Diabetes is a disease that occurs when the pancreas is unable to produce or use insulin well, resulting in a high blood sugar level. When the body fails to make insulin at all, this results in Type 1 diabetes. With Type 2 diabetes, the body does not produce or use insulin effectively. Both types come with side effects that are detrimental to a person’s life. On the African continent, South Africa has the second largest population of people with diabetes. Here are five facts that you should know about diabetes in South Africa:

5 Facts About Diabetes in South Africa

  1. Diabetes is a leading cause of death in South Africa. With non-communicable diseases (NCDs) like diabetes on the rise globally, South Africa is no exception. In 2016, diabetes and other NCDs caused 16% of the total deaths in the country. Among the South African population, there is a major lack of awareness of the disease and access to proper healthcare. Because the prevalence of diabetes in South African adults is 12.8%, it is crucial that other countries continue to support the funding and research of diabetes in South Africa.
  2. There are many adverse side effects for those living with diabetes. Diabetics must consistently track their blood sugar levels to ensure they don’t go into a diabetic coma. Additionally, diabetics are two times likelier to experience cardiovascular problems, like heart attacks or strokes. Diabetes can cause an individual’s kidneys to stop working. In most healthcare facilities in South Africa, they lack the procedures necessary to help a diabetic undergoing kidney failure, like renal replacement therapy by dialysis or through transplant. Another symptom of diabetes is neuropathy – or nerve damage – in the feet, which can lead to infection or potential amputation. In healthcare centers in South Africa, there is little equipment available for testing nerve damage in the feet and symptoms like this can often slip under the radar. Through an increase in funding from other countries, individuals suffering from diabetes in South Africa can have access to more equipment and medication necessary for dealing with diabetes.
  3. Socioeconomic disparities and other factors contribute to the prevalence of diabetes in South Africa. In South Africa, proper healthcare is inaccessible in poorer communities. The deficiency of experienced health professionals and respectable clinics makes it hard for citizens to undergo testing or treat the disease if they have it. More than one million citizens in South Africa do not know if they are diabetic. With more accurate and accessible testing, a greater population can begin treatment for the disease. It is crucial that the government receive funding to build diagnostic centers and train medical staff.
  4. Diabetes in South Africa is preventable and treatable in many ways. The most effective way to decrease the prevalence of diabetes in South Africa is to prematurely educate citizens and encourage healthy decision making. South Africa is currently working towards this goal. One recent preventative measure taken by the South African government is the implementation of a sugar tax. By charging more for sugary drinks and foods, the government is fighting obesity and helping citizens make more conscious decisions. In July 2019, South Africa briefly launched a Diabetes Prevention Programme (DPP). The DPP aims to integrate intervention treatments into a culturally relevant context through household questionnaires and group gatherings for at-risk individuals. In the conclusion of this program, the DPP will focus on using the information they gathered to create a curriculum that can educate communities about diabetes.
  5. Many countries and organizations help by funding testing centers and medical treatment in South African cities. The International Diabetes Federation (IDF) works with several organizations in the South African region to help combat the severity of the disease through advocacy, funding and training. The three organizations that are a part of IDF are: Diabetes South Africa (DSA), Society for Endocrinology, Metabolism and Diabetes of South Africa (SEMDSA), and Youth with Diabetes (YWD).  DSA is a nonprofit that centers around mobilizing volunteers to demand better treatment for those with diabetes, and also focuses on educating citizens and lobbying the government for better facilities and cheaper healthcare. Further, SEMDSA researches the genetic sources and causes of diabetes. This organization also promotes high standards of treatment and encourages the widespread availability of medicine.

Ultimately, it is crucial that the issue of diabetes in South Africa is at the forefront of the political agenda. With funding and research from other sources, the South African government can begin to tackle this massive health crisis.

