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Diabetes South Africa: A picture of the condition in SA

Diabetes South Africa: what is the story? We all know that more and more people are now living with Type 2 diabetes. It used to be seen as a condition for the wealthy, but today it’s increasingly common in every community – rich and poor. Nicole McCreedy takes a look.

Diabetes in South Africa

Diabetes in South Africa is often associated with the Indian community among whom – compared with other cultures – it is more widespread. According to a study by the Human Sciences Research Council and Medical Research Council, 61% of South African Indians over the age of 45 have pre-diabetes, and are more likely, with age, to develop Type 2 diabetes.

But the Indian community is no longer the only group facing the diabetes challenge. It is now being reported as one of the leading causes of death in areas where diabetes was once unheard of.

The rapid rise in diabetes

There are a number of factors that put a person at risk for developing Type 2 diabetes (here are the risk factors in a 1-minute video). A family history of the condition, your lifestyle – what you eat, whether you smoke and how often you exercise – as well as your environment all play a role.

In the past, the Indian and white population in South Africa were more likely to be urbanised and wealthier, while Africans lived in the rural areas. Living in an urban environment often means longer hours at work, commuting and easy access to cheap fast foods. This type of lifestyle is linked to higher levels of overweight and obesity, and in turn diabetes. A study from 2005 found South African Indians ticked all the boxes: a diet low in fibre and high in unhealthy fats, physical inactivity, and insulin resistance.

However, in recent decades, South Africa has undergone both political and economic change. As a result, many people living in rural areas, especially Africans, have moved to cities for work and better opportunities. Being less physically active and eating a more Western diet (high in carbs and fats) is contributing to the growing diabetes burden in the African and coloured communities.

South Africans are overweight

The relationship between overweight/obesity and Type 2 diabetes is critical. An unhealthy diet and not enough exercise can lead to being overweight or obese. Carrying extra weight, especially belly fat, is bad for your health, specifically leading to insulin resistance, high cholesterol and high blood pressure. All of which are damaging to long-term health.

What’s scary is that in South Africa, 7 out of 10 women and 4 out of 10 men have significantly more body fat than is healthy. The issue of overweight and obesity is emerging as a particular health concern among black women living in urban areas where there is a high rate of HIV. Weight gain, especially among black women, has always been seen as a sign of wealth, health and success in traditional African society, while being thin is associated with being HIV-infected. But overweight and obesity is also linked to diabetes. In a study on body perception among urban-dwelling black women, as many as 90% were overweight and obese, while almost three-quarters had diabetes.

The next generation

Your lifestyle not only affects your own health; it can also impact the health of your children. High blood sugar levels in pregnancy impact the unborn baby’s genes, making them more vulnerable to Type 2 diabetes later in life. Babies exposed to high blood sugar in the womb may have a higher birth weight and this can continue into adulthood with serious effects on their long-term health. Among South African Indians, where high blood sugar has been a problem for much longer, diabetes is now showing up at a much younger age than ten years ago – as early as between 25 to 45 years old.

Diabetes South Africa: the problem

For many individuals, diabetes is a problem they don’t want to acknowledge. “A big concern is that people with diabetes are not taking their condition seriously enough,” says Jenny Russell from Diabetes South Africa’s Durban branch. “They want to swallow their tablets and carry on their unhealthy lifestyles.” According to Jenny, “in the Indian community, it is almost accepted as ‘normal’ that if you have diabetes, you will have diabetes-related complications: limb amputation, blindness or needing kidney dialysis.”

Others struggle with feelings of guilt. But whatever your culture, as Jeannie Berg, a pharmacist and diabetes educator in Mpumalanga, says:

“Diabetes is the same for everyone. Don’t let it define your life: it is not who you are, it is a part of your life you need to manage.”

Find out more about Diabetes South Africa (the organisation) at

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  1. Pieter Pieter

    I am 1.8 meters and weigh 80kg. I have never smoked and exercise three times a week – 5 hours in total above 80% of my max heartrate. I have a healthy low carb diet

    I am a type 2 diabetic and in my case it has nothing to do with being obese, lazy, smoking or lifestyle. Diabetes is not always something you did wrong. It can not always be prevented.
    Despite my diabetes I have an active lifestyle and do the thinds I enjoy but just keep the diabetes in mind in all my choices.

    If you do have or develop diabetes, learn about this illness and manage your life with it – don’t let diabetes dictate your life and make you feel like a victim!

    • I couldn’t agree more, Pieter! I think Type 2 has such a stigma attached because the general media classifies it only as a lifestyle disease, without mentioning that there’s a genetic component.
      Keep up the great work!

  2. Joey labuschagne Joey labuschagne

    I was diagnosed with diabetes on 3 rd of December 2014 after having a ❤️ hearth attach. I received a stent on the day I had the ❤️ hearth attack 19th March 2014. I have to manage two diets, one for the heart and one for diabetes. After one year I notic bolting to the extreme when eating any green veg, Doctor told me to leave it. My age is 65. I was diagnosed at 18.6 and is now standing at 6.6, with not really having any decent diet I get pain in my legs and hands I have also start taking vitamin tablets. I also spike with my sugar dropping very low.

    • Wow, Joey, what an experience! Do you have a diabetes specialist? And a dietician? Your blood sugar is amazing with having to balance all that…

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Sweet Life is a registered NPO/PBO (220-984) with a single goal: to improve diabetes in South Africa. We are funded by sponsorships and donations from aligned companies and organisations who believe in our work. We only share information that we believe benefits our community. While some of this information is linked to specific brands, it is not an official endorsement of that brand. We believe in empowering people with diabetes to make the best decisions they can, to live a healthy, happy life with diabetes.