By Fedhealth

Discover why diabetes is rising across South Africa and learn 6 proven strategies to prevent and manage Type 2 diabetes through diet, exercise, and awareness.

Diabetes has emerged as one of the most pressing concerns of the 21^st century described by experts a “global tsunami.” In South Africa, this condition has reached epidemic proportions, surpassing HIV/AIDS and cancer in mortality rates. According to the University of Pretoria Diabetes Research Centre more than 4 million South Africans are living with diabetes, while an additional 5 million have prediabetes, placing them at high risk of developing the condition. These figures underscore a dramatic transformation from a once rare condition into a major national health emergency.

Understanding Prediabetes and Diabetes

Prediabetes occurs when blood glucose levels are higher than normal but not yet high enough to be classified as diabetes. According to Mayo Clinic a healthy fasting blood sugar level is below 100, whereas a person with prediabetes has a fasting blood sugar level between 100 and 126. Once levels have surpassed 126, it’s classified as type 2 diabetes. This indicates that the body resists insulin or doesn’t produce enough to maintain healthy blood sugar levels.

Diabetes results from the body’s inability to produce or properly use insulin—a hormone essential for regulating blood sugar. Over time, uncontrolled glucose levels damage blood vessels and nerves, leading to severe complications such as heart disease, kidney failure, nerve damage, and vision loss.

Type 2 diabetes, which accounts for over 90% of diabetes cases globally, is often referred to as “the silent killer” because it can progress unnoticed for years before diagnosis. Many individuals only discover the condition after significant organ damage has occurred. Early detection, preventative measures, and effective management are therefore vital to slowing the disease’s progression and reducing its impact on public health.

The Rise of Diabetes in South Africa

South Africa’s increasing diabetes prevalence is driven by rapid urbanisation, sedentary lifestyles, and widespread consumption of processed foods high in sugar, salt and unhealthy fats. Furthermore, socioeconomic disparities limit access to nutritious food and healthcare, leaving many individuals unable to detect or manage the disease early.

Diabetes is now the second leading cause of death in the country, following tuberculosis. Alarmingly, many people with prediabetes remain undiagnosed, putting them at heightened risk of developing diabetes and its associated complications.

Evidence-Based Prevention and Management Strategies

Although the statistics are concerning, diabetes and prediabetes are largely preventable and manageable through sustainable lifestyle choices. Evidence shows that individuals who adopt healthy dietary patterns, maintain active lifestyles, and manage their weight, can significantly reduce their risk of developing Type 2 diabetes – or if already diagnosed, can control and even reverse the condition.

Below are 6 scientifically supported strategies for diabetes prevention and management:

1. Maintain a Healthy Weight

Excess body weight, particularly abdominal fat, increases insulin resistance and the likelihood of developing Type 2 diabetes. Research by the University of Texas MD Anderson Center shows that losing as little 10% of your body weight can significantly decrease your risk for insulin resistance. Adopting a balanced diet combined with regular physical activity is therefore essential.

2. Choose a Balanced, Fibre-Rich Diet

Nutrition plays a central role in diabetes prevention and management. A diet rich in whole grains, legumes, vegetables, fruits, and lean proteins can help regulate blood sugar levels and promote sustained energy. Foods high in fibre slow glucose absorption, preventing sudden spikes in blood sugar. Conversely, refined carbohydrates, sugary beverages, and processed snacks – which are common in urban South African diets – should be minimised.

Healthy fats found in olive oil, avocado, and nuts also support stable glucose levels, heart health, and other metabolic functions.

3. Quit Smoking

Smoking increases the risk of developing Type 2 diabetes by impairing insulin function and worsening vascular damage. The National Library of Medicine notes that quitting smoking offers significant advantages in managing diabetes related complications. Seek support from healthcare professionals or smoking cessation programmes to improve your chances of success.

4. Stay Hydrated

Water is fundamental to optimal metabolism and glucose control. Dehydration can cause blood sugar levels to rise, while sugary beverages, soft drinks, and fruit juices contribute to weight gain and insulin resistance. Healthline recommends drinking six to eight glasses of water daily.

