Diabetes: education key to fighting a ‘silent killer’
Diabetes is known as a "silent killer" among health workers because many people don’t realise they have the chronic metabolic disease that can cause blindness, kidney failure, heart attacks, stroke and lower limb amputation.
According to a World Health Organization fact sheet, published on November 14, World Diabetes Day, the number of people living with diabetes rose from 200 million in 1990 to 830 million in 2022. Prevalence has been rising more rapidly in low- and middle-income countries than in high-income countries.
In 2021, diabetes was the direct cause of 1.6 million deaths, and 47% of all deaths due to diabetes occurred before the age of 70. Another 530 000 kidney disease deaths were caused by diabetes, and high blood glucose causes around 11% of cardiovascular deaths. And since 2000, mortality rates from diabetes have been climbing.
Diabetes, notes the WHO, is characterised by elevated levels of blood glucose (or blood sugar), which leads over time to serious damage to the heart, blood vessels, eyes, kidneys and nerves. The most common is type-2 diabetes, usually in adults, which occurs when the body becomes resistant to insulin or doesn't make enough insulin. Type-1 diabetes, once known as juvenile diabetes or insulin-dependent diabetes, is a chronic condition in which the pancreas produces little or no insulin by itself.
Early detection and treatment and education play a vital role in tackling diabetes, say health experts, and “Breaking Barriers, Bridging Gaps” the theme for World Diabetes Day this year stressed the importance of improving access to quality health-care, according to Red Cross War Memorial Children’s Hospital, Groote Schuur Hospital and Tygerberg Hospital.
The Fish Hoek Lions Club, as part of its commitment to fighting diabetes - one of the core pillars of Lions Clubs International - held a wellness day at Longbeach Mall on Saturday November 16, to raise awareness and promote early detection.
The club screened 133 people for diabetes during the event, which was organised in support of Diabetes Awareness Month.
In addition to screening for diabetes, other free health tests included 27 eye screenings, 34 hearing tests, 49 blood grouping tests, 12 blood tests for prostate cancer, and 48 breast exams, said club president Mandy Proctor.
Most of those tested had blood sugar levels within a healthy range, but several diabetics had very high blood sugar levels and were advised to have their medication adjusted, she said.
Some of those tested had not realised they might have pre-diabetes or even diabetes, and they were given information on the disease and advice on the next steps, said Ms Proctor.
“It is these cases that we are particularly pleased to have identified so that these people can get the help they need. At Fish Hoek Lions Club, we aim to raise awareness, promote testing, and empower our community with the knowledge and resources to manage and prevent diabetes effectively," she said.
According to the WHO, lifestyle changes, such as maintaining a healthy weight, exercise, a healthy diet that avoids sugar and saturated fats and quitting smoking, are the best ways to prevent or delay the onset of type 2 diabetes.
Dr Michelle Carrihill, a paediatric endocrinologist at the Red Cross War Memorial Children’s Hospital, said the hospital saw around three to five newly diagnosed patients a month and most children presented with type 1 diabetes, often in a critical condition.
“According to our registry, over the last six years, we have averaged around 50 new patients per year. However, this number can vary significantly, with as few as three or as many as 12 new cases in a single month. Our primary concern is that many young patients with diabetes arrive very sick, sometimes requiring ICU admission, which can be traumatic for both the children and their families,” she said.
Dr Carrihill said common symptoms in children include sudden bed wetting or frequent urination, increased thirst, weight loss or not picking up weight, difficulty concentrating at school, vision problems, and vomiting.
Early detection was crucial in preventing severe illness, she said.
The hospital also provides care to children with type 2 diabetes.
“Obesity is a concern in children and children can develop type 2 diabetes. We are seeing more type 1 diabetic children presenting earlier because they’re overweight or obese and need more insulin, which their pancreas can’t produce. Some of our patients are as young as 6 or 7 years old,” she said, adding that they also saw cases of “double diabetes”, where children had both type 1 and type 2 diabetes.
Prevention began in utero with healthy pregnant mothers, she said.
Antenatal care should include education on healthy eating, which continues with healthy feeding and breastfeeding after birth which can reduce the risk of diabetes.
“Families need to be educated on nutritious meals and the dangers of processed foods, starting in schools and extending beyond.”
Dr Marli Conradie-Smit, head of endocrinology at Tygerberg Hospital, said the hospital’s adult diabetes clinics treated between 109 type 1 to 190 type 2 patients a month with about six new cases each week.
In adults, she said, the most common type of diabetes was type 2.
Dr James Rice, head of the retina service at Groote Schuur Hospital’s ophthalmology department, said the hospital had conducted 456 retinal operations between January 2023 and June 2024, of which 256 (57%) involved diabetic eye problems.
Diabetic eye problems, he said, specifically a condition called diabetic retinopathy, could be prevented if caught early enough. There were ways to prevent it before it became serious, using strategies to stop the disease from getting worse.
“Eye screening is an important part of managing your condition, regardless of the type of diabetes you have. As diabetic retinopathy does not show any symptoms in the early stages when they are most treatable, it can become quite advanced before you start to notice it,” he said.
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