Diabetes is a global health crisis that affects millions of people worldwide. In 2021 alone, there were a staggering 529 million individuals living with this condition. South Africa, in particular, had 4.2 million diabetes cases, with the majority being type 2 diabetes.
What's even more alarming is that approximately half of all diabetes cases go undiagnosed, leaving people without the necessary treatment and putting their health at serious risk.
Type 1 diabetes (T1D) can develop at any age, but it is most commonly diagnosed in children and adolescents. This form of diabetes occurs when the pancreas fails to produce enough insulin to regulate glucose levels effectively.
On the other hand, type 2 diabetes (T2D) primarily affects adults. However, there has been a concerning rise in its diagnosis among children due to the increasing prevalence of overweight and obesity in this age group.
Weight plays a significant role in the development of type 2 diabetes. Up to 90% of adults with this condition fall into the overweight or obese category. This connection highlights the importance of maintaining a healthy weight to reduce the risk of developing the disease.
According to the Discovery Health Medical Scheme, the prevalence of diabetes in South Africa has been steadily increasing.
From 2018 to the present, the Discovery Health Medical Scheme (DHMS) said that they have witnessed a 5.9% annual rise in diabetes cases among its members. Currently, over 148,000 DHMS members have been diagnosed with diabetes. Traditionally, type 2 diabetes has been considered a progressive disease.
However, recent medical and lifestyle interventions have shown promising results in halting its progression. Through weight reduction and other interventions, glucose levels can return to normal, leading to the reversal of the condition without the need for ongoing medical treatment.
As World Diabetes Day was commemorated this month with this year's theme, “Know your risk, Know your response,” it brings forward the importance of understanding risk factors and taking appropriate action. Experts also believe that it highlights the potential for achieving diabetes remission.
Clinical leaders, including Dr Mosima Mabunda, head of Vitality Wellness, and Dr Noluthando Nematswerani, chief clinical officer at Discovery Health, stressed the significance of knowing your risk and managing your weight in combating diabetes.
They share the same sentiments that diabetes can be well controlled, leading to a significant reduction in long-term health risks and the possibility of achieving remission.
Meanwhile, the International Diabetes Federation described type 2 diabetes as a “pandemic of unprecedented magnitude, spiralling out of control.” It is currently one of the top ten leading causes of death globally, with at least 1.5 million deaths directly attributed to diabetes each year.
They estimated that by 2050, the number of people living with diabetes will reach 1.31 billion. Already 4.2 million people in South Africa are living with diabetes, according to DHMS experts.
In addition, the cost of treating diabetes in the country's state healthcare sector alone amounts to nearly R20 billion annually. More than half of the people living with diabetes in the African Region remain undiagnosed, totalling 54% of cases.
And while type 1 diabetes remains the most prevalent form of the disease in children, there has been a concerning increase in type 2 diabetes cases.
Experts estimate that one in three new diabetes diagnoses in children in 2023 will be type 2 diabetes, primarily due to the global rise in childhood obesity and physical inactivity.
The World Obesity Federation predicts that by 2035, over four billion people worldwide will be overweight or obese, with 1.5 billion adults and nearly 400 million children living with obesity.
South Africa is facing high rates of overweight and obesity, both in adults and children. By 2030, it is estimated that 37% of local adults (primarily women) and 27% of children (the highest rates on the African continent) will be obese.
Factors such as the availability and consumption of high-calorie and ultra-processed foods, as well as insufficient physical activity levels, contribute to this problem.
Mabunda, an expert in the field, highlighted the need for action, stating, “In South Africa, 31% of men and 68% of women are overweight or obese.”
It's also crucial to address the connection between diabetes and mental illness, experts believe. Studies show that individuals with both conditions are 7% less likely to adhere to their diabetes medication regime. It is also believed that holistic management that takes into account mental health is essential for effectively managing diabetes.
There is an urgent need to support individuals at risk of or already diagnosed with type 2 diabetes to prevent or control the disease.
“Remission means that the person no longer experiences persistent high blood glucose levels,” Nematswerani explained. “It is very important to maintain regular check-ups to ensure that the diabetes remains in remission.”
Mabunda also stressed the importance of regular health checks that can detect warning signs of diabetes.
He also encouraged engaging in healthy lifestyle behaviours, such as regular physical activity, a balanced diet, and maintaining a healthy weight, as crucial ways to prevent or manage the risk of diabetes.