A look into the global drive to tackle diabetes: A grassroots community-based approach to improve diabetes care access.
World Diabetes Day was created in 1991 by The International Diabetes Federation (IDF) and the World Health Organization (WHO) in response to growing concerns about the escalating health threat posed by diabetes. World Diabetes Day became an official United Nations Day in 2006 with the passage of United Nation Resolution 61/225. It is marked every year on 14 November, the birthday of Sir Frederick Banting, who co-discovered insulin along with Charles Best in 1922. Every year, the World Diabetes Day campaign focuses on a dedicated theme that runs for one or more years. The theme for World Diabetes Day 2021-23 is Access to Diabetes Care.
Diabetes and its complications are strongly associated with modifiable risk factors and determinants. Previous studies of diabetes in South Africa have focused on the traditional determinants of diabetes and its comorbidities, investigating how socio-demographic factors (socioeconomic status, age, sex, marital status, level of education, income, occupation, social position, and residential area) and behavioral factors (smoking, poor diet, physical inactivity, excess alcohol consumption) impact diabetes prevalence and management. (SANHANES-2023)
Results from the South African National Health and Nutrition Examination Survey (SANHANES-1) sourced that 4.58 million people aged 20–79 years who were estimated to have diabetes in South Africa in 2019, 52.4% were undiagnosed. South Africa has the second highest number of people living with type 2 diabetes in sub-Saharan Africa. In South Africa, diabetes is the leading underlying natural cause of death in women and the second highest underlying cause of death for the entire population.
Over the past three decades, since the advent of democracy in the country, increasing household income and urbanization have led to accelerated changes in environmental and social stressors, diet, and physical activity behaviors of South Africans, predisposing them to increased risk for a range of non-communicable diseases (NCDs), including diabetes. This epidemiological transition is evident in the rapidly rising levels of obesity and the increasing prevalence of cardiovascular disease over the past 25 years.
As the health crisis in South Africa shifts from communicable diseases like tuberculosis and HIV / AIDS towards non-communicable diseases, the prevalence of diabetes in the country is expected to continue rising to about 10.4% (822 million people) by 2040, according to The IDF’s Diabetes Atlas, 7th Edition.
Let’s delve deeper into the worldwide effort to emphasize the significance of taking united and coordinated measures to tackle diabetes. We’ll explore how we can apply this approach at the community level to improve access to diabetes care by teaching people how to live better by eating better.
There is a general perception that healthy food, like fresh protein, fruit and vegetables, is expensive and that most people who have a well-balanced diet are people with plenty of money to spare. This is consistent with the perception that for food to be healthy it has to be high-priced.
We are here to tell you, that’s not true – “Cheap food is an illusion’’, author Michael Pollan said in the documentary Fresh. “There is no such thing as cheap food. The real cost of the food is paid somewhere, and if it isn’t paid at the cash register, it’s charged to the environment or to the public purse in the form of subsidies. And it’s charged to your health.”
Diabetes currently affects one in ten people worldwide. In many cases, type 2 diabetes and its complications can be delayed or prevented by adopting and maintaining healthy habits. When not detected and treated early, diabetes can lead to serious and potentially life-threatening complications.
- For people at risk of type 2 diabetes, knowing your risk and what to do is important to support prevention, early diagnosis and timely treatment.
- For people living with diabetes, awareness and access to the correct information and best available medicines and tools to support self-care is vital to delay or prevent complications.
- For healthcare professionals, access to sufficient training and resources is required to detect complications early and provide the best possible care.
Understanding the condition is the first step towards managing and preventing it. In conjunction with the IDF’s World Diabetes Day 2023, which will focus on Access to Diabetes Care, Eat Better South Africa has developed a health awareness campaign #KnowYourNumber to help people with diabetes and those who care for them to make informed decisions about their condition.
Some of our programs are focused on Introducing community-based nutrition education intervention that’s modelled to empower people with knowledge and information on how diabetes develops in the body, describes the main types and explores the warning signs, risk factors and complications.
Eat Better South Africa is a non-profit organization that operates at grassroots levels within South African low-income and urban poverty-stricken communities, to support the local public healthcare systems while establishing stable food security support systems through education, advocacy, and knowledge sharing approach.
