affected woman might feel thirstier than normal or have to urinate more often.

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