As SA marks Women’s Month, health experts are warning of a growing but overlooked threat. Diabetes has become the leading cause of death among SA women — surpassing heart disease, cancer and HIV — and urgent action is needed to reverse the trend.
“We’re facing a public health crisis,” Pharma Dynamics’ scientific division marketing manager Ingrid Singels said.
“Worldwide, diabetes affects men and women equally, but in SA, we see significantly more women living with diabetes than men, and they also face more severe complications. Yet, diabetes remains underdiagnosed and undertreated.”
While genetics and family history can increase susceptibility, lifestyle-related factors, such as poor diet, physical inactivity, obesity, smoking and chronic stress play a larger role in type 2 diabetes.
Other contributors include age, hormonal changes (such as menopause or gestational diabetes), waist circumference and co-existing conditions like high blood pressure and high cholesterol. In SA, living in or close to a city, and unemployment, also play roles.
One of the biggest risk factors is obesity.
According to the SA South African Demographic and Health Survey (SADHS), nearly 68% of women in the country are either overweight or obese. Excess body fat, especially around the abdomen, increases the risk of type 2 diabetes by promoting insulin resistance.
A woman’s risk of developing diabetes is influenced not only by personal lifestyle choices, but also by her environment and socioeconomic circumstances. Research published in BMC Public Health (2023)1 shows contributing factors include limited access to nutritious food, inadequate recreational facilities and poor access to preventative healthcare.
“These realities show that for many SA women, managing or preventing diabetes isn’t just about making healthier choices, it’s about addressing the challenges that limit those choices in the first place,” Singels said.
In SA, diabetes-related deaths are statistically higher among Indian and coloured populations compared to black or white groups.
While diabetes affects both genders, women face unique challenges:
Hormonal changes during pregnancy and menopause can make blood glucose control more difficult.
Gestational diabetes, which develops during pregnancy, increases the risk of type 2 diabetes later in life for both mother and child.
Women are also more likely to suffer from depression, which is linked to poor diabetes self-management and worsened outcomes.
Diabetes symptoms, such as frequent urination, fatigue, blurred vision or increased thirst can be subtle and mistaken for stress or ageing.“Early screening, especially after 40 or during pregnancy, can save lives,” Singels said.
What can be done?
There is no cure for diabetes, but lifestyle interventions can prevent or delay its onset:
Regular exercise (150 minutes per week);
Weight loss (even a 5-10% reduction);
Balanced and healthy low-GI diet;
Routine screening and monitoring.