The primary objective of Eat Better South Africa is to build long-term, health-promoting environments and to create sustainable and community-driven change by empowering individuals, families, and communities to improve their general health and well-being. While creating awareness among participants about what they can do for themselves to improve their health, and generate an understanding on the importance of nutrition as a medium in the prevention, treatment and management of diseases that stem from poor nutrition and lifestyles, as well as non-communicable diseases.
The Noakes Foundation is another organization dedicated to promoting better access to diabetes care, through evidence-based nutrition information and research. The Noakes Foundation’s work emphasizes the importance of research and questioning the science to help prevent or delay long-term complications of diabetes.
The Noakes Foundation is a non-profit organization that was founded in 2014 by Prof Tim Noakes, a world-renowned scientist and medical doctor. The Foundation was established to advance medical science’s understanding of the benefits of a low-carb high-fat (LCHF) lifestyle by providing evidence-based information on optimum nutrition that is free from commercial agenda.
At The Noakes Foundation, they believe in questioning the science. Their work is guided by a commitment to scientific integrity and academic freedom of speech. They believe that scientists should be free to investigate and publish research that may be considered controversial or threatening to commercial interest, without fear of retribution or censorship. Through their research and advocacy efforts, they aim to promote a culture of open inquiry and critical thinking that fosters scientific excellence and advances public health.
The Noakes Foundation raises funds to research the insulin resistance paradigm, low carbohydrate lifestyle and academic free speech, current research themes are:
- Evaluating nutrition education in under-resourced communities
- From clinical practice to published research on nutritional effects of insulin resistance
- Academic free speech and digital voices
If you are interested in the topic of diabetes, or looking to understand the value of post-diabetes diagnosis support and how nutrition can be applied as a medium in clinical practice to prevent, treat and manage diabetes and its associated conditions. Nutrition Network provides a wide range of online training to empower patients, communities, medical and allied healthcare professionals with a better understanding of diabetes and insulin resistance. This in turn lifts the load on the healthcare system and provides nutritional counselling to communities outside the consultation room:
- A Patient’s Guide to Blood Glucose Management
- Eat Better: Group Facilitation Training
- Diabetes Reversal
At Eat Better South Africa, we recognize the need to help community members understand their condition and keep their diabetes knowledge up to date in order to manage it. Our programs have been designed to make the benefits of a healthy lifestyle financially feasible for low-middle-income and urban poverty-stricken South African communities. All of this leads to an improved access to diabetes care.
You can join the call to action supporting Eat Better South Africa’s diabetes awareness campaign #KnowYourNumber by donating any amount or a specific in-kind good from our wish list below, or email us at: email@example.com or phone: +27 78 143 7358 for more information.
- Blood glucose monitors (machine, and testing strips)
- Fingerstick- blood samplers
- Alcohol swabs
- Disposable gloves
- Hand sanitisers
- Reusable medical waste bins
- Cotton pads
In conclusion, Diabetes Awareness Month inspires us to not merely commemorate November 14th (World Diabetes Day), it’s a call to action to increase awareness, enhance care, and promote better access to diabetes care for all who call South Africa home. We must join hands, share resources, and work together to build a coalition towards reducing the damaging impact of diabetes in our communities.
World Health Organization (WHO) Classification of Diabetes Mellitus 2019; World Health Organization: Geneva, Switzerland, 2019: https://www.who.int/publications/i/item/classification-of-diabetes-mellitus
Prevalence and Psychosocial Correlates of Diabetes Mellitus in South Africa: Results from the South African National Health and Nutrition Examination Survey (SANHANES-1): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10218408/
90-60-50 – can South Africa meet its diabetes targets, and would we know if we did?: https://www.dailymaverick.co.za/article/2023-06-19-can-south-africa-meet-its-diabetes-targets/
Our world in data: https://ourworldindata.org/grapher/diabetes-prevalence
“Fresh” New thinking about what we’re eating: https://www.imdb.com/video/vi1208813337/?playlistId=tt1637620&ref_=tt_pr_ov_vi
Social support in type II diabetes care: A case of too little, too late: Full article: Social support in type II diabetes care: a case of too little, too late (tandfonline.com)
International Diabetes Federation: Know Your Risk, Know Your Response https://worlddiabetesday.org/about/prevention/
International Diabetes Federation’s IDF Diabetes Atlas, 7th ed: https://diabetesatlas.org/atlas/seventh-edition/