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More than half of diabetics unaware they have killer disease

South Africa’s diabetes time bomb is much bigger than previously thought.

Almost one in five (18.9%) people over 40 have diabetes‚ the country’s second biggest natural killer‚ according to a study by Boston University School of Public Health.

The US researchers‚ who claim to have provided the first nationally representative estimate of the burden of diabetes in adults‚ said the previous accepted prevalence rate was one in seven (14.3%).

Discussing their findings‚ the researchers make several alarming observations‚ including:

- A lack of screening meant 53.7% of diabetics were undiagnosed;

- Among those on insulin‚ only 51.2% had controlled blood sugar; and

- Only 19.4% were being treated and had their blood sugar under control‚ “suggesting that 80.6% of the diabetic population had unmet need for care”.

“Several factors may contribute to the high rate of unmet need for diabetes care in South Africa ... among them problems with access‚ health-seeking behaviour‚ and health system quality‚” lead researcher Andrew Stokes writes in the journal PLOS ONE.

“Insufficient access to health care services is widespread‚ with the most important barriers to access relating to low socio-economic status‚ racial background‚ lack of health insurance and the costs incurred in travelling to clinics.”

Stokes and his team looked at 4‚083 people questioned and tested in 2011 and 2012 by the Human Sciences Research Council as part of its South African National Health and Nutrition Examination Survey.

They found that diabetes prevalence was higher in blacks‚ particularly Indians and Asians. The number of unscreened diabetics was also higher among blacks.

But the researchers said the launch in 2013 of the health department’s strategic plan to prevent and control non-communicable diseases‚ including diabetes‚ was a source of optimism.

“Given South Africa’s large past investments in chronic HIV care‚ the national non-communicable diseases strategy outlines an approach that integrates diabetes care into these existing systems.”

The new figures should be used as a benchmark for evaluating the effectiveness of the new strategy‚ “particularly the re-engineering of primary care”.

 

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