Resources

The latest research papers and information about diabetes and NCDs in South Africa. A space for all research on diabetes in SA.
Please send contributions to info @ diabetesalliance.org.za


WHO Health literacy development for the prevention and control of noncommunicable diseases

Here is Volume 1 of this important report – click here to download volumes 2, 3 and 4.

This report provides a pragmatic approach to health literacy development for the prevention and control of noncommunicable diseases (NCDs). It provides new insights into what people know about NCDs and their risk factors, and these new insights reveal the mechanisms behind how people, communities, and organizations learn and can be supported to take action against NCDs, including their risk factors and determinants.

Importantly, health literacy is understood as a social practice whereby decisions about health, and the available support to change to, or maintain, healthy behaviours, are determined by powerful and unique community norms and cultures, and organizational and political factors impacting communities.


ISPAD Clinical Practice Consensus Guidelines 2022: Management of the child, adolescent, and young adult with diabetes in limited resource settings

These updated and very thorough guidelines outline exactly what is expected for the management of children, adolescents and young adults with diabetes.


An open letter to the Minister of Health on World Diabetes Day 2022

Dr. Patrick Ngassa Piotie, Chairperson of the Diabetes Alliance, addresses the need for a national diabetes education programme in this open letter.


Knowledge of diabetes and associated factors in rural Eastern Cape, South Africa: A cross sectional study

Adequate disease knowledge is required in order to engage in appropriate self-
management behaviours. Yet, patients’ knowledge of diabetes and associated factors are
scarcely investigated. Context-specific data on diabetes knowledge are crucial for designing appropriate interventions for improving knowledge and treatment outcomes. This study examined the level of diabetes knowledge and its associated factors among persons with diabetes in Eastern Cape Province, South Africa.


Evaluating the Implementation of the GREAT4Diabetes WhatsApp
Chatbot to Educate People With Type 2 Diabetes During the
COVID-19 Pandemic

This Convergent Mixed Methods Study illustrates that this WhatsApp Chatbot has the potential to complement traditional health care approaches for people with diabetes and
assist with more comprehensive patient education.


Statistics SA Mortality and Causes of Death

The latest (2018) statistical release on mortality and causes of death in South Africa finds that diabetes remains the leading cause of death in women, and the second leading underlying cause of death in the country.


Department of Health Strategic plan 2020/1 – 2024/5

The strategic plan was developed by the management of the National Department of Health under the guidance of Dr Z.L Mkhize and it takes into account all the relevant policies, legislation and other mandates for which the National DoH is responsible and it accurately reflects outputs which the National Department of Health will endeavor to achieve over the period 2020/21-2024/25.


Designing an integrated, nurse-driven and home-based digital intervention to improve insulin management in under-resourced settings

In primary care, initiation of insulin may be delayed due to a shortage of healthcare workers. The delayed initiation of insulin is also exacerbated by the reported resistance of both healthcare providers and people with type 2 diabetes to start insulin. In South Africa, telehealth provides an opportunity to overcome these challenges and
manage insulin therapy in primary care.


The ability of primary healthcare clinics to provide quality diabetes care: An audit

The capacity to deliver quality care is compromised by the poor availability of
guidelines, educational material and the absence of monofilaments.


Diabetes in the Western Cape, South Africa: A secondary analysis of the
diabetes cascade database 2015 – 2020

The aim was to describe the demographics, comorbidities and outcomes of care for patients with diabetes at primary care facilities in the Western Cape, South Africa, between 2015 and 2020.


Cost-Effectiveness of Population Screening Programs for Cardiovascular Diseases and Diabetes in Low- and Middle-Income Countries: A Systematic Review

This systematic review aims to consolidate and synthesize economic evidence of screening programs for cardiovascular diseases (CVD) and diabetes from LMICs.


Risk factors for COVID-19 hospitalisation and death in people living with diabetes

This virtual cohort study from the Western Cape Province offers insights from the 64,476 COVID-19 patients. Of 9305 PLWD, 44.9% were hospitalised, 4.0% admitted to ICU, 0.6% received ventilation and 15.4% died.


Enabling telemedicine for people living with diabetes: Focus on South Africa

In South Africa, COVID-19 put a spotlight on the dangers of diabetes and enabled remote patient consultations for the first time. This Economist Intelligence Unit report takes a deep dive into this issue.


WHO Draft Recommendations to strengthen and monitor diabetes responses within national non-communicable disease programmes

This WHO discussion paper includes challenges and opportunities, lessons learned, recommendations for strengthening diabetes responses and setting diabetes coverage targets.


