Siyabonga Kwanele Zuma has been living with Type 1 diabetes for over 15 years.

The 27-year-old from Howick in Kwa-Zulu Natal was first introduced to the chronic condition in 2007 when his older sister was diagnosed with it. A year later he was diagnosed at the age of 12.

“It was an ordinary day at school. I just felt sick and then my teacher called my parents to come fetch me and I was taken to a doctor. The doctor almost misdiagnosed me as having the flu. This happened to my sister too.

“Luckily another doctor walked in and noticed that I had diabetes symptoms. He suggested my blood sugar levels be checked. It was high and I was sent to the hospital where I was diagnosed,” says Zuma.

Type 1 and 2 diabetes usually share similar symptoms including urinating frequently, thirst, constant hunger, weight loss, vision changes and fatigue. With type 2, symptoms may develop a bit slower and also include numbness and pain in the limbs.

At first Zuma was excited. As a child he felt like having this condition would mean getting the same attention his sister had been getting. But he soon realised how serious the condition is.  Type 1  diabetes is a chronic condition in which the pancreas produces little or no insulin by itself. It happens when the immune system attacks and damages the cells in the pancreas that make insulin. It often starts and is diagnosed in childhood or early adulthood.

Type 1 diabetes can be hereditary.  Type 2 occurs when the body doesn’t make enough insulin or can’t use insulin properly. It commonly develops in adults, but can appear in children too and is linked to lifestyle factors.

People with Type 1 diabetes need daily insulin injections to control the levels of glucose in their blood. There are various ways to manage the condition including things like a continuous glucose monitor, glucose metres, lifestyle and dietary changes.

Access to affordable treatment, including insulin, is critical.  

Financial woes

Around the time Zuma was diagnosed, his father’s business was going through financial constraints. Though he did not understand much as a child, Zuma still noticed that there was a change. 

“When my sister was diagnosed, she went to a private hospital and when I got diagnosed I went to a public hospital,” he recalls. “We couldn’t afford a diet that’s considered healthy for people with diabetes. It’s hard having a diet specifically for you when you live in a household of eight plus people, so I just ate whatever was prepared for me.” 

People with diabetes need to follow a strict diet and avoid unhealthy foods. Healthier food tends to be a bit more expensive than easily accessible unhealthy food. According to the Pietermaritzburg Economic Justice & Dignity Group’s household affordability index for November 2023 the cost of a basic nutritious diet for a family of seven, per month is R6 494,04. The national minimum wage sits at R4 473,92.

Adjusting to change

As a child, Zuma had to adjust to a lot of things. For example, he had to wear shoes all the time because he was told that a person with diabetes’ injuries or wounds take longer to heal. 

According to the Podiatry Association of South Africa (PAOSA), feet and ankles are particularly vulnerable to diabetes-related wound problems. This is because lower limb areas are prone to swelling, which can hinder the healing process. 

People with diabetes are also more likely to have calluses, dry skin and nerve damage. This makes it difficult to avoid foot wounds, increasing the risk of ulcers and infection.

Early detection of wounds can be a challenge for a person living with diabetes, as many lose feeling in their feet. Vision impairment  is also a common symptom, making it difficult to see small wounds before they develop into a bigger issue. 

PAOSA states that when a wound becomes infected it can be far more serious than simply causing pain and inconvenience. For people who live with diabetes, complications can cause so much tissue and bone damage that amputation is sometimes the only option.

Support is key

Growing up with a sister who has diabetes helped Zuma navigate and manage the condition. But there were parts of growing up he struggled to avoid. 

“When I got to high school, peer pressure came into play and I started hiding my diabetes. This affected the way I took care of myself. I started not taking my medication on time and stopped being active which would negatively impact my sugar readings.

“But now I’m more conscious of exercising, what I eat and how much I eat. Sometimes I go to the gym and when I can’t afford to, I jog or walk in my neighbourhood,” he says. – Health-e News