Furthermore, diabetes accounts for almost one out of every three deaths among the economically active age group of 30 to 40 years. Consequently, the economic burden of diabetes in terms of healthcare costs and loss of productivity is massive.
According to The International Diabetes Federation, one in every 11 adults worldwide and up to 2,28m adults in South Africa have diabetes. And these figures are expected to rise dramatically in the future. Over the next 20 years, the current population of some 14,2m people with diabetes in Africa will increase to over 3m.
Type 2 accounts for nine out of 10 cases of diabetes. Primarily caused by an unhealthy diet, lack of physical activity and excess body weight, it can progress undiagnosed for years. Around half of all people with type 2 diabetes are unaware that they have it.
In type 2 diabetes, careful control of glucose can help to reduce the risk of cardiovascular, kidney, eye and nerve disease. When this control is achieved early on, the benefits remain for many years. Type 2 diabetes is a progressive disease, although dietary and lifestyle changes may initially be effective in controlling blood glucose, ultimately most people will require escalating doses of medication and many will require insulin.
With appropriate doses it’s possible to achieve target blood glucose control depending on what is required for an individual patient. However, in practice, achieving and sustaining these targets is very difficult, because doctors can err on the side of caution when it comes to dosages, or patients are lax about taking the medication as prescribed. Close to 40% of diabetics report that daily medication interferes with their ability to live a normal life.
Local and international diabetes specialists came together at the first New Generation Insulin Summit in Cape Town, to share advancements in understanding of diabetes and its management with over 200 healthcare providers from around the country.
Professor Brynne Ascot-Evans, head of the division of endocrinology and diabetes at the University of Stellenbosch and Tygerberg Academic Hospital, highlighted the global epidemic of diabetes and its effect on South Africans. Speakers included private physicians, Dr Adri Kok and Dr Tanya Kinvig, who spoke about the challenges faced by both prescribers and patients with particular emphasis on those posed by insulin therapy.
They explained that even with the availability of insulin, it is estimated that no more than one quarter of diabetes sufferers currently achieve and maintain their glucose targets, even at tertiary care and university-associated hospitals. These speakers highlighted the importance of education for both patients and healthcare providers and the need for effective treatments that are easy to administer with a low risk of side effects.
Endocrinologist, Dr Zane Stevens, and clinical pharmacology, Professor Jacques Snyman, reviewed highlights in the history of insulin and development of novel molecules that have revolutionised the lives of people with diabetes. These treatments, which are easier to use, require less frequent administration and are less likely to cause serious side effects, such as hypoglycaemia or weight gain, are expected to go at least part of the way in making glucose targets more achievable.
To close the meeting, Dr Manash Baruah, director and consultant endocrinologist at the Excel Centre, Guwahati, India provided some insight into clinical experience with new diabetes treatments that are expected to be available soon.