The impact of a face-to-face peer-support intervention on adults with type 2 diabetes: a cluster-randomised trial

To establish the impact of a face-to-face peer-support intervention on adults with type 2 diabetes in South Africa.


A diabetes peer support intervention: Patient experiences using the Mmogo-method.

The study aimed to explore the experiences of adults with type 2 diabetes who took part in a diabetes peer support intervention in the Free State, South Africa.


Self-management in face-to-face peer support for adults with type 2 diabetes
living in low- or middle-income countries: a systematic review.

The purpose of the review was to synthesize the best available evidence on face-to-face peer support models for adults with T2D in low and middle-income countries.


Living great with diabetes

This brochure provides you with information about “Living GREAT with diabetes”. This
is an initiative that works with groups of patients to educate and empower them for self-management and better control of their diabetes as well as training healthcare workers to
facilitate these groups.


Public health system challenges in the Free State, South Africa: a situation appraisal to inform health system strengthening

The South African government has been putting charters, policies, strategies and plans in place in an effort to strengthen public health system performance and enhance service
delivery. However, public health programme performance and outcomes remained poor while the burden of disease increased.


Community health worker diabetes toolkit, facilitator guide 2021

This toolkit is the culmination of evidence obtained through the input of various stakeholders and the guideline specifically directs facilitators to train community health
workers in the towns of Springfontein and Trompsburg in the Free State province of South Africa.


The impact of intensified clinical care on glycaemic control in patients with type 2 diabetes at Khayelitsha Community Health Centre, South Africa

The aim was to evaluate the effect on glycaemic control of more intensive care for patients with very uncontrolled type-2 diabetes (HbA1c > 10%) at Khayelitsha Community Health Centre, South Africa.

Click here to read research paper.


Cost-effectiveness of a diabetes group education program delivered by health promoters with a guiding style in under served communities in Cape Town, South Africa

This study aimed to evaluate the cost-effectiveness of a group diabetes education program delivered by health promoters in community health centers in the Western Cape, South Africa.

Click here to read research paper.


Effectiveness of a group diabetes education programme in under-served communities in South Africa

To evaluate the effectiveness of group education, led by health promoters using a guiding style, for people with Type 2 diabetes in public sector community health centres in Cape Town.

Click here to read research paper.


Evaluation of the “Take Five School”: An education programme for people with Type 2 Diabetes in the Western Cape, South Africa

To evaluate the Take Five school (TFS) group education programme for patients with Type 2 Diabetes in South Africa

Click here to read the research paper


Preventing diabetes blindness: Cost effectiveness of a screening programme using digital non-mydriatic fundus photography for diabetic retinopathy in a primary health care setting in South Africa.

A screening programme using a mobile fundal camera in a primary care setting has been shown to be effective in the country. Information on affordability and cost is essential for policymakers to consider its adoption.

Click here to read research paper.


The ability of health promoters to deliver group diabetes education in South African primary care.

This study assesses a group diabetes education programme using motivational interviewing in public sector health centres serving low socio-economic communities in Cape Town. The programme was delivered by mid-level health promotion officers (HPOs).

Click here to read research paper.


Effectiveness of a group diabetes education programme in under-served communities in South Africa

To evaluate the effectiveness of group education, led by health promoters using a guiding style, for people with type 2 diabetes in public sector community health centres in Cape Town.

Click here to read research paper.


Evaluating point-of-care testing for glycosylated haemoglobin in public sector primary care facilities in the Western Cape, South Africa.

To evaluate the costs and consequences for quality of care by introducing point-of-care (POC) testing for HbA1c for patients with type 2 diabetes at community health centres in Cape Town, SA.

Click here to read research paper.


Prevalence of disease complications and risk factor monitoring amongst diabetes and hypertension patients attending chronic disease management programmes in a South African Township

We assessed risk factor monitoring, prevalence and determinants of diabetes related complications amongst type-2 diabetes (T2D) and hypertension (HTN) patients attending two CDMPs.

Click here to read research paper


The epidemiology and pathogenesis of type 1 diabetes mellitus in Africa

Type 1 diabetes is poorly characterised, and there is sparse information regarding the aetiology and epidemiology of this disease in Africa. However, there is some evidence of a later age of onset in African type 1 diabetic patients compared to European diabetics.


Incidence of HNF1A and GCK MODY Variants in a South African Population

Our study aimed to investigate and report on the incidence of MODY-related variants,
specifically HNF1A variants, in a population from the Western Cape.


Is screening for microalbuminuria in patients with type 2 diabetes feasible in the Cape Town public sector primary care context? A cost and consequence study

The aim of this study was to assess the practicality, costs and consequences of introducing a screening test for microalbuminuria into primary care.

