Why Diabetes Screening Is Essential

Diabetes is a silent killer. Here are your screening options. 

It’s human nature to avoid bad news. The problem is that the longer you leave it, the worse the news can get – especially when it comes to chronic illnesses like diabetes. Mediclinic Vergelegen’s Dr Elmo Pretorius, a specialist physician and endocrinologist, was reminded of this sobering lesson repeatedly in the early days of the COVID-19 pandemic. 

“Lots of patients admitted to hospital with COVID-19 pneumonia and other complications turned out to have undiagnosed diabetes – in my practice alone, I got probably about 20 new patients who hadn’t known before COVID-19 that they were diabetic,” says Dr Pretorius.

This is often the case with type 2 diabetes, the more common of two varieties of the disease; the other, type 1, is caused by a lack of insulin in the body, while type 2 is what the Mayo Clinic describes as “an impairment in the way the body regulates and uses sugar (glucose) as a fuel” – many of us will recognise the term “insulin resistant” to describe this condition. The symptoms of type 2 diabetes don’t always present early on in the disease. “Often, you’re asymptomatic for years”, explains Dr Pretorius. This, he says, emphasises how important it is to screen regularly for diabetes.

Risks and testing

It’s particularly important for high-risk individuals to undergo screening for diabetes as part of their annual health check. This includes people with a family history of the disease; those who have hypertension or a history of cardiac conditions; those who are obese and women with polycystic ovarian syndrome. If you don’t fall into any high-risk groups, you should still start screening annually once you reach age 45. But, as Dr Pretorius points out, many health insurers suggest clients check their sugar levels annually, whether they have symptoms – e.g., constant thirst, more frequent urination, unexplained weight loss or blurry vision – or not. That’s because early detection, treatment and management can make all the difference. 

Various tiers of testing for type 2 diabetes exist. If you’re low risk and have no symptoms, a simple finger prick glucose value test will more or less exclude overt diabetes, Dr Pretorius says. There’s also the fasting glucose value test, which involves having blood drawn while fasting and the plasma glucose being tested. An oral glucose tolerance test is the most sensitive and is used, for instance, to ensure that pregnant women don’t have undiagnosed type 2 diabetes. Your GP or pharmacist can advise about the best test for your requirements.

A rising pandemic

These days when we think of the word “pandemic”, our minds likely turn to COVID-19. But Dr Pretorius warns that type 2 diabetes, too, fits the bill. According to the World Health Organization, 422 million people worldwide have diabetes, most of them in low- and middle-income countries. It’s the second leading cause of death in South Africa. Data from 2018 released by Statistics SA in 2021 found 5.9% of natural deaths had diabetes as their underlying cause. And academic research has established that the prevalence of type 2 diabetes is rising in our country.

“Type 2 diabetes is a fairly new pandemic in the world; it used to be quite rare. We’re living now in a time of opulence with so much food – people don’t watch what they eat, and we know that obesity is one of the greatest risk factors. This is a disease of lifestyle,” Dr Pretorius says.

I got probably about 20 new patients who hadn’t known before COVID-19 that they were diabetic.

And it’s a disease for life: “It is a long-term thing. There are no quick fixes; no quick solutions, or a pill or operation that will solve the problem. It’s about long-term control – a marathon, not a sprint.”

That’s why developing a relationship with your GP or a specialist is vital.

“You walk a path with your patients, guiding them through changing their lifestyle, and assessing what the right medication is for them when there are so many drugs on the market. Patients need to make choices that will help change their lifestyles. Be proactive. Get diagnosed, get onto medication, get controlled,” Dr Pretorius advises.

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