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Understanding diabetes and glucose control in South Africa

Diabetes is one of the fastest-growing health conditions in South Africa, affecting a lot of adults — and increasingly, younger people. Many cases remain undiagnosed until complications develop.

But here’s the good news: with the right knowledge, screening, lifestyle changes and early support, most blood sugar problems can be prevented or managed effectively.

This article explores how diabetes develops, why it is so common in South Africa, and the practical steps individuals and families can take to support healthy blood sugar levels.

What is diabetes?

Diabetes occurs when the body cannot regulate blood sugar (glucose) properly.

There are two main types:

Type 1 diabetes

• Usually develops in children or young adults
• The body does not produce insulin
• Requires lifelong insulin therapy

Type 2 diabetes

• The body becomes resistant to insulin or doesn’t produce enough
• Strongly influenced by lifestyle, diet and genetics
• Often preventable or manageable with lifestyle changes

Why diabetes is so common in South Africa

1. Diet high in refined carbohydrates and sugary drinks

• Sweetened beverages
• Tea/coffee with sugar
• White bread
• Vetkoek, magwinya, pastries
• Highly processed snacks

These foods spike blood sugar quickly.

2. Sedentary lifestyle

Urbanisation, long commutes and work-from-desk lifestyles reduce movement.

3. Overweight and obesity

Excess weight — especially around the stomach — is a major risk factor.

4. Family history / genetics

If a parent or sibling has diabetes, risk increases significantly.

5. Stress and poor sleep

Chronic stress and lack of sleep contribute to insulin resistance.

6. Limited awareness and screening

Many people assume they are “fine” until complications arise.

Common symptoms of high blood sugar

Early signs may include:

• Excessive thirst
• Frequent urination
• Fatigue
• Blurry vision
• Slow wound healing
• Pins-and-needles in hands or feet

Serious symptoms (urgent)

• Severe thirst
• Vomiting
• Confusion
• Unexplained weight loss
• Rapid breathing

These require immediate medical attention.

Pre-diabetes — the warning stage

Pre-diabetes means blood sugar levels are higher than normal but not high enough for a diabetes diagnosis.

The good news?
Pre-diabetes is reversible.

Lifestyle changes at this stage can prevent diabetes entirely.

How to support healthy glucose control

1. Prioritise balanced, low-GI meals

Choose foods that release energy slowly:

✔ Good low-GI options:

• Whole-wheat bread
• Oats
• Brown rice
• Maize meal (soft porridge, not sugary)
• Sweet potatoes
• Legumes (beans, lentils, chickpeas)
• Green vegetables
• Fruit (whole fruit, not juice)

✔ Foods to limit:

• White bread and rolls
• Sugary cereals
• Crisps
• Doughnuts, cakes, biscuits
• Sweetened drinks
• Sugar-loaded tea and coffee

Small swaps make a big difference.

2. Adopt the healthy plate method

• ½ plate: vegetables
• ¼ plate: lean protein (fish, chicken, eggs, beans)
• ¼ plate: wholegrain or starchy foods

This method is ideal for South African meals and easy to apply.

3. Exercise regularly

Movement helps lower blood sugar naturally.

• 30 minutes of movement most days
• Walking, dancing, gardening, gym, outdoor activities
• Muscle-strengthening twice a week

Exercise improves insulin sensitivity — essential for diabetes prevention.

4. Maintain a healthy weight

Losing just 5–10% of body weight can significantly:

• Lower blood sugar
• Reduce blood pressure
• Improve energy
• Reduce diabetes risk

Weight loss does not need to be fast or extreme — slow, sustainable is best.

5. Improve sleep quality

Poor sleep disrupts hormones that regulate appetite and glucose.

• Reducing screen time before bed
• Keeping a consistent schedule
• Avoiding caffeine late in the day
• Creating a cool, dark sleep environment

6. Manage stress

Stress hormones increase blood sugar.

• Breathing exercises
• Light exercise
• Journaling
• Prayer or meditation
• Talking to supportive friends
• Setting boundaries

7. Drink clean, safe water

Hydration helps regulate glucose and reduce cravings.

Avoid:

• Fruit juice
• Fizzy drinks
• Energy drinks

These can cause massive sugar spikes.

Common myths about diabetes

❌ Myth 1: Eating sugar alone causes diabetes.
Diabetes is influenced by multiple factors, including weight, genetics and overall diet.

❌ Myth 2: If I feel healthy, my sugar is fine.
Many people have high blood sugar without symptoms.

❌ Myth 3: Only overweight people get diabetes.
People of all sizes can develop type 2 diabetes.

❌ Myth 4: Fruit is bad for diabetes.
Whole fruit is healthy — but fruit juice is not.

❌ Myth 5: Diabetes cannot be prevented.
Many cases are preventable with lifestyle interventions.

Frequently asked questions (FAQs)

Q: How often should I test my blood sugar?
If you’re at risk: yearly screening
If you have diabetes: follow your clinician’s advice (often daily or weekly)

Q: Is rice allowed?
Yes — choose brown rice or smaller portions of white rice paired with vegetables.

Q: Are sweeteners safe?
Most non-nutritive sweeteners are safe in moderate amounts.

Q: Can stress raise blood sugar?
Yes — cortisol increases glucose levels.

Q: Can diabetes be reversed?
Type 2 diabetes can be improved — and sometimes reversed — with weight management and lifestyle changes.

Practical blood sugar checklist

• Choose low-GI foods
• Move for 30 minutes a day
• Drink water, not sugary drinks
• Control portion sizes
• Maintain a healthy weight
• Prioritise sleep
• Reduce stress
• Limit salt and fatty foods
• Test sugar levels regularly if at risk
• Attend annual check-ups

When to seek medical help

Seek medical attention if you experience:

• Excessive thirst
• Rapid weight loss
• Persistent fatigue
• Frequent infections
• Wounds that don’t heal
• Severe dizziness
• Numbness in hands or feet

Early intervention prevents complications.

References

• WHO – Diabetes Fact Sheet
• Heart and Stroke Foundation South Africa (n.d.)Diabetes

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