/ 9 November 2001

Dealing with diabetes

November 14 is World Diabetes Day, but the government has paid little attention to the rise of the disease

Barbara Erasmus

South Africa could learn a lesson from Tanzania when it comes to confronting the two plagues of the millennium the high-profile killer Aids and the less acknowledged pandemic diabetes.

Tanzania has achieved recognition for its Aids awareness programme and has made similar strides in dealing with a staggering increase in diabetics.

Professor George Alberti, president of the International Diabetes Foundation, recently carried out a study in Tanzania where a local programme changed the habits of a whole community.

“By involving community leaders, we were able to persuade people to change their diets and their lifestyles, thus halving their chances of becoming diabetic,” he says.

Diabetes occurs when the body either fails to produce insulin (diabetes type one) or produces insufficient insulin (diabetes type two) .

Type one usually occurs in young children and daily insulin injections are necessary for survival. The World Health Organisation (WHO) estimates that only 3% of people with diabetes in developing countries are treated with insulin.

The Centre for International Health in London says that while the average diabetic in Britain could earn the money needed for a year’s supply of insulin in two days, in Tanzania it would take nine months.

Clearly, it is incumbent on the government of a developing country to take preventative measures to ensure that its population is not afflicted with this debilitating disease.

The South African government has been criticised for its ambivalent response to the link between Aids and HIV but less attention has been paid to its inadequate preparation in dealing with the country’s dramatic increase in diabetic patients. The WHO predicts that in South Africa numbers will triple in the next 15 years.

About 90% of patients suffer from type two diabetes. Typically they are over 35, overweight, under-exercised smokers, many genetically predisposed to the illness.

At least half the people in South Africa suffering from diabetes type two do not know they have the disease. By the time it is diagnosed, they could be threatened with blindness, kidney failure, nerve damage to the feet leading to amputation and cardiovascular disease. The latter is the cause of death in 80% of diabetic patients and is consequently the focus of World Diabetes Day 2001.

Dr Larry Distiller, MD of the Centre for Diabetes and Endocrinology in Johannesburg, stresses the seriousness of the situation. “Diabetes type two can reduce the life expectancy of a patient by eight years. And it’s not when you die, but how you die. This illness, with its implications, is not so much the silent killer as the silent maimer”.

The cost of undiagnosed diabetes is huge, not only in terms of personal trauma and loss of productivity. The major financial burden lies in the cost of hospitalisation due to the side effects of the disease. The total annual financial cost of diabetes to the South African health care system is estimated at R3,3-billion by the International Diabetes Foundation.

ENDS