Diabetes Pandemic - South African overview

-By Dr. Marlo Swanepoel
 
Diabetes mellitus (aka sugar diabetes as called by many south Africans) is a metabolic disorder in which the body becomes resistant to the effect of insulin or where the body does not produce enough of insulin. Therefore, there is a build-up of glucose (sugar), in the body. This excess glucose can lead to serious health complications.
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During 2016 and 2017, Diabetes was the second leading underlying cause of death in South Africa and the number one cause of death in females.
It was estimated that 4.58 million people between the ages 20 and 79 years old suffered with diabetes in South Africa in 2019. There was a rapid increase in the prevalence of diabetes, from 4.5% in 2010 to 12.7% in 2019. This caused South Africa to be named the unhealthiest county in the world in 2019. This in turn lead to the sugar tax being implemented and increased by the South African Government in order to fight the global Diabetes pandemic.
 
Types of Diabetes Mellitus
There are two main types of Diabetes Mellitus:

• Type 1 Diabetes Mellitus
  • is due to an autoimmune disease affecting the pancreas, resulting in the inability to produce insulin thus leading to elevated glucose levels
  • Irreversible
  • Autoimmune related
  • Requires exogenous insulin

 

• Type 2 Diabetes Mellitus
  • is due to insulin resistance, where the body does not use or respond to the insulin produced thus leading to high blood glucose levels
  • Revisable
  • Lifestyle related
  • Does not always require exogenous insulin
  • Type 2 Diabetes is the most common form of Diabetes. It accounts for more than 90% of all Diabetes cases. It is caused mainly by excess carbohydrate and sugar consumption and a lack of activity or exercise.

 
 
Testing for Diabetes
Doctors will do a blood test to measure HbA1C levels. This stands for glycated haemoglobin. This test measures how well the body controls glucose over a period of 120 days, which is the lifespan of a red blood cell.
Red blood cells contain haemoglobin. This protein is responsible for carrying oxygen.  Once haemoglobin binds to glucose it becomes glycated. The higher the blood glucose levels the higher the number of glycated red blood cells would be thus the higher the HbA1C level.
Normal HbA1C levels should be less than 5.7%. People are diagnosed with Diabetes if their HbA1C levels are higher than 6.5%.
 
Complications of Diabetes

• Blindness
• Kidney failure
• Heart disease
• Stroke
• Nerve damage – loss of sensation in hands and feet

 
Prevention of Type 2 Diabetes Mellites
Progressing from prediabetes to diabetes isn’t certain.
Some risk factors like age, sex and genetics may not be altered but this does not mean it will cause or lead to diabetes.
As mentioned before Type 2 Diabetes is mainly caused by lifestyle.
How to reduce the risk

• Reduce your total carb intake
• Exercise regularly - Exercise increases the insulin sensitivity of your cells, meaning that you need less insulin to manage your blood sugar levels
• Lose excess weight - Visceral fat is associated with insulin resistance, inflammation, prediabetes, and type 2 diabetes
• High fiber diet. Soluble fiber and water form a gel like substance in your gut which slows down food absorption, in turn leads to a gradual rise in blood glucose
• Optimize vitamin D levels
• Minimize your intake of highly processed foods. Highly processed foods have undergone major processing which generally contain added sugars, unhealthy fats, and preservatives