The importance of lifestyle modification in the prevention of developing type-2 diabetes cannot be underestimated and must be a primary focus of the management of the disease…

This World Diabetes Day, AstraZeneca is advocating for healthy lifestyle change for all South Africans through its Yes2Life Pledge Campaign.

“We recognise that a healthier world begins with education to help individuals make informed decisions and navigate available tools and resources. Yes2Life is an extension of our early action initiative and we are asking South Africans what they will do to change their story and say Yes2Life. We are inviting them to commit to healthier eating, increased exercise, better stress management, more sleep and balanced living and to kick bad habits,” says Rodney Gillespie, Country President, AstraZeneca South Africa.

Increase in diabetes in Africa

Statistics from the International Diabetes Federation’s 2015 update show that the total number of people with diabetes in Africa is expected to increase by 20 million in 20401, bringing the total to 34,2 million diabetic patients on the continent1.

A figure that was 14,2 million in 2015 – it’s not over reaching to suggest that we are facing a diabetes pandemic. Globally the picture is as bleak with 642 million people expected to develop type-2 diabetes1 within this same timeframe. A disease that is associated with significant comorbidities that contribute to an increased risk of costly hospitalisations2; the logical response is to radically change the approach to the prevention, diagnosis and treatment of this disease.

“Treatment goals still remain suboptimal

Commenting on the severity of the illness and how it’s currently being managed, AstraZeneca CV/Met Medical Advisor, Arvind Hariram says, ”While existing medicines have been of great benefit in the management of diabetes, treatment goals still remain suboptimal3 and there’s a need for newer treatment options to manage this progressive disease which is responsible for someone dying every six seconds4 globally.”

“We are entering a new era of diabetes care and have the potential to change the diabetes landscape. At AstraZeneca we are pushing the boundaries of science so that we might offer new treatment options to better manage this disease and we’re proud to have brought the first SGLT2 inhibitor to the South African market. A medication that works in the kidney by blocking the reabsorption of glucose which is then excreted in the urine; it’s part of a new class of blood glucose lowering medicines. We believe this innovative approach will help improve the current unmet need.”

Education and advocacy needed

Dr Sundeep Ruder made a strong case for education and advocacy in the treatment of diabetes, stating that science cannot be seen in isolation. He says, “With current research showing the impact of stress, job strain, sleep abnormalities and food security on increased risk of diabetes – there’s now an even stronger need for education to better manage the pandemic.”

‘Early Action in Diabetes’ initiative

AstraZeneca has pioneered and funds The Early Action in Diabetes initiative – a multi-year, multi-stakeholder global collaboration launched in 2015 that aims to radically transform the world’s approach to type-2 diabetes.

By design the programme is committed to translating evidence into practical policies applicable in low-, mid- and high income countries. It’s built on four pillars of early action, including prevention; early detection; early control; and early access. These pillars are firmly rooted in the evidence base of what is most valuable in reducing the economic, societal and personal burden of type-2 diabetes – which accounts for 90% of cases5.

100 leading global diabetes experts gathered together

The most recent meeting of the Early Action stakeholders, saw over 100 leading global diabetes experts gather in Rome for the 2017 Global Diabetes Policy Forum.  Besides the agreement that the proportions of diabetes show no signs of relenting – the interconnectivity of metabolic, cardiovascular and renal diseases was a central theme.

”It’s quite uncommon for patients to have type-2 diabetes without other CV, renal or metabolic conditions6,”

Expanding on this, Dr Ruder explains that many individuals with cardiovascular (CV), renal or metabolic diseases have either symptoms or underlying pathologies associated with more than one of these diseases 6. ”It’s quite uncommon for patients to have type-2 diabetes without other CV, renal or metabolic conditions 6,” he says.

Supporting this claim – a cross-sectional study using data from the Diabetes Collaborative Registry (DCR) confirms that more than 95% of people with type-2 diabetes have at least one other CV, renal or metabolic condition and more than half (58,6%) of patients presented with at least three additional conditions 6. The most prevalent individual conditions were hypertension, hyperlipidaemia, coronary artery disease (CAD) and chronic kidney disease (CKD) – 87%, 85%, 37% and 24%, respectively6.

Cardiovascular-related events are the underlying cause of death for more than half of people with type-2 diabetes, reducing overall life expectancy by five to 15 years7.

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  1. IDF Diabetes Atlas. 7th edition. 2015
  2. Khalid, J. M., Raluy-Callado, M., Curtis, B. H., Boye, K. S., Maguire, A. and Reaney, M. (2014), Rates and risk of hospitalisation among patients with type 2 diabetes: retrospective cohort study using the UK General Practice Research Database linked to English Hospital Episode Statistics. Int J Clin Pract, 68: 40–48. doi:10.1111/ijcp.12265
  3. Stark Casagrande S, et al. The Prevalence of Meeting A1C, Blood Pressure, and LDL Goals Among People With Diabetes, 1988–2010. Diabetes Care 2013;36:2271–2279
  4. IDF Diabetes Atlas. 7th edition. 2015
  5. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: Diagnosis and classification of diabetes mellitus. Geneva, World Health Organization, 1999 (WHO/NCD/NCS/99.2).
  6. LoCasale RJ, Gannedahl G, Wang J, et al. Describing the cardio-renal-metabolic patient within the Diabetes Collaborative Registry. Poster presented at the American Diabetes Association 77th Scientific Sessions, 9-13 June 2017, San Diego, CA, USA.
  7. Morrish NJ, et al. Mortality and causes of death in the WHO Multinational Study of Vascular Disease in Diabetes. 2001;44 Suppl 2:S14-21. Available online:

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