4 million South Africans have diabetes—most don’t even know it.

South Africa is facing a “diabetes car crash” of epidemic proportions. Currently, an estimated 4.3 million people are living with the condition, making it the country with the highest prevalence of diabetes in Africa—and another 1.6 million may be undiagnosed. Projections warn that by 2045, we could see 7.4 million cases nationwide. (International Diabetes Federation, 2023).

Diabetes is already the leading cause of death among women and the second most fatal chronic disease overall, yet many people miss the early warning signs because they appear gradually and can be mistaken for normal fatigue, aging, or stress.

Prevalence and Statistics

• The International Diabetes Federation (IDF) reports that diabetes has become the leading cause of death in South Africa since 2019, highlighting the severity of the epidemic.

• Despite the high prevalence, many individuals remain undiagnosed, leading to complications that further strain the healthcare system. It is estimated that 10-30% of people achieve adequate control of their diabetes, indicating significant management challenges.

Early Signs & Symptoms to Watch For

While the disease is serious, the body often whispers before it shouts. Symptoms include:

• Persistent thirst and frequent urination (especially at night)

• Unexplained weight loss despite normal or increased appetite

• Blurred vision

• Slow-healing sores or frequent infections

• Tingling, pain, or numbness in hands or feet

• Extreme fatigue and irritability

When to Seek Medical Advice

Don’t wait for symptoms to become severe. You should get tested if you:

• Have two or more symptoms above

• Are over 45 years old

• Have a family history of diabetes

• Are overweight or obese

• Have high blood pressure, high cholesterol, or a history of heart disease

• Had gestational diabetes during pregnancy

Early detection changes everything. A simple finger-prick glucose test or HbA1c check can identify risks before irreversible damage occurs.

Why It’s Often Overlooked

• Gradual onset: Type 2 diabetes develops slowly, so symptoms blend into daily life.

• Misattribution: Tiredness gets blamed on work stress, thirst on the heat, and vision changes on “getting older.”

• Low access to screening: In rural and underserved communities, basic blood glucose checks are not routine.

• Cultural and stigma barriers: Many fear a diagnosis means “a life of illness,” so they avoid testing.

Shockingly, the International Diabetes Federation estimates that 45% of people with diabetes in Africa are undiagnosed—meaning nearly 1 in 2 are walking around unaware of the risks brewing inside their bodies.

The Pharmacist’s Expanding Role in Diabetes Care

South Africa’s diabetes crisis doesn’t make headlines—but it's just as critical as any epidemic. Recent data shows that only 19.4% of adults with diabetes are both diagnosed and effectively managed—meaning over 80% remain invisible or untreated PMC.

Dr. Patrick Ngassa Piotie of the University of Pretoria cuts to the core:

“People with diabetes are not adequately counted in the country… you can’t assess or evaluate the efficacy of your policies” bhekisisa.orgup.ac.za.

This isn’t just a statistic—it’s a call to action: modern, proactive screening and treatment must become the norm, not the exception.

Pharmacists are increasingly becoming the frontline of chronic care, stepping into roles traditionally reserved for doctors.

Pharmacists now:

• Conduct screenings for diabetes and other chronic diseases

• Educate patients on blood glucose monitoring and healthy lifestyle changes

• Review medication regimens to prevent dangerous drug interactions

• Suggest cost-effective alternatives to help patients manage treatment expenses

• Connect patients to prescription assistance programmes to reduce costs

The Cost of Care – and How Pharmacists Help

Chronic illness is expensive. For many South Africans—especially the 83% without private medical cover—medication costs are a deciding factor to follow consistent treatment.

Pharmacists can:

• Recommend generic medications with equal efficacy but lower costs

• Help patients optimise their prescription schedules to avoid wastage

• Enroll patients in chronic medicine dispensing programmes which Pharmacy Direct is proud to support—improving access, adherence, and convenience

A Human Story: When Advice Saves More Than Money

One patient, a 56-year-old woman from Mpumalanga, had been rationing her diabetes medication because of cost. When she finally mentioned this to her pharmacist, they reviewed her prescription, switched her to an equally effective but cheaper generic, and enrolled her in a home delivery programme. Within months, her HbA1c dropped from 10.5% to 7.1%, reducing her long-term risk of complications like kidney disease and blindness.

This is the hidden power of pharmacy-led care—where education, access, and affordability intersect.

Pharmacy Direct: Driving Access and Adherence in Diabetes Care

At Pharmacy Direct, our mission is to ensure no patient is left behind. We:

• Deliver chronic medication for free to homes, workplaces, or doctor’s rooms nationwide

• Partner with government and medical aids to streamline chronic care

• Provide direct patient support for adherence, lifestyle guidance, and follow-up

• Leverage digital-first solutions to ensure timely refills and ongoing education

In a country where millions risk undiagnosed or poorly managed diabetes, we believe

access + education + affordability = better outcomes!!

Community and Support Initiatives

• Organizations like Diabetes South Africa and the Diabetes Alliance are actively working to improve awareness, education, and access to care for individuals living with diabetes. They aim to create a united voice for diabetes advocacy and enhance collaboration among various stakeholders in the healthcare system.

• The Sweet Life community also plays a crucial role in empowering individuals with diabetes through education and support, helping to normalize discussions around the condition and its management.

In summary, diabetes poses a significant health challenge in South Africa, with high prevalence rates and management issues that require urgent attention and coordinated efforts from healthcare providers, policymakers, and community organizations.

Over to you:

Have you or someone you know experienced challenges in diabetes diagnosis or management? How has your pharmacist played a role in your care? Let’s talk.

#Diabetes #PharmacistsCare #ChronicCare #ValueBasedCare #DigitalHealth #PharmacyDirect