EDITORIAL | Diabetes crisis in South Africa: a nation at a crossroads

Diabetes in South Africa is no longer a silent threat — it is a raging health storm, quietly sweeping through communities, leaving destruction in its wake.

We stand at a crossroads of a public health crisis and cannot ignore the reality: millions of South Africans are living with diabetes, many unaware, many undiagnosed and many suffering without the proper care.

With more than 4.5-million South Africans affected, and diabetes being one of the world’s fast-growing epidemics and the ninth leading cause of death around the world, we must ask: how did we get here, and what are we going to do about it?

Diabetes is a chronic condition that occurs when the body cannot produce any or enough insulin, or cannot effectively use the insulin it produces. It can cause blindness, kidney failure, heart attacks, stroke and lower limb amputation, among other medical issues.

At its core, diabetes should be preventable, yet the figures continue to rise. The International Diabetes Federation (IDF) paints a grim picture with nearly one in eight South African adults living with type 2 diabetes, a largely lifestyle-driven condition.

The IDF has also indicated that 10.5% of the world’s adult population aged between 20 to 79 years had diabetes in 2021, and this is expected to reach 12.2% in 2045. 

The story behind this epidemic is one of poor diet, limited access to healthcare and a society that is slowly but surely losing the battle against sedentary living.

Our urban areas, teeming with fast-food outlets and convenience stores selling processed sugar-laden foods, have become breeding grounds for diabetes. Yet in our rural areas, the picture is just as grim, where poverty, poor access to healthcare and a lack of education make the fight against diabetes all the more challenging.

This crisis doesn’t only strike the wealthy or the urban elite. Diabetes is a disease that disproportionately affects the poor, the marginalised and those who struggle to make ends meet.

In low-income communities, where access to fresh, healthy food is often limited, the rise in diabetes feels like an inevitable fate. People are forced to make do with cheap, unhealthy food, while physical activity becomes a luxury, often squeezed out by the demands of survival.

This is not just an issue of lifestyle choices — it’s an issue of inequality, of systemic barriers that prevent millions from accessing the resources they need to stay healthy. From the moment a diagnosis is made, the financial toll is immediate. Treating diabetes, managing its complications and paying for necessary medications can drain family savings, pushing already struggling households further into poverty.

With this also comes the long-term costs: heart disease, kidney failure, amputations — the list goes on. These complications not only destroy lives but strain our healthcare system, already buckling under the weight of the disease.

If we are to address this looming crisis, we need more than just a medical response. We need a societal shift.

We need a national movement that places health at the forefront of our priorities. It’s time to stop treating diabetes as a distant problem and confront it head-on. Prevention must become our battle cry.

Education is our first line of defence. We must flood communities with knowledge about the risks, symptoms and, most importantly, the preventable nature of diabetes.

Health education should no longer be a luxury for the few — it must be a fundamental right for all South Africans. We need to teach our children and adults alike the power of good nutrition, the benefits of exercise and the importance of regular check-ups.

Schools must become hubs of health education, where children are not only learning their ABCs but are also gaining the tools to make healthy choices for life.

The fight against diabetes requires more than just government action — it requires a collective effort. NGOs, private companies and local communities must come together to share knowledge, resources and solutions. The battle cannot be won in isolation; it must be fought with the full force of the nation behind it.

Diabetes doesn’t wait for us to catch up. It strikes with devastating speed, and if we don’t act now, it will continue to devastate families, communities and the future of our nation.

It’s not too late to turn the tide, but it will take all of us working together. By prioritising education, improving access to healthy food and making healthcare more accessible, we can tackle the diabetes epidemic head-on.

South Africa has the potential to be a leader in health and wellness — but only if we’re willing to invest in our future, today.

We stand at a crossroads. Will we take the path towards a healthier, diabetes-free South Africa, or will we continue to ignore the signs and suffer the consequences? The time for action is now — our nation’s health depends on it.