World Diabetes Day was on 14 November and the International Diabetes Federation published a study that found that a staggering 12% of the adult population in South Africa, about 4.5 million people, are living with diabetes, putting them at risk of life-threatening complications.
Luleka Mzuzu only found out about her type 2 diagnosis when she woke up in the hospital in 2015 after fainting on her way home from work. Luleka had no major warning until then - she thought she was simply a little stressed and overworked. The unexpected news of the serious diagnosis left her and her family in shock and worried about her future. She was the first one in the family to be diagnosed with diabetes.
"When I found out that I was diabetic I was confused and scared. I was scared that I was going to die and I was scared that I would have to be amputated because I didn't have information about diabetes and in my head it was a very scary thought because I was sent to ICU," said Mzuzu.
Mzuzu struggled with lack of information about the condition and its treatment in the first months after her diagnosis. She was at first shy to talk about living with diabetes to her colleagues and friends, given the stigma that surrounds the condition. Only later, when she consulted a dietician, she found out that diabetes was completely different from what she had originally thought about the condition.
"It has changed [our family] a lot. Whatever we eat, we're more cautious about reading the labels. We try and walk the dogs, play with the kids, we're more active than usual now and we try to not buy takeaways as much as we used to. My kids know what to eat, what not to eat. They knows why we exercise and we try to educate them as much as we can and we try to live a healthy lifestyle," said Mzuzu.
South Africa is among the top ten countries when it comes to the prevalence of diabetes. Over two million of the 4.5 million citizens estimated to be living with diabetes are undiagnosed and as a result, may be particularly at risk.
According to the World Health Organisation diabetes is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. Insulin is a hormone that regulates blood sugar. Hyperglycaemia, or raised blood sugar, is a common effect of uncontrolled diabetes and over time leads to serious damage to many of the body's systems, especially the nerves and blood vessels.
Globally, over 400 million people are estimated to be living with diabetes and 46% of people with diabetes are undiagnosed. The figure is expected to rise to 642 million people living with diabetes worldwide by 2040.
According to the report, the rise in the number of people with type 2 diabetes is driven by a complex interplay of socio-economic, demographic, environmental and genetic factors. Key contributors include urbanisation, an ageing population, decreasing levels of physical activity and increasing levels of overweight and obesity.
Diabetes has an impact on all age groups, regardless of geography and income. Globally, over 1.1 million children and adolescents are living with type 1 diabetes, while three in every four people with diabetes are between the ages of 20 and 64. The rise in prevalence is putting a strain on the capacity of countries to guarantee regular and affordable access to essential medicines and appropriate care. This leaves many struggling to manage their diabetes, placing their health at serious risk.
"Diabetes is a serious threat to global health that respects neither socioeconomic status nor national boundaries," said Dr Dinky Levitt from Groote Schuur Hospital and University of Cape Town. "The increasing prevalence of diabetes in South Africa is a wake-up call. Much can be done to reduce the impact of diabetes."
When diabetes is undetected or when there is inadequate support, people with diabetes are at risk of serious and life-threatening complications, such as heart attack, stroke, kidney failure, blindness and lower-limb amputation. These result in reduced quality of life and higher healthcare costs, and place undue stress on families.
"We have evidence that type 2 diabetes can often be prevented, while early diagnosis and access to appropriate care for all types of diabetes can avoid or delay complications in people living with the condition. We must do more to prevent type 2 diabetes and we must ensure that every person with diabetes has uninterrupted access to the quality care they need in their communities," said Levitt.
"I realised that awareness about diabetes and general education about our wellbeing is not out there and people are not aware of the symptoms, they don't know how to live with diabetes and they don't have information," said Mzuzu. "When they go to the clinic, they get their medication but when they get home they default on their medication because one day their sugar levels are fine and they tell themselves I don't need to inject today or I don't need to drink my tablet today. So I realized I had the information, especially in my community."
She has started a support group to help share information about diabetes among people with the same diagnosis.