Every 14 November, we observe World Diabetes Day, a global initiative launched in 1991 by the International Diabetes Federation and the World Health Organisation. It was created to respond to the growing threat of diabetes, and since 2006, it has been recognised by the United Nations. This day also honours the birthday of Sir Frederick Banting, who, alongside Charles Best, discovered insulin in 1922, a breakthrough that continues to save millions of lives.

The theme for World Diabetes Day from 2024 to 2026 is ‘Diabetes and Well-being’, which highlights a crucial yet often overlooked aspect of diabetes care – mental health. With proper access to both medical care and well-being support, individuals with diabetes can live healthier, more balanced lives. But today, millions struggle to manage their condition, juggling demands at home, work and school. They must be highly organised, resilient and focused – a mental burden that can exacerbate stress, anxiety and burnout.

Consider a primary school child living with type 1 diabetes. They have to monitor their blood sugar, administer insulin and follow a strict diet, all while navigating the typical challenges of childhood. This heavy responsibility can disrupt their mental and emotional well-being, making it hard to fit in with peers, excel in academia or participate in sport. Similarly, an adolescent grappling with diabetes faces the complexities of growing up – peer pressure, identity formation and academic stress – with the added challenge of managing a chronic illness. The emotional toll often leads to anxiety, burnout and social isolation. The stigma around diabetes only adds to their struggle, making it harder to cope.

Enhancing health literacy and providing tools for self-management are thus essential to address these issues. Empowering people who have diabetes to manage both their physical and mental well-being is a vital step towards achieving better outcomes.

The burden of diabetes in South Africa

South Africa is in the midst of a diabetes epidemic, with nearly 4.3 million adults currently living with the condition. According to Statistics South Africa, diabetes is a leading cause of death in the country, with the numbers continuing to climb. Many people are diagnosed late, after serious complications like heart disease, kidney failure, amputations or vision loss have already occurred. The economic cost is staggering, with diabetes-related expenses consuming a large portion of the national healthcare budget.

However, while the physical toll of diabetes is well documented, its mental health impact is often ignored. The constant need to manage the condition can lead to emotional exhaustion (burnout), anxiety  and depression. In South Africa, where access to mental health services is limited, many individuals face these psychological challenges without adequate support.

Diabetes and mental health: A critical link

The connection between diabetes and mental health is undeniable. Research shows that people with diabetes are two to three times more likely to experience depression than those without it. Anxiety, burnout and even eating disorders are common, particularly when diabetes is poorly controlled. In South Africa, the lack of a healthcare system that integrates both physical and mental care only compounds these issues. Despite the well-documented relationship between diabetes and mental health, routine screenings for psychological issues are rarely part of diabetes care. Additionally, healthcare professionals often lack the training to identify and address these mental health challenges.

The University of Pretoria’s (UP) Diabetes Research Centre is determined to change this. With a focus on a holistic approach, the centre’s mental health and well-being cluster, which we lead, is committed to placing mental health at the core of diabetes care. In September 2023, the centre hosted a ground-breaking webinar titled ‘Mental health and well-being of people with diabetes’. The event brought together experts and people living with diabetes to highlight the critical need for comprehensive care that includes mental health support. This event showcased the urgent need to address the psychosocial dimensions of diabetes to improve overall well-being.

In May 2024, the centre hosted another webinar, titled ‘Mental health in diabetes care’, in partnership with the Health Psychology Division of the Psychological Society of South Africa. This event was aimed at healthcare professionals and focused on mental health challenges in diabetes care, exploring practical interventions to help patients manage both the emotional and physical burdens of the disease.

Current research: Exploring psychological distress in people with diabetes

Building on these insights, UP launched a study in October 2024 titled ‘Psychological distress and mental health support among people living with diabetes: A South African study’. This research explores the psychological distress experienced by individuals with diabetes, and examines their perceptions of the accessibility and quality of mental health support. The study, conducted online, invites people with type 1, type 2 or gestational diabetes to share their experiences. The findings will provide insights that will inform future interventions and policies to improve mental health support for people living with diabetes in South Africa.

A call to action

This World Diabetes Day, we call on healthcare providers, policymakers and the public to prioritise the well-being of people living with diabetes. This year’s theme reminds us that diabetes care must go beyond controlling blood sugar levels – it must ensure that individuals feel supported, both physically and emotionally.

For millions, diabetes is more than a medical condition; it’s a daily challenge that touches every aspect of their lives. By focusing on well-being, we can create a better future for those living with the condition. Access to comprehensive care, including mental health support, is not a privilege but a right. This World Diabetes Day, let’s commit to making well-being a central part of diabetes care. The time for change is now – if not now, when?

Dr Patrick Ngassa Piotie is the Senior Programme Manager at the UP Diabetes Research Centre and Dr Sonja Mostert is a Senior lecturer at the Department of Psychology at the Faculty of Humanities.

Disclaimer: The opinions expressed in the article are solely those of the authors and do not necessarily reflect the views of the University of Pretoria.