The number of people in South Africa, and around the world who live with diabetes, is staggering. According to the International Diabetes Federation (IDF) 537 million adults between the ages of 20-79 years are living with diabetes, roughly one in 10, with almost with almost half unaware that they are living with the condition.
This number is projected to rise to 643 million by 2030 and 783 million by 2045. It is also South Africa’s second biggest killer, according to research carried out by Wits University. As of August 2024, approximately 4.2 million people in South Africa had diabetes, representing about one in nine adults. However, the accurate number of individuals with diabetes is uncertain due to insufficient surveillance.
There is not enough understanding of the links between diabetes and hypertension, and heart failure. Not many South Africans realise that common conditions like diabetes and hypertension are not just chronic illnesses to be managed on their own — they are also major drivers of heart failure.
According to Lizeth Kruger, Dis-Chem Clinic Executive, all too often patients are not aware of the direct correlation between non-communicable diseases like diabetes and hypertension and heart failure.
“While Diabetes Awareness Month highlights the importance of managing blood sugar levels, it’s equally vital to understand the broader impact of diabetes on heart health. These diseases are diagnosed, treated, and managed daily, yet awareness of how they contribute to serious complications such as heart failure remains low,” she says.
Diabetes significantly increases the risk of heart disease because consistently high blood sugar levels damage blood vessels and nerves, leading to a condition called atherosclerosis, where plaque builds up in arteries. This leads to reduced blood flow which can cause coronary artery disease, heart attacks, and heart failure.
High blood sugar from diabetes causes hidden damage. Over time, it can damage blood vessels and the nerves that control the heart, and the progression of heart disease can go unnoticed because the damage doesn’t typically have visible symptoms in its early stages. Furthermore, nerve damage from diabetes can mask heart attack symptoms, causing them to go undetected or be mistaken for other issues.
People with diabetes may experience heart problems that don’t feel like the typical chest pain; they might notice unexplained fatigue, shortness of breath or dizziness. Many factors that raise the risk of heart disease, like high blood pressure and abnormal cholesterol, also occur with diabetes, so it can be hard to separate diabetes’ exact role. Daily diabetes care, especially keeping blood sugar in check, can take up a lot of attention and make long-term heart risks easy to overlook. If you already have heart disease, your risk is even higher if you also have conditions like high blood pressure or obesity.
Other risk factors like high cholesterol, obesity and high blood pressure often occur alongside diabetes, further increasing the danger to the heart. Managing blood glucose, blood pressure, and cholesterol, alongside lifestyle changes like healthy eating and regular exercise, is crucial for managing heart health in individuals with diabetes.
“People often don’t correlate diabetes and heart disease because the connection isn’t always obvious, even though they are closely linked,” says Kruger.
To stay heart-healthy while managing diabetes, she proposes these proactive steps:
- Have regular check-ups and talk to your pharmacist or healthcare provider about your heart health.
- Keep an eye on your blood pressure and cholesterol, and have your nurse check them during your visits.
- Quit smoking to reduce your cardiovascular risk.
- Eat a balanced diet rich in whole foods and low in added sugars and salt.
- Stay active with regular physical movement suited to your lifestyle and fitness level.
- And if you experience sudden fatigue, dizziness, or shortness of breath, seek medical advice immediately.
These small, consistent actions can make a significant difference in protecting your heart and improving your long-term health.