Don't wait until it hurts: Diabetes calls for early action

Detailed summary

Diabetes is a silent condition that often causes years of unseen damage before symptoms appear. Endocrinologist Dr Ankia Coetzee explains why early testing,…

Saturday 14 November is World Diabetes Day. For 2026 and 2027, the International Diabetes Federation (IDF) and the World Health Organisation (WHO) have chosen the theme “Early action on diabetes”. As an endocrinologist, I cannot think of a theme closer to my heart.

Almost every week, someone sits across my desk and says: “But doctor, I didn't feel a thing.” Often they discover their high sugar by chance, at an insurance medical or before an operation. Sometimes the diagnosis is only made after a complication such as a heart attack or stroke, or when an eye specialist notices damage to the retina. Diabetes is a silent disease, and that is exactly what makes it so dangerous. By the time it hurts, it has usually been causing damage, unnoticed, for years.

The numbers are sobering. According to the IDF, more than half a billion people worldwide live with diabetes, and almost half of them do not know it. One in eight adults is at high risk of developing type 2 diabetes. The WHO aims for 80% of people with diabetes to be diagnosed by 2030. In South Africa the picture is even worse: it is estimated that up to two-thirds of people with diabetes remain undiagnosed.

First, get tested. The good news is that it is easy. The oral glucose tolerance test remains the gold standard, but any opportunity to test should be used: fasting or a random glucose test, or an HbA1c test, which reflects your average sugar over the past three months and does not require fasting.

International guidelines recommend that all adults be tested from the age of 35 years, and earlier if you have risk factors. These include being overweight, especially around the middle, a family history of diabetes, diabetes during a previous pregnancy, high blood pressure or cholesterol, or an inactive lifestyle. Know the warning signs: thirst, passing urine often, tiredness, blurred vision, weight loss and recurrent infections.

Remember, too, that one normal test is not a lifelong guarantee.

Second, prediabetes is an…

Opening of the article, excerpted from Mail & Guardian. To read the rest, open the article on the publisher's site.