Diabetes is on the rise in South Africa, as more people give in to bad lifestyle choices, experts say.
This is especially troubling in 2020 as diabetics are the highest risk group for serious illness and death if they contract Covid-19.
It can also lead to a range of problems if not properly managed, like kidney failure, heart attacks, strokes, blindness and lower limb amputation.
“It’s a horrible disease to have. There are so many complications that can occur,” says Dr Valencia Eagles, a physician at Mediclinic Louis Leipoldt in Bellville.
“Yet it’s very treatable.”
World Diabetes Day was observed this past Saturday and TygerBurger went to find out more about this disease.
What is diabetes? And type 1 and 2?
Eagles says those suffering from diabetes can’t make enough insulin or can’t effectively use the insulin they do make.
“It’s basically an insulin deficiency.”
Those born with the illness are categorised as type 1 diabetics and those who develop the illness later in life (usually because of lifestyle) are type 2 diabetics, but as with everything there are exceptions to this.
The disease is treated by controlling the diet and giving insulin – via injection or insulin pumps.
Initially, those with type 2 diabetes are given tablets sensitising their bodies to insulin.
They later undergo a test which shows the average level of blood sugar over the past two to three months.
This should be under 7. If not, something needs to change – whether diet or stronger medication.
She says type 2 diabetics, who are often older and overweight, are typically not compliant when it comes to adjusting their diets, which is frustrating when one keeps the risks in mind.
“This is the biggest problem I have – insight into the disease and compliance to the diet. Many people just don’t know. And sometimes you get wilful people who just don’t want to eat healthy foods.”
In the end, you’re the one living with the illness, she emphasises. Depend on yourself to fix the things you can (like your diet) and not on the doctor to prescribe stronger medication.
On the rise
Eagles says type 2 diabetes is definitely on the rise. “It’s cheaper to buy McDonald’s than it is to buy healthy foods,” she explains.
But it’s also not that simple, she says. People are working three jobs and it’s often just more convenient to eat unhealthy.
People also often underestimate which foods have the most sugar-like carbohydrates like bread, rice and potatoes.
“Because it’s not sweet. And (carbohydrates) are the staple of many people’s diet. It also contributes a lot to belly fat.
Another problem she sees often is that people are scared and therefore resistant to insulin.
“We shouldn’t see it as a last resort.” People are often also unnecessarily scared of using needles.
Dr Iqbal Karbanee, CEO of Paed-IQ BabyLine, a 24/7 telephonic-based helpline for medical advice, given by paediatric-trained nurses, agrees.
Karbanee, who works as a paediatrician at Cape Gate Mediclinic in Brackenfell, says he has seen diabetes in children rise dramatically.
“Oftentimes parents believe that it is only the child that needs to undergo changes to curb the onset of obesity, when in fact it is an opportunity for the whole family to make lifestyle changes,” he explains.
According to Karbanee, it is not a low rate of physical activity that can lead to obesity, but rather a poor diet.
“The dynamic of a rapidly urbanised population exposed to a myriad of food choices has led to major dietary changes. Coupled with socio-economic and genetic factors, obesity is a complicated disease that can lead to Type 2 diabetes. Both these lifestyle diseases are 100% preventable,” says Karbanee.
“Furthermore, diabetes can occur in children from a very young age. Although far less common than adult-onset diabetes, when it does occur it has a major impact on the child and family.”
Diabetes and Covid-19 and the Western Cape’s response
Eagles says those with diabetes are at risk of a severer infection of Covid-19. Added to this, many type 2 diabetics are often more overweight, which is an additional comorbidity.
“Obesity is a co-morbidity meaning that if your child is suffering from carrying excess weight, he or she is at increased risk of complications if diagnosed with the coronavirus,” says Karbanee.
Premier Alan Winde is a diabetic himself and in a press statement released earlier this week, he said it is a cause close to his heart. Earlier this year the Western Cape Government introduced the Vector (Virtual Emergency Care Tactical Operation) programme.
This programme saw doctors consulting telephonically with diabetic patients who had tested positive for Covid-19. They screened the patients according to their risk factors and referred those with the highest risk to facilities for observation.
“Between the launch of the Vector programme (in July) and 30 October, 1 786 patients have been placed on the programme,” Winde said in his statement.
“Of these, 1 488 had fully recovered by 30 October. We also saw a significant decline in the death rates associated with this group, which were at about 28% prior to our interventions, and fell to below 5% within the first month of operations.”
The following are warning signs for diabetes. Visit a healthcare facility for a diabetes test if you experience one or more of the following:
These symptoms can all occur within a short period of time - a few weeks or a month or two.
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