Johannesburg, 9 November21: World Diabetes Day (WDD) is marked every year on 14 November and the 2021 to 2023 global campaign theme is “Access to Diabetes Care – If Not Now, When?”1a
If ever there were a time to focus attention on diabetes, that time is now.1b Nearly 500 million people are currently living with diabetes worldwide.1c However, access to insulin and diabetes care still remains a challenge for many.1c
The facts about diabetes
- The number of people living with diabetes is expected rise to 578 million by 2030.2a The majority have type 2 diabetes.2a
- 1 in 2 adults with diabetes remain undiagnosed (232 million).2a
- More than 3 in 4 people with diabetes live in low- and middle-income countries.2a
- 1 in 6 live births (20 million) are affected by high blood glucose (hyperglycaemia) in pregnancy.2a
- Two-thirds of people with diabetes live in urban areas and three-quarters are of working age.2a
- 1 in 5 people with diabetes (136 million) are above 65 years old.2a
- Diabetes caused 4.2 million deaths in 2019.2a
- There are about 1 in 10 South Africans with diabetes, but roughly 1 in 2 of these individuals don’t know it because it has not been diagnosed.3c
“In South Africa, the number of SA adults with diabetes has soared to more than 4.5 million people,” says Cape Town-based endocrinologist, Dr Zane Stevens. “It is a disease that is increasing globally, mostly because of unhealthy eating patterns and lack of exercise. Increased consumption of carbonated drinks and foods high in carbohydrates have contributed to unhealthy eating. We recommend a diet low in saturated fat and high in fibre. It should include grains and plenty of fruits and vegetables, as well as good fats such as olive oil, flaxseed, and walnuts. It’s important to avoid processed foods.”
What is diabetes?
Diabetes is a condition that occurs when the levels of glucose (sugar) in the body are too high, either because the body doesn’t produce enough insulin or the body doesn’t use the insulin it produces effectively.3a Insulin is a hormone necessary to carry glucose from the bloodstream into the cells where it is used for energy.3a If there is too little insulin or resistance to insulin, blood glucose levels continue to rise, because glucose is not removed from the bloodstream.3a
Dr Stevens says there are three main types of diabetes:
Type 1: Autoimmune diabetes requiring insulin treatment.
Type 2: Lifestyle related diabetes, often with a family history of the condition.
Gestational diabetes: High glucose levels occur only during pregnancy. This type of diabetes can be resolved after giving birth but can also increase the risks of Type 2 diabetes developing later in life.
People are more likely to develop diabetes if they have one or more of the following risk factors:
- Overweight or obese1b
- Physical inactivity1b
- Unhealthy diet1b
- Family history of diabetes1b
- Previous diabetes in pregnancy (gestational diabetes)1b
Type 2 diabetes is known as a “lifestyle disease” because age and overweight are the main risk factors.4a Between 60 and 90% of patients are significantly overweight.4a While the disease mostly occurs after the age of 40, there are an increasing number of cases of diabetes among obese adolescents.4a A sedentary lifestyle is also a risk factor.4a Losing weight, exercising and adopting a healthy diet are part of standard treatment.4b
“Because Type 2 diabetes emerges silently, you should see a doctor if you are at risk,” says Dr Stevens. “By adopting a healthy lifestyle, the risks and symptoms can be reduced. If treatment is prescribed in addition to lifestyle and dietary measures, the secret to it being effective is to take it properly.”
Symptoms and severe consequences of diabetes
It is important to be aware of the symptoms of diabetes and whether you are at risk, as the consequences of unmanaged diabetes can be extremely serious. The three most common symptoms of diabetes are extreme thirst5a, blurred vision5c, and extreme fatigue5e.
Between 10% and 40% of type 2 diabetics can suffer from kidney failure.5a About 1 out of 3 adults with diabetes has kidney disease.5a If you are experiencing extreme thirst, this may be a sign of diabetes.5a
Cardiovascular disease, such as heart attack and stroke, is a major cause of mortality among people with type 2 diabetes.5b If you constantly feel fatigued, this may be a symptom of diabetes and can lead to cardiovascular disease.5e Blurriness, or poor vision, is one of the most common warning signs of diabetes.5c Diabetic retinopathy is the leading cause of blindness before the age 65, which is why diagnosis is so critical.5f
Data also suggests that patients with diabetes and poor glycaemic control before infection might have an increased risk of more severe illness if they contract COVID-19 and have a higher risk of death.6a
Tips for managing diabetes
Follow these guidelines to maintain your health during the COVID-19 pandemic:
- Continue taking your diabetes medicines and insulin as usual.6a
- Test your blood sugar and keep track of the results, as directed by your healthcare provider.6a
- Make sure that you have at least a 30-day supply of your diabetes medicines, including insulin.6a
- Follow your healthcare provider’s instructions if you are feeling ill, as well as the sick day tips for people with diabetes.6a
- Call your healthcare provider if you have concerns about your condition or feel sick.6a
- If you don’t have a healthcare provider, contact your nearest community health centre or GP practice.6a
The importance of regular HbA1c testing
If you suspect you may have diabetes, or you have been diagnosed with diabetes, it is important to have the HbA1c test. The HbA1c is a laboratory blood test which reflects an average of your blood sugar (glucose) control over a two-to three-month period, making it an important indicator of whether your glucose levels are remaining within range.7a It does not represent an actual blood glucose level as you would get from the home blood glucose monitoring that is done each day.7a Diabetes care focuses on what you eat, how physically active you are and taking the correct medication at the correct time and at the correct dose.7b An HbA1c test helps you and your healthcare team to evaluate how these three elements of diabetes management are working for you.7b
Because diabetes is a ‘Prescribed Minimum Benefit’ (PMB) condition, patients on medical aid have the benefit of four free HbA1c tests per year.
Take your medication
Diabetes is a manageable condition. If you experience any warning signs, contact your healthcare provider and ask them to conduct blood tests. If you are diagnosed with diabetes, good adherence to treatment can make a big difference to maintaining a positive lifestyle. Be proactive and take your medication!
For further information, visit the Centre for Diabetes and Endocrinology here: http://www.cdediabetes.co.za/
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References:
1. International Diabetes Federation. About World Diabetes Day. [11 Oct 2021]. Available from: https://worlddiabetesday.org/about/
2. International Diabetes Federation. Facts and Figures. [11 Oct 2021]. Available from: https://worlddiabetesday.org/about/facts-figures/
3.The Heart & Stroke Foundation South Africa. Diabetes. [11 Oct 2021]. Available from: https://www.heartfoundation.co.za/diabetes/
4. Servier. Type 2 Diabetes: The Lifestyle Disease. Mediator Information. [11 Oct 2021]. Available from: https://servier.com/en/informations-mediator/
5. Servier. Act Now for Diabetes. Campaign at a Glance. [11 Oct 2021].
6. Centers for Disease Control and Prevention (CDC). Coronavirus Disease 2019 (COVID-19). People with Certain Medical Conditions. [11 Oct 2021]. Available from: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fneed-extra-precaution%E2%80%A6
7. Cardiovascular Diabetes Education (CDE). Understanding your HbA1c test. [20 Oct 2011]. Available from: /www.cdediabetes.co.za/uploads/images/files/Understanding%20your%20HbA1c%20test.pdf
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