Diabetes is one of South Africa’s most urgent and fastest growing health challenges, and early action remains the strongest defence against its long-term impact.
There is an urgent need for greater awareness of the early signs of diabetes, the importance of timely treatment to achieve optimal glycaemic control, and the need for care that supports both physical and emotional well-being.
“Insulin remains essential and irreplaceable in managing diabetes,” says Dr Rust Theron, physician at Mediclinic Durbanville. “Despite advances in treatment options, insulin remains the cornerstone for achieving and maintaining glycaemic control (control of blood sugar) when oral medicines alone are no longer enough.
“It’s vital to start or intensify insulin therapy at the right time and without delay. Timely insulinisation helps prevent complications, preserves long-term health outcomes and empowers people with diabetes to live well.”
He explains that South African eating habits have shifted sharply over time, contributing to a growing burden of diabetes. “Healthier food choices like fruit and vegetables are not always at the top of shopping lists. On average, South Africans consume about twice the recommended daily amount of salt and sugar. These trends contribute to a growing burden of diabetes and other non-communicable diseases.”
Type 1 and Type 2 diabetes are different conditions, but both require lifelong management:
- • Type 1 diabetes is an autoimmune condition in which the body cannot produce insulin at all.
- • Type 2 diabetes, which affects about 90% of people living with the disease, develops when the body does not produce enough insulin or cannot use it effectively.
Pregnant women who have high risk factors (e.g. overweight/obesity; family history) also have the potential to develop gestational diabetes.
Both Type 1 and Type 2 diabetes can lead to serious complications if blood glucose levels remain high for too long. These complications include heart disease, kidney disease, nerve damage and vision loss.
Many people do not recognise the symptoms
Because Type 2 diabetes often appears gradually, symptoms may be dismissed as stress or ageing.
The five most common symptoms are:
- • Needing to urinate more than usual, especially at night
- • Constant thirst
- • Increased hunger
- • Unexplained weight loss
- • Extreme tiredness
Anyone experiencing symptoms, or who is at risk, should consult a healthcare professional for blood glucose testing.
“Early diagnosis is a critical step in preventing irreversible damage,” says Dr Theron. “Furthermore, delayed diagnosis and poor glycaemic control increase the risk of serious and costly complications including heart disease, stroke, kidney failure, blindness, nerve damage, amputations and pregnancy-related complications.
“These outcomes not only affect individuals and families but also place an increasing financial and operational burden on South Africa’s healthcare system,” he adds.
Identifying diabetes early is one of the most effective ways to stop the silent, ongoing damage that occurs long before symptoms are obvious. A simple finger-prick blood glucose test at a pharmacy or clinic takes less than five minutes and provides immediate results.
Timely treatment supports long-term health
Because Type 2 diabetes progresses, treatment needs to change in line with the patient’s needs. For many people, a glucocentric approach focused on blood glucose–lowering medicines is effective in the early stages.
But as the body’s ability to maintain glycaemic control declines, additional support may become necessary. When oral medicines are no longer sufficient, initiating insulin at the appropriate time helps prevent complications and supports better long-term outcomes.
“The message: The Right Patient. The Right Insulin. The Right Time emphasises the need for individualised care,” says Dr Theron. “Individualised insulin therapy ensures optimal glycaemic control. Not everyone needs insulin at the same stage. Treatment decisions depend on lifestyle, risk factors, symptoms, fasting patterns and overall health.
“The important thing is to start the right treatment at the right time, with guidance from a healthcare professional. That’s how we protect long-term health and quality of life.”
Diabetes also impacts emotional well-being
According to the International Diabetes Federation (IDF), 589 million people worldwide are living with diabetes. In South Africa, an estimated 2.3 million adults are affected – highlighting the urgent need for improved awareness, earlier diagnosis and better long-term management.
Diabetes affects how people feel every day. Fluctuating glucose levels (poor glycaemic control) can lead to pressure, guilt, fear, frustration or burnout. Effective diabetes care must support both physical health and the psychological resilience patients need.
A global survey by the IDF shows that:
- • 77% of people living with diabetes have experienced anxiety or depression linked to their condition.
- • The fear of developing complications (83%) was the biggest driver of emotional distress.
Other significant factors included: the pressures of daily diabetes management (76%); stigma or discrimination (58%); fear of needles (55%). This emotional strain can make day-to-day management significantly more challenging.
“Living with diabetes means making continuous, often complex decisions about food, medication, activity and daily routines,” says Dr Theron. “You may experience pressure, guilt, fear, frustration or even burnout when your glucose levels fluctuate. That emotional burden can erode your confidence and affect your overall well-being. Effective diabetes care must support both physical health and the psychological resilience patients need to manage the condition sustainably.”
A call for awareness, early testing and personalised support
Recognising the signs early and having an open conversation with a doctor or nurse about your symptoms, risks and treatment options – including whether it may be time to consider insulin – can make a real difference to your long-term health.
If you’re worried about your glucose levels or feel your current treatment isn’t working as well as it used to, reach out to your healthcare provider. Together, you can decide on the next steps that will give you the best chance of staying well and maintaining the quality of life you deserve.
Image credit: Magnific/DC Studio