– Danielle Kuzel
Photo: Flickr

Diabetes in Developing Countries
Type 2 diabetes results from the body’s ineffective use of insulin, a hormone that the pancreas makes and allows the body to either convert glucose into energy or store it. Insulin prevents one’s blood sugar from getting too high since it effectively removes glucose from the bloodstream. Diabetes is a major cause of blindness, kidney failure, heart attacks and stroke among other conditions. While there are many risk factors for diabetes, physical inactivity and excess body weight are two of the most significant contributors to type 2 diabetes across the globe. However, there is an increasing prevalence of type 2 diabetes in developing countries where investments in health care are often inadequate.

Diabetes in Developing Countries

Globally, the number of people with diabetes increased from 108 million in 1980 to 433 million people in 2019. Estimates determine that the global prevalence of diabetes is 9.3 percent, and about one in two people with diabetes are undiagnosed. The International Diabetes Federation projects that global prevalence will increase by 25 percent in 2030 and by 51 percent in 2045 if prevention methods and treatment programs remain unchanged.

Type 2 diabetes relates to obesity and overeating. Therefore, people in the past have associated it primarily with high-income countries, but this viewpoint is changing. The prevalence of diabetes in developing countries has been rising rapidly. In 2019, 79 percent of adults with diabetes were living in middle-low income countries.

Risk Factors of Diabetes in Developing Countries

A majority of type 2 diabetes cases are in advanced nations. However, the disease is becoming a serious problem in developing countries. Diabetes prevalence in low-middle-high SDI countries is 1.48, 3.74, and 3.42 percent, respectively. SDI refers to the Sustainable Development Index as an updated version of the human development index and measures the ecological efficiency of human development. Middle SDI countries also have the highest annual rate of increase in prevalence. The prevalence of diabetes in developing countries is growing with westernization and with the urbanization of rural areas. In Pakistan, for example, a recent study found that urban areas have a prevalence rate of 28.3 percent which was just higher than the rate of 25.3 percent in rural areas.

Obesity, a main contributor to the diabetes epidemic, is increasing rapidly in developing countries. This shift also connects with the nutrition transition. The nutrition transition results from changes in agricultural systems. Specifically, there is a decrease in fruit and vegetable consumption. There is also a rise in processed foods such as refined carbohydrates, added sweeteners, edible oils and animal products.

In many Asian populations, the risk of diabetes starts at a lower BMI than for Europeans. Additionally, increased intake of meat, oils, highly saturated ghee (a type of butter used in Asian cooking) and added sugar have also marked diet shifts in Asia. Before urbanization, physical activity counteracted the effects of high fat and sugar diets. Unfortunately, physical activity has also decreased as a result of the shift from agricultural labor to working in manufacturing services.

Preventive Methods

The current trends show that type 2 diabetes in developing countries will likely significantly increase, but these outcomes are preventable through lifestyle and dietary changes. Since treatments such as drugs and insulin are costly and developing countries have limited resources, people must prioritize prevention. It is crucial to raise awareness about the effects of lifestyle shifts on obesity and type 2 diabetes globally. Low-cost innovations include training non-medical health professionals and using mobile devices to spread awareness about type 2 diabetes prevention. In addition to technology, countries should develop solutions using networks of community health workers.

Accredited social health activist (ASHA) workers are an example of this type of intervention in Asia, where 70 percent of the population lives in rural areas with very limited access to health care facilities and skilled health workers. ASHA workers are health educators in their own communities and have the ability to care for patients at home while also providing guidance regarding diet and physical activity. Telemedicine and the use of technology support this system and keep the ASHA workers in touch with medical professionals. This intervention also offers employment to people with some medical knowledge. ASHAs are able to make money by charging low fees for their services and provide for their families.

Making cities more walkable or cyclable through urban planning can increase physical activity while taking some of the prevention weight off of health systems, especially in countries with limited health resources. Making healthy food more affordable through redesigning subsidies needs to be a priority. This is because industrialization makes processed food cheaper and more accessible. These actions require political will and an understanding of the negative implications of the growing diabetes prevalence. Such actions could make a significant difference in decreasing the epidemic globally.

Maia Cullen
Photo: Pixabay