The number of SA adults with diabetes has soared to 4.5-million people, more than double the figure estimated in 2017, according to a new report from the International Diabetes Federation (IDF) released on Thursday.

It means SA now has the highest proportion of adult diabetics on the continent, and the greatest number of deaths due to the disease.

The IDF’s 2019 Diabetes Atlas shows 12.7% of adults in SA have diabetes in 2019, a 137% increase on the 2017 figure of 5.4%. The figures are age-adjusted to allow comparisons between countries that take account of the differences in their populations’ age structure.

The report adds weight to a forecasting study published in the Lancet medical journal last year, which predicted a large global shift in deaths from infectious diseases to deaths from noncommunicable diseases such as diabetes, chronic obstructive pulmonary disease, kidney disease and lung cancer.

The Lancet study found the top causes of death in SA in 2016 were HIV/Aids, lower respiratory infections and road injuries, with diabetes coming in sixth. By 2040, however, diabetes was predicted to be the leading cause of death, followed by road injuries, and lower respiratory infections.

Diabetes is a lifelong condition in which the body either cannot make enough insulin or cannot effectively use what it produces.

“The increasing prevalence of diabetes in SA is a wake-up call,” said Dinky Levitt from Groote Schuur Hospital and the University of Cape Town, and a member of the IDF Diabetes Atlas committee. She described diabetes as a “serious threat to global health that respects neither socioeconomic status nor national boundaries”.

The IDF said both type 1 diabetes and the more common type 2 diabetes were on the rise.

The growing number of people with type 2 diabetes was driven by a complex interplay of socioeconomic, demographic, environmental and genetic factors that included urbanisation, insufficient physical exercise, and increasing levels of obesity. Type 1 diabetes was less well understood.

Levitt said there was strong evidence that type 2 diabetes could be prevented with a healthy lifestyle, and that early diagnosis and access to care for all types of diabetes could avoid or delay complications.

“We must ensure that every person with diabetes has uninterrupted access to the quality care they need in their communities,” she said.

Worldwide half the people with diabetes are undiagnosed, and in SA the figures are not much better. An estimated 2-million South Africans do not know they have diabetes, according to the IDF.

Globally, an estimated 463-million adults are living with diabetes and there are 19-million in Africa alone. Type 2 diabetes accounts for up to 90% of the total, it said.


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