Diabetes Red Flags You Might be Ignoring 🚨

November is Diabetes Awareness Month. Pre-diabetes is the quiet corridor that leads to type 2 diabetes—and it often arrives without any noticeable symptoms. An estimated 4.2million people in South Africa have diabetes, with a significant portion of these cases being undiagnosed. That implies that you probably know someone who is in danger, or it could be you. The good news is that, with prompt intervention, pre-diabetes can be reversed. Here's what to do today, when to get screened, and how to recognise the signs.

Why this matters for South Africans

• Diabetes is rising fast in South Africa, driven by ultra-processed foods, inactivity, and high rates of obesity.
• Hypertension and high cholesterol commonly travel with diabetes, boosting the risk of heart attack and stroke.
• Many South Africans only get diagnosed at hospital—after nerve, kidney, or eye damage has started. Acting now can help you avoid expensive care and medical debt.

The subtle red flags most people miss

Pre-diabetes symptoms are easy to dismiss because they’re vague. Keep an eye out for:

• Constant thirst and frequent urination
• Fatigue that lingers even after sleep
• Blurry vision that comes and goes
• Tingling or numbness in hands/feet
• Slow-healing cuts or recurring skin infections
• Unexpected weight changes
• Increased hunger shortly after meals

Not everyone will have symptoms. That’s why screening is essential, especially if you have risk factors like a family history of diabetes, are overweight, have gestational diabetes, or live an inactive lifestyle.

When to get screened?

• Adults over 35: test regularly if you have risk factors.
• High-risk groups (overweight, hypertension, high cholesterol, family history, history of gestational diabetes): test yearly.
• If you have symptoms: don’t wait—book screening at your nearest clinic, GP, or pharmacy wellness clinic.
• Common tests include fasting glucose, HbA1c, and an oral glucose tolerance test (OGTT). Ask your healthcare provider which is appropriate based on your situation and access.

Potential treatments

Lifestyle changes

Making lifestyle modifications is crucial for diabetes. Adopting a healthy diet that focuses on whole grains, lean proteins, and plenty of vegetables can help control blood sugar levels. This doesn’t need to be complicated or expensive—local, familiar foods can work well. Aim to:

Build balanced plates: half vegetables or salad; a quarter lean protein like chicken, fish, eggs, beans, or lentils; and a quarter high-fibre starch such as brown rice, samp-and-beans, wholewheat pasta, or sweet potato.

Choose smart swaps: wholewheat instead of white bread; smaller pap portions with extra spinach/morogo; rooibos tea or water instead of sugary cooldrinks and energy drinks; grilled rather than fried foods; beans and tinned fish as affordable protein options.

Watch portions: use a smaller plate, slow down while eating, and aim for mealtime consistency to avoid large spikes.

Add fibre: oats, beans, lentils, apples, pears, and leafy greens help stabilise blood sugar and keep you fuller for longer.

-Limit highly processed foods: crisps, sweets, pastries, and takeaways can push blood sugar and weight up quickly.

Nutrition support for low-income communities

• Addressing diabetes in South Africa requires targeted efforts to support low-income communities. Many individuals may struggle to access healthy foods due to financial constraints. Practical steps can help:
• Prioritise budget-friendly staples: beans, lentils, split peas, tinned fish, eggs, seasonal vegetables, bulk oats, and brown starches can be affordable and nutritious.
• Batch cooking and portioning reduce costs and help prevent overeating.
• Shop with a list, compare unit prices, and limit sugary snacks and drinks that drain the budget and raise blood sugar.
• Community gardens, food cooperatives, and stokvels can improve access to fresh produce and shared cooking resources.
• Seek dietetic advice where available through clinics or community programmes—small adjustments can make traditional meals more diabetes-friendly.

Regular physical activity is also essential. Even simple, consistent movement helps. Try:

• At least 150 minutes per week of moderate activity (brisk walking, dancing, cycling), broken into 20–30-minute sessions.
• Add 2 days per week of strength activities (bodyweight exercises, resistance bands, or simple home routines) to improve insulin sensitivity.
• Short post-meal walks (10–15 minutes) to reduce glucose spikes.
• Use community-based exercise programmes, walking groups, or local sports to stay accountable. Churches, community halls, and parks can be low-cost venues to keep active.
• Small changes add up. Even a 5–10% weight reduction can significantly improve blood sugar levels, blood pressure, and cholesterol.

Diabetes education and support

Education and support programs are vital in helping individuals understand and manage their diabetes. Community-based clinics, hospitals, and NGOs often provide diabetes education, teaching patients about blood sugar monitoring, medication management, and healthy lifestyle choices. Support groups can also provide emotional support and motivation for those living with diabetes.

• Learn to use a glucose monitor, interpret readings, and adjust habits accordingly.
• Understand your targets and what to do when numbers are high or low.
• Get practical food coaching to manage cultural and family foods in a diabetes-friendly way.
• Join support groups—peer connection improves motivation and quality of life.

If available, ask your clinic or pharmacy about group classes, WhatsApp support, or nurse-led education sessions

Regular screenings and check-ups

Regular check-ups with healthcare providers are essential for monitoring diabetes and its potential complications. You should emphasise the importance of routine screenings for diabetes-related complications, including:

- Eye exams to detect diabetic retinopathy early and prevent vision loss.

- Foot exams to detect neuropathy, calluses, poor circulation, and foot ulcers—check your feet at home weekly and seek help for any wounds.

- Blood pressure and cholesterol checks to reduce heart and stroke risk.

- Kidney tests (urine and blood) to pick up early damage and treat it promptly.

- Dental check-ups—gum disease is more common in diabetes and can affect glucose control.

Use primary healthcare clinics, pharmacy wellness clinics, or your GP, depending on what you can access. If costs are a barrier, ask about public-sector options, chronic medication dispensing, and community screening days.

The bottom line

Diabetes is a major public health issue in our nation, and managing this chronic illness requires knowledge of the warning signs and available treatments. People can enhance their quality of life and lower their risk of difficulties by identifying red signs early, being evaluated promptly, and adhering to a realistic plan that includes changing lifestyle choices, taking medication when necessary, and scheduling routine checkups.

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