Ahead of World Diabetes Day on 14 November, the Project Manager of the Tshwane Insulin

Project at the University of Pretoria (UP) Diabetes Research Centre, Dr Patrick Ngassa Piotie, says there is an urgent need to increase access to quality diabetes education to manage the condition.

World Diabetes Day was established by the International Diabetes Federation (IDF) and is commemorated annually to keep this global health concern in the spotlight. The IDF estimates that 24 million people in Africa are living with diabetes, or one in 24 individuals. In South Africa, the figure stands at about 4.2 million people, 45.4% of whom are undiagnosed.

Diabetes is a global health emergency; the number of people living with it is expected to rise to 643 million by 2030 and 783 million by 2045. In Africa, the number is likely to increase to 55 million in 2045. Last year, at least 416 000 deaths on the continent were associated with diabetes.

This year, the theme for World Diabetes Day is “Education to protect tomorrow”. With one in 10 people living with the condition and 6.7 million related deaths in 2021, the IDF has called on policy makers to increase access to diabetes education to help improve the lives of more than half a billion people living with the condition worldwide.

“Education is the cornerstone of diabetes care,” says Dr Ngassa Piotie. “Diabetes is a chronic condition, and affected people need to be informed and taught the skills required to manage the disease daily. They need to be equipped to become active participants in their care.”

According to Dr Ngassa Piotie, South Africans with diabetes lack sufficient knowledge about their condition. This impacts their ability to adopt the changes necessary to take care of their condition. Consequently, diabetes control is suboptimal, resulting in high rates of otherwise preventable diabetes-related complications such as amputations, kidney failure, stroke and blindness.

Dr Ngassa Piotie says there is an urgent need to improve access to diabetes education for those living with the condition and for healthcare providers.

“The UP Diabetes Research Centre strongly advocates for access to diabetes education,” he says. “The empowerment of healthcare workers and South Africans living with diabetes has been a priority of the centre. To this end, the centre has been collaborating with the Tshwane district and the City of Tshwane to train healthcare workers in comprehensive diabetes and hypertension management in primary care. Since 2019, with the help of funding from the Lilly Global Health Partnership, we have been delivering about 10 free training workshops annually. We train 40 to 50 healthcare providers per workshop.”

The UP Diabetes Research Centre is also running a diabetes and insulin education drive at primary care facilities around Tshwane to commemorate World Diabetes Awareness Month this November. It is raising awareness about the importance of good diabetes care, including insulin’s role in treating type 2 diabetes. The centre engages with people who have diabetes to answer any questions they may have on topics such as diabetes prevention, adopting a healthy lifestyle and the use of insulin.

Additionally, in collaboration with Aviro Health, the UP Diabetes Research Centre will bring digital innovation to the care and management of type 2 diabetes. A diabetes module on Aviro’s Pocket Clinic has been developed to support healthcare workers and facilitate efficient, effective diabetes care. The product is a scalable digital diabetes solution that will assist community healthcare workers and nurses to improve patient support during home and clinic visits, and to deliver quality diabetes education.

“We see significant opportunities for digital technology to transform the delivery of diabetes care in South Africa and enable healthcare providers to empower people with diabetes on their health journeys,” Dr Ngassa Piotie says.

He notes that diabetes is the number one cause of death among women in South Africa and the second cause of death among men and women combined, only second to tuberculosis. This underscores the need for education and a comprehensive plan to address the condition.

“More needs to be done,” Dr Ngassa Piotie says. “Our efforts and those of other non-profit organisations and diabetes research entities are sporadic and unsustainable. Cohesive, standardised diabetes education programmes that are accessible nationwide are required.”

“We applaud the adoption of a 90- 60-50 cascading approach by the National Department of Health to improve early detection and treatment of diabetes and hypertension,” he adds. The 90-60-50 cascade is a strategy that was adopted by South Africa’s national Department of Health in 2022. The approach’s target is that 90% of all people over 18 will know whether they have raised blood pressure and/ or raised blood glucose, 60% of people with raised blood pressure or blood glucose will receive an intervention and 50% of people receiving interventions will be controlled.

“We further welcome the government’s commitment to achieving the World Health Organisation’s (WHO) diabetes coverage targets.” These are global targets for diabetes that WHO member states, including South Africa, have adopted to strengthen and monitor diabetes responses within national noncommunicable disease programmes.

The targets are aimed at reducing the risk of diabetes and creating a world where all people who are diagnosed with diabetes have access to equitable, comprehensive, affordable and quality treatment and care.

Achieving these targets will not be possible without improving access to quality diabetes education.

“As a society, we can do more,” Dr Ngassa Piotie says. “Our overburdened public health sector and its overworked healthcare workforce cannot address the challenges related to diabetes education alone. The UP Diabetes Research Centre pledges its support to national, provincial and local health authorities in their efforts to improve access to diabetes education to better the lives of South Africans living with diabetes,” Dr Ngassa Piotie says.