Click here to read the research paper


A diabetes profile of the eight districts in the public health sector, Eastern Cape Province, South Africa

To investigate the frequency, age proportion and distribution of new patients diagnosed with diabetes in the public healthcare sector of Eastern Cape (EC) Province, South Africa (SA).



Data Centre Profile: The Provincial Health Data Centre of the Western Cape Province, South Africa

The Western Cape Provincial Health Data Centre (PHDC) consolidates person-level clinical data across government services, leveraging sustained investments in patient registration systems, a unique identifier, and maturation of administrative and clinical digital health systems.


African Cuisine-Centered Insulin Therapy: Expert Opinion on the Management of Hyperglycaemia in Adult Patients with Type 2 Diabetes Mellitus

To date, there are no published clinical guidelines to guide practitioners and patients on tailoring insulin to match the high carbohydrate content in African cuisine.



Health Dialogue Elements Identified during Health Communication between Nurses and Patients

Health dialogue, imbedded within the participatory communication paradigm, is instrumental in facilitating patient-centred health care.


The impact of a face-to-face peer-support intervention on adults with Type 2 diabetes: a cluster-randomised trial

An intervention to establish the impact of a face-to-face peer-support intervention on adults with Type 2 diabetes in South Africa.


A diabetes peer support intervention: Patient experiences using the Mmogo-method

Peer support for patients with Type 2 diabetes appeared to be a valued intervention, as participants related well to community health workers, who are ideally positioned in the healthcare system to provide the service.


Self-management in face-to-face peer support for adults with Type 2 diabetes living in low- or middle-income countries: a systematic review

An analysis of the current research that has been done on face-to-face peer support, both peer support and CHWs.



Validation of the Sesotho Health Literacy Test (SHLT): An indigenous, general health literacy test

This article describes a phased approach that was followed to validate the Sesotho Health Literacy Test (SHLT).


The prevalence and risk factors for diabetes in healthcare workers

A retrospective study on the prevalence and risk factors for diabetes mellitus in healthcare workers at Tygerberg hospital, Cape Town.


Health Dialogue: A concept analysis

Health dialogue encompasses strategies to influence decisions to improve health, but it is often still poorly understood. This concept analysis makes it clearer.


Development of a health dialogue model for patients with diabetes: A complex intervention in a low-/middle income country

This culturally sensitive health dialogue model has the potential to improve adherence to treatment, leading to greater satisfaction and consequently improved health outcomes.


An Observational Checklist of Health Dialogue Elements: Development and evidence of reliability

This article, published in the Journal for New Generation Sciences, explains the phased process used to develop an Observational Checklist of Health Dialogue Elements (OCHDE), and discusses evidence of its reliability.


South African Health Review 2019

An overview of health in South Africa, including available statistics for diabetes (from page 60 onwards) and the challenges facing people with diabetes in South Africa.


Perceptions of patients regarding diabetes-related health communication strategies in the Free State, South Africa

This article outlines a study in perceptions of health communication: how it informs, influences and motivates individuals to adopted health-focused lifestyles.


Diabetes-related knowledge, attitude and practices (KAP) of adult patients with Type 2 diabetes mellitus in the Free State province, South Africa

An article in the South African Journal of Clinical Nutrition that looks at the demographic status and anthropometry of adult patients with T2DM, and determines their diabetes-related KAP.


Development of a Sesotho health literacy test in a South African context

This article details the development of an appropriate health literacy test for use among South African public health service users with Sesotho as their first language.


A Pilot investigation into the readability of Sesotho health information pamphlets

This article, published in Communitas, looks at printed patient health communication in South Africa and a pilot of Sesotho health information pamphlets.


Management of Type 2 diabetes in primary care

The South African National Department of Health policy guidelines for management of Type 2 diabetes in primary care, which was published in 2014.


Diabetes prevalence, diagnosis and treatment in SA

This article on diabetes prevalence, diagnosis and treatment in SA was provided by the SAPH research programme from the HSRC . The data is from a national survey, the SANHANES, conducted in 2012.

Prevalence and unmet need for diabetes care across the care continuum in a national sample of South African adults

The aim is to evaluate the prevalence of and health system response to diabetes through a diabetes care cascade using data from the first comprehensive national survey on NCDs—the South African National Health and Nutrition Examination Survey (SANHANES-1 (2011–2012))



Fact sheet: Diabetes in SA

This fact sheet was prepared by Priscilla Reddy, Natisha Dukhi, Ronel Sewpaul of the Social Aspects of Public Health (SAPH) programme at the Human Sciences Research Council (HSRC). It includes the latest data on diabetