Legacy Effect
Early intervention in diabetes management significantly impacts long-term health outcomes. Studies indicate that good blood sugar control in the early stages of type 2 diabetes can create a lasting “legacy”. The UK Prospective Diabetes Study found that patients who received intensive treatment shortly after diagnosis experienced 15% fewer heart attacks and 13% fewer deaths even ten years later, despite their sugar levels aligning with those of a comparison group.
In type 1 diabetes, similar results were noted in the DCCT/EDIC studies, which revealed that early tight control reduced the risk of future heart disease by half. The period immediately after diagnosis is a critical window of opportunity.
Our Words Matter
Stigma surrounding diabetes is a pressing issue. Many patients feel guilt and shame regarding their diagnosis, believing, “I brought this on myself,” which is simply not true.
It’s essential to state clearly: diabetes is not your fault. Type 2 diabetes has a strong genetic component. If a close family member has it, your risk is significantly higher, regardless of your lifestyle. Genetics influence how your body regulates insulin, and you can’t control that. Additionally, we live in an environment filled with cheap, processed food and sedentary lifestyles, a mismatch for our survival instincts.
While we shouldn’t solely blame genetics, lifestyle choices like diet, exercise, sleep, and stress management can either delay diabetes onset or help manage it. Type 1 diabetes, however, is an autoimmune condition unrelated to lifestyle habits.
Guilt and shame achieve nothing; they drive people away from doctors and testing, countering the goal of early intervention. I urge healthcare professionals, employers, media, and families to refer to individuals as “people with diabetes” rather than “diabetics”, fostering support over blame.
Care
A diagnosis is only beneficial if it leads to effective care. The WHO emphasises that diagnosis means little without timely, affordable, and consistent management. In South Africa, we face significant challenges.
Many patients wait months for appointments, encounter shortages of medication at clinics, or cannot afford necessary test strips and medications. Policymakers, medical schemes, and employers need to recognise that investment in prevention and proper management today reduces future healthcare costs.
It Is Never Too Late
For those already living with diabetes, it’s not too late to take action. Most complications can be prevented or delayed. Monitor your health metrics, including BMI, HbA1c, blood pressure, and cholesterol. Avoid smoking, and ensure regular eye and foot check-ups along with kidney screenings through simple urine tests. Treatment options have dramatically improved recently, adding heart and kidney protection, as well as technology like glucose monitors to reduce burdens.
This World Diabetes Day, I encourage everyone to get tested. Request a glucose test or HbA1c from your doctor or pharmacy, particularly if you’re over 35 or have risk factors. Motivate family and colleagues to do the same. A simple blood test today can safeguard your health for years to come.
Diabetes won’t wait for us, so we shouldn’t delay in addressing it.