5. Maintain Healthy Vitamin D Levels

Vitamin D supports glucose metabolism and insulin sensitivity. Insufficient Vitamin D levels have been linked to an increased risk of insulin resistance and Type 2 diabetes. Including fatty fish, eggs, cheese, and fortified dairy products in your diet—or getting moderate sunlight exposure—can help to maintain optimal Vitamin D levels.

6. Engage in Physical Activity

Regular exercise enhances insulin efficiency, improves circulation, supports mental well-being and aids in maintaining a healthy body weight. At least 150 minutes of moderate-intensity physical activity weekly, such as brisk walking, cycling, or swimming is recommended. For beginners, even a 30-minute daily walk can make a measurable difference in controlling blood glucose levels.

Diabetes may be a lifelong condition, but it does not have to be a life sentence. November 14 marks World Diabetes Day, a campaign dedicated to raising awareness about diabetes prevention and management.

With awareness, commitment, and proactive lifestyle choices, it is possible to live a full, healthy life.

References

• American Diabetes Association. (n.d.-a). Weekly exercise targets. Retrieved from https://diabetes.org/health-wellness/fitness/weekly-exercise-targets
• American Diabetes Association. (n.d.-b). What superfoods are good for diabetes? Retrieved from https://diabetes.org/food-nutrition/food-and-blood-sugar/diabetes-superstar-foods
• Cleveland Clinic. (2023). Diabetes. Retrieved from https://my.clevelandclinic.org/health/diseases/7104-diabetes
• Fedhealth. (2014). Commit to quit: Understanding smoking cessation. Retrieved from https://www.fedhealth.co.za/articles/how-to-quit-smoking-2/
• Fedhealth. (2016). We’ve got to move-it, move-it! Retrieved from https://www.fedhealth.co.za/articles/weve-got-to-move-it-move-it/
• Harvard Health Publishing. (2023). Healthy lifestyle can prevent diabetes (and even reverse it). Retrieved from https://www.health.harvard.edu/blog/healthy-lifestyle-can-prevent-diabetes-and-even-reverse-it-2018090514698
• Higuera, V. (2024). What to know about diabetes and dehydration. Healthline. Retrieved from https://www.healthline.com/health/diabetes/diabetes-and-dehydration
• Hofman, K., et al. (2023). Diabetes: SA’s second biggest killer. University of the Witwatersrand. Retrieved from https://www.wits.ac.za/news/latest-news/opinion/2023/2023-11/diabetes—sas-second-biggest-killer.html
• Mayo Clinic. (2023). Prediabetes. Retrieved from https://www.mayoclinic.org/diseases-conditions/prediabetes/symptoms-causes/syc-20355278
• Mayo Clinic. (2024). I’ve been diagnosed with prediabetes: What does that mean? Retrieved from https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/ive-been-diagnosed-with-prediabetes-what-does-that-mean
• Mayo Clinic. (2025). Type 2 diabetes. Retrieved from https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/symptoms-causes/syc-20351193
• Ngassa, P., et al. (2024). South Africa has more than 4 million people living with diabetes—many aren’t getting proper treatment. University of Pretoria Diabetes Research Centre. Retrieved from https://www.up.ac.za/diabetes-research-centre/news/post_3214595-up-expert-opinion-south-africa-has-more-than-4-million-people-living-with-diabetes-many-arent-getting-proper-treatment
• South Africans with Diabetes. (n.d.). #WearBlueforDiabetes & Change a Life. Retrieved from https://sweetlife.org.za/wear-blue-for-diabetes/
• Van Thomme, G. (2025). What’s the best diet for insulin resistance? University of Texas MD Anderson Center. Retrieved from https://www.mdanderson.org/cancerwise/whats-the-best-diet-for-insulin-resistance.h00-159774078.html
• Walicka, M. (2024). Influence of quitting smoking on diabetes-related complications. National Library of Medicine. Retrieved from https://pubmed.ncbi.nlm.nih.gov/38810420/