Education

The potential threat from type 2 diabetes in  South Africa remains dangerously underestimated and its current prevalence widely unrecognized. Yet the problem is growing at an alarming rate. A series of factors that are particular to the region represent enormous obstacles to an effective response by people with the condition, healthcare providers and wider society. In this article, Noy Pullen identifies some of the key socio-economic, environmental and educational issues affecting rural South Africa.

Environmental  factors,  such  as  lifestyle  and  dietary choices, play a key role in determining a child’s body weight. Omnipresent and relentless advertising for low-quality convenience foods together with an over-reliance during leisure hours on television, computers and video games are driving an alarming increase in the incidence of obesity-related non-communicable diseases like type 2 diabetes among young people worldwide.

The World Diabetes Day campaign is led by the International Diabetes Federation and its member associations. Created by the Federation and the World Health Organization in 1991, World Diabetes Day is an official United Nations Day. The campaign draws attention to issues of paramount importance to the diabetes world and keeps diabetes firmly in the public spotlight. The campaign is represented by a blue circle logo that was adopted after the passage of the United Nations Resolution on diabetes.

Diabetes provokes a range of reproductive and sexual health problems: menstrual changes, fertility disorders, urinary and vaginal infections, urinary incontinence and sexual dysfunction. Early diagnosis and treatment of these problems, with well-planned pre-conception care, can protect maternal and infant health. In this report, Seyda Ozcan and Nevin Sahin call for reproductive and sexual healthcare to be included in women’s diabetes management plan.

The period after a woman gives birth provides a window of opportunity to impact on her short- and long-term future health. The end of a pregnancy heralds a transition both physically and mentally, and in terms of self-care. After delivery, most of the hormones that make a woman with gestational diabetes insensitive to the action of insulin are no longer present. In women with pre-existing diabetes, insulin needs drop dramatically; some women requiring insulin therapy to live may not need insulin for up to 72 hours.

Registered nurse and diabetes educator, Michael Porter, first presented the Sugarman project at a hospital in South Australia and has since used it at events around the country. His aim was to tackle the serious and growing problem of diabetes in the Indigenous population by devising a way to provide diabetes education to adults and children in an enjoyable and interactive way. The Sugarman takes the form of an outline of a body on a large piece of canvas. Participants in the Sugarman sessions carry out activities to learn about glucose metabolism and aspects of the management of diabetes.

People  with  diabetes  face  a  range  of challenges. Having the condition affects all areas of life; a number of psychological and emotional factors are involved. Recently, one of the authors of this article, Robin Wynyard, was diagnosed with type 2 diabetes. The shock of being diagnosed provoked in him and his partner, Sue Shea, negative feelings that included fear, anxiety and uncertainty – a common emotional response which often goes unreported in the related literature.

The type 2 diabetes epidemic is having a growing impact on individuals, communities, healthcare systems and national economies. There are an estimated 246 million people worldwide diagnosed with some form of diabetes; it is estimated that, by 2025, this number will grow to 380 million. In developing regions, the growth rate of diabetes is 70%, which is greater than that in other parts of the world.

Many people with diabetes live with some form of visual impairment due to a variety of possible causes. Visual impairment due to diabetic retinopathy is a long-term complication of the condition. Diabetes also raises the risk for visual impairment due to cataracts, glaucoma and stroke. Age-related macular degeneration is not caused by diabetes, but like type 2diabetes, it occurs more frequently as people age, and many people have both.

Diabetes management involves more than just medical treatment (healthcare providers prescribing insulins and other medications to people with the condition in order to avoid or postpone diabetes complications); it is far more complex. People with diabetes are required to take responsibility, with the help of professional educators, for the day-to-day management of their condition. A major challenge inherent in diabetes management is striving to become a fully participating, active, productive member of society.