Thandi Puoane, Peter Delobelle, Lungiswa Tsolekile and David Sanders
DIABETES is a disease in which the body is unable to produce or does not use insulin properly, which is a hormone needed to convert sugar, starches and other food into energy so that it can be utilised by the body.
There are three types of diabetes. Types 1 diabetes, which usually starts in young people is characterised by a lack of insulin production; Type 2 diabetes results from inadequate production or ineffective use of insulin in the body (sometimes referred to as insulin resistance); and gestational diabetes, which usually occurs halfway through a pregnancy due to the inability of the pancreas to make additional insulin, which often disappears after pregnancy.
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.
In 2014, 9 percent of adults 18 years and older had diabetes. In 2012, diabetes was the direct cause of 1.5 million deaths. More than 80 percent of diabetes deaths occur in low- and middle-income countries.
The World Health Organisation (WHO) projects that diabetes will be the seventh leading cause of death in 2030. Healthy diet, regular physical activity, maintaining a normal bodyweight and avoiding tobacco can prevent or delay the onset of Type 2 diabetes.
FIRST LADY: Bongi Ngema Zuma attending the World Diabetes Day Event in KZN, Pietermaritzburg, last year. JAB: A diabetic gives herself an insulin injection. Type 1 and 2 diabetics need regular insulin treatment to keep their glucose levels stable. their peers without diabetes.
In South Africa, the majority of people with diabetes have Type 2, although many are undiagnosed as there are few symptoms initially. Nine percent of the population aged 30 years and above is thought to have Type 2, which represents approximately 2 million cases.
The number of people with Type 2 diabetes has grown hugely in the last decades and is associated with a sharp rise in the incidence of overweight and obesity. Obesity is a complex disease with genetic and environmental determinants, such as high-fat diets and physical inactivity, and a well-established risk factor for diabetes and other chronic diseases.
South Africa has the highest prevalence of obesity in sub-Saharan Africa, especially in urban African women.
Although genetic factors play a role, sociocultural, environmental and behavioural factors, as well as the influence of socioeconomic status, more likely explain the high prevalence of obesity.
The increase in diabetes is fuelled by urbanisation, leading to changes in diet from a traditional diet high in legumes, and low in processed and refined carbohydrates to a Western diet high in fat, sugar and salt. Sales of packaged foods have increased rapidly: for example, between 2005 and 2010 sales of ready-made meals increased by 43 percent. Many also purchase street and fast foods, which is a cause for concern.
Consumption of cola averages 254 litres per person per year in South Africa, which is nearly three times the global average.