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Improving access to diabetes care for people in the Western Cape

On World Diabetes Day, November 14, the Western Cape Department of Health and Welfare is encouraging residents to know their risk of type 2 diabetes and to take proactive steps to help delay or prevent this chronic disease. If not detected and treated early, diabetes can lead to serious and potentially life-threatening complications. Under the theme, ‘Access to diabetes care, health professionals across the province regularly participate in raising awareness among community members and patients. Their efforts include topics on how to prevent diabetes, early detection, knowing the signs and symptoms, and available treatment to manage the disease at all levels of care.

Western Cape Health and Welfare Minister Dr Nomafrench Mbombo says: “As we mark World Diabetes Day today, it is crucial that we all raise awareness of the global health challenge that diabetes still poses to people around the world. This is why the Ministry has continued with its Western Cape on Wellness (WOW) healthy lifestyle initiative to promote better understanding of diabetes and other chronic diseases in our communities. It is important that we continue to advocate healthy lifestyles to prevent, reduce and manage one’s chances of developing chronic lifestyle diseases.”

“As a diabetic, I appreciate the critical importance of managing this condition. This includes regular exercise, following a diet and seeing your doctor as often as possible. Diabetes can be controlled, but we must take personal responsibility and adopt a healthier lifestyle. Many of our residents who live with this condition are able to lead healthy, active and fulfilling lives. Let’s beat diabetes together,” says Alan Winde, Premier of the Western Cape.

Diabetes caused 6.7 million deaths globally in 2021, which is 1 death every 5 seconds. An estimated 44% of adults with diabetes are undiagnosed and therefore not receiving treatment or care. Diabetes is also a leading cause of blindness, amputations and end-stage kidney disease. The most common is type 2 diabetes, usually in adults, which occurs when the body becomes resistant to insulin or does not produce enough insulin. Over the past three decades, the prevalence of type 2 diabetes has increased dramatically in countries of all income levels. More than 95% of people with diabetes have type 2 diabetes, and almost half have not yet been diagnosed. This type of diabetes is mostly the result of excess body weight and physical inactivity.

In the Western Cape, diabetes is one of the leading causes of early death and affects women more than men.

  • In 2021, more women (63.1%) than men (36.9%) lived with diagnosed diabetes.
  • Diabetes was most prevalent in the age group 40-64 years (51.65%), then in the age group 65+ years (38.8%), 20-39 years (8.9%) and 0-19 years. age group (0.6%).

Type 2 diabetes and its complications can be delayed or prevented by adopting and maintaining healthy habits. “Type 2 is a preventable and treatable disease and its prevalence within the Western Cape is worrying. We encourage people affected by diabetes to understand diabetes, obesity and the associated risks. When it comes to prevention, we understand it’s a shared responsibility, and we all prioritize a healthy, active lifestyle,” says Dr. Hilary Goeiman, director of service priority coordination at the Department.

The department encourages all people over the age of 35 who have any of the risk groups to be screened at our clinics every year. This especially includes men, who are often reluctant to access health care. A simple finger prick test can diagnose a high probability that you have diabetes within a minute.

David Solomons (72) was diagnosed with diabetes about 20 years ago. “I didn’t know I had it. I remember when I was at the Vanguard Clinic for a checkup and when they pricked my finger, the nurse asked me if I was diabetic, ‘I told her no, that’s for older people’. When they checked the reading, it was 17. I was quite surprised. From there I had to go to the clinic regularly to get medicine.”

Solomons, a self-taught musician and singer, admitted that he lived a very busy life and that his health was not his top priority. “Music is my life. I had various opportunities to sing. First, after the diagnosis, I stopped taking medication.” This led to further complications when he lost the sight in one eye. “The doctors told me that they could not save the eye. I had to undergo an intensive three-hour operation to save the left eye. It was at Groote Schuur Hospital, where I received great care regarding complications with my eye. The doctors sat with me and explained the whole process. The fears I had about taking medication didn’t matter when I could see how non-adherence was having a negative effect on my body.” Since then, he has adopted and maintained healthy habits and used the tools available to him to support self-care to delay or prevent further complications.

The department strives to provide access to patients at all levels of care. Central hospitals, such as the Tygerberg Hospital, play a role in the treatment of complex diabetic conditions as a reference center.

dr. Marli Conradie-Smit, head of endocrinology at Tygerberg Hospital, points out that late diagnosis of patients is a global problem. “This is worrying because patients have complications such as cardiovascular disease (myocardial infarction or stroke). Diagnosis of all cardiovascular risk factors, including diabetes, is important for effective management of conditions and reduction of risk of complications. In the case of diabetes, this also includes microvascular diseases such as retinopathy and kidney disease.”

This Diabetes Day, citizens are reminded to ensure they have access to the screening tool available free of charge in clinics. This is especially important if someone in their family has diabetes that they should visit their clinic for regular check-ups. The message of adhering to a healthy lifestyle, diet and regular exercise cannot be overemphasized.

Living with diabetes can affect our mental health. Reflecting on how he managed to maintain his health, including mental well-being, over these many years, Solomons had to prioritize his health. “You have to do something to keep your mind focused and that helps give you purpose in life. If I didn’t take care of my health, I wouldn’t be able to do music. I’ve seen people lose their legs or arms. It is important to prevent or delay diabetes by making feasible lifestyle changes that have helped me manage my condition.”

Solomons encourages everyone living with diabetes to recognize their value, especially to those around them. “Will you take your pills and take them? Or do you say to yourself, you don’t feel like it? If you want to live a long healthy life, take your medicine. I have been married for 52 years; I know my wife of 55 years. My granddaughter got married on Saturday. I have four children, the oldest is 53 years old. I have six grandchildren and six great-grandchildren. I love them to pieces! They give me the inspiration to ‘keep going’.”

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