How much do you really know about diabetes?

Millions of South Africans are diagnosed with diabetes, which is often a contributing factor to strokes. Wheelchair users are no exception! Here is what you need to know about the different kinds of diabetes and how it can be managed.

Diabetes in South Africa has been described as an approaching tsunami. These are the words of Dr Larry Distiller, founder and managing director of the Centre for Diabetes and Endocrinology in Johannesburg. Diabetes is a disease whereby the blood sugar is elevated. During normal metabolism certain foods are broken down into simple sugars which the body uses as energy.

Normally the levels of blood sugar are controlled by hormones, but in diabetes these controls do not function optimally. There are several different types of diabetes and, alarmingly, statistics indicate that about 30 percent of persons with diabetes are diagnosed late – when damage to one or several target organs has already occurred.

Diabetes causes very significant disability in South Africa and the disease (with its accompanying complications) is on the rise. Currently, it is estimated that approximately
3,5 million South Africans suffer from diabetes and a further five million have elevated blood sugar levels but have not yet been diagnosed as diabetic. It has been predicted that the incidence of diabetes in Africa is expected to double by 2030.

Of particular concern to ROLLING INSPIRATION readers is the devastating effect of a stroke, in which the underlying cause (or at least one of the contributing factors) is often poorly controlled diabetes. Poorly controlled diabetes can lead to heart disease and heart attack, kidney failure, blindness, and severe vascular disease compromising blood flow and ultimately necessitating amputation.

Diabetes types

Essentially there are three types of diabetes. Early onset or Type 1 diabetes (usually at a young age) is a condition where the body stops producing insulin – an essential hormone produced by the pancreas to convert the sugars found in the blood into energy.

Type 2 diabetes, which is the most common form seen in South Africa, is a condition that develops over time where the body is unable to use insulin properly. This is normally found in older patients; hence this is often referred to as maturity onset diabetes.

Gestational diabetes is the third type of diabetes and is a form of diabetes that occurs during pregnancy due to hormonal changes, genetics and lifestyle factors.


As the symptoms of diabetes develop over time, patients often do not report them to their doctor until there is evidence of damage. Typically, symptoms include excessive thirst, having to pass urine more often than normal, repeated infections, especially thrush or yeast infection (both oral and vaginal), slow wound healing, excessive fatigue and difficulty with vision.


Diabetes cannot be cured. However, it is completely treatable. In the early stages (pre-diabetic) when blood sugars are elevated beyond normal range but not high enough to make a diagnosis of diabetes, control of elevated blood sugar can be achieved through lifestyle and dietary changes such as avoiding sugars of any form, weight loss and a healthy exercise programme.

Type 1 diabetes normally requires replacement of the body insulin by subcutaneous injections – either by a long-acting treatment once daily or several times per day with meals. Type 2 diabetes can normally be controlled with oral medications.

It is imperative that the diagnosis is made early in order to prevent long-term irreversible damage to the target organs, a stroke or amputations. A simple blood test should be done as part of a routine GP visit, especially if you’re presenting with symptoms or there is a strong family history of diabetes.


Dr Ed Baalbergen is the medical officer at the Vincent Pallotti Rehabilitation Centre (Cape Town) and is a member of the International Spinal Cord Society and the Southern African Neurological Rehabilitation Association. email:

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