WORLD DIABETES DAY: Nearly 80 South Africans Die from Diabetes Daily – UP Expert Calls for Urgent National Action
PRETORIA – Diabetes has remained South Africa’s leading underlying natural cause of death for three consecutive years, claiming nearly 29 000 lives in 2024 alone. A University of Pretoria (UP) public health expert is calling for urgent action to strengthen healthcare and prevent avoidable deaths.
According to the latest Statistics South Africa mortality report, 28 767 South Africans died from diabetes-related complications in 2024. This represents 6.1% of all recorded deaths, or about 79 people every day.
Diabetes was also the leading underlying natural cause of death in 2022 and 2023, with 33 126 and 27 967 deaths, respectively.
Dr Patrick Ngassa Piotie, co-founder of UP’s Diabetes Research Centre and Chairperson of the Diabetes Alliance, says these figures expose a persistent public health crisis that demands immediate intervention.
“These numbers cannot be accepted as South Africa’s new normal,” he says. “Diabetes is mostly preventable and manageable. With timely support, people can lead long, healthy lives free from preventable complications.”
Diabetes is a chronic condition in which the body cannot properly regulate blood sugar levels. Without appropriate treatment, it can cause life-threatening complications affecting the heart, kidneys, eyes, and blood vessels.
Women and working-age adults are most at risk
The national statistics reveal significant inequalities in the burden of diabetes.
In 2024, diabetes claimed 17 429 women’s lives, accounting for 7.9% of all recorded female deaths. Among men, it caused 11 334 deaths, representing 4.5% of male deaths.
Working-age South Africans are also particularly vulnerable. Diabetes was the leading natural cause of death among people aged 45 to 64, accounting for 9 364 deaths, or 7.9% of deaths in this age group.
It also ranked as the leading natural cause of death in five provinces: Gauteng, KwaZulu-Natal, Western Cape, Eastern Cape, and Limpopo.
The findings reflect a broader national health challenge, with noncommunicable diseases, including diabetes and cardiovascular conditions, accounting for 60.7% of all recorded deaths in 2024.
Why better healthcare could save lives
Dr Ngassa Piotie argues that mortality statistics tell us how many lives have been lost to diabetes, but reveal little about the circumstances surrounding those deaths, including whether they could have been prevented through earlier diagnosis, timely treatment, and better-quality care.
“We should not wait until people die to identify where our health system is failing them,” he says. “We must use the evidence available today to improve care, prevent avoidable complications, and save lives.”
Death certificates cannot reveal whether patients received timely diagnoses, had reliable access to medication, or were regularly monitored for complications.
Through UP’s Tshwane Insulin Project, researchers have demonstrated how nurse-led care can help patients with type 2 diabetes start and adjust insulin treatment at primary healthcare facilities, supported by follow-up care at home.
“Survival rarely hinges on high-tech interventions,” Dr Ngassa Piotie says.
Instead, effective diabetes care depends on trained healthcare workers, reliable medicine supplies, regular screening, continuous monitoring, and support that accommodates patients’ everyday circumstances.
From policy to action: Preventing avoidable deaths
South Africa’s National Strategic Plan for Non-Communicable Diseases includes targets known as 90-60-50. These aim to ensure that 90% of adults know their blood pressure and blood glucose status, 60% of those with elevated levels receive treatment, and 50% of those receiving care achieve clinical control.
However, translating these commitments into effective healthcare remains a challenge.
Dr Ngassa Piotie advocates for the establishment of a national diabetes registry and the integration of digital health systems to track patients from diagnosis through treatment, identify those who discontinue care, and monitor complications.
He identifies three immediate priorities: connecting early diagnosis to sustained treatment, measuring healthcare outcomes across districts and provinces, and addressing socio-economic barriers such as food insecurity, transport costs, and limited healthcare access.
Following the 2025 Diabetes Summit, the Diabetes Alliance launched the Johannesburg Declaration for Accelerated Action on Diabetes in South Africa, calling for coordinated national leadership, sustainable financing, and stronger primary healthcare.
For Dr Ngassa Piotie, preventing avoidable diabetes-related deaths requires more than awareness campaigns. It demands a coordinated national response that ensures patients receive the continuous care they need.
“People living with diabetes must help define what quality care looks like,” he says.
Read Dr Ngassa Piotie’s full article in The Conversation.
