World Diabetes Day: “Breaking Barriers, Bridging Gaps”

Diabetes and Tuberculosis (TB) are two significant public health challenges in South Africa, both of which are worsening due to systemic gaps in healthcare delivery. This is coupled with insufficient data collection and inadequate prevention efforts. As the world observes World Diabetes Day under the theme “Breaking Barriers, Bridging Gaps”, the question of how diabetes contributes to TB patients is once again raised.

Diabetes has become one of the top ten causes of death in the country, and the rising prevalence of type 2 diabetes is being fuelled by urbanisation, changing lifestyles and a lack of targeted healthcare interventions. This growing burden not only exacerbates the challenges faced by an already overburdened public healthcare system but also threatens to reverse progress in controlling TB – a long-standing public health priority. Together, diabetes and TB form a dangerous synergy that requires urgent attention and integrated management strategies.

In an article published by Spotlight, highlights the crisis posed by diabetes in South Africa. Emphasising the absence of a centralised registry or comprehensive data on its prevalence. The lack of data leaves many patients undiagnosed or untreated, with disparities in access to care specifically in rural areas. While prevention programmes such as public awareness campaigns, lifestyle interventions and enhanced screening are critical, they remain poorly coordinated and underfunded. Furthermore, national policy frameworks have not prioritised diabetes adequately and investment in research remains insufficient to address the knowledge gaps needed for informed decision-making.

This narrative by illustrating the complex relationship between diabetes and TB is similarly addressed in the 2019 International Union Against TB and Lung Disease article which shows how the two diseases exacerbate one another. Diabetes increases the risk of developing active TB disease by two to three-fold, with the association further amplified by risk factors such as HIV infection and smoking.

The interplay between diabetes and TB shows the interconnected nature of chronic and infectious diseases in the country. As diabetes prevalence continues to rise, fuelled by systemic gaps and socio-economic factors, it threatens to reverse gains in TB control and place an even greater strain on the healthcare system. Addressing these dual epidemics requires a coordinated response that prioritises prevention, improves data collection, and integrates care delivery. Only through these measures can South Africa mitigate the impact of diabetes and TB on its population and strengthen its healthcare system to meet the needs of those most affected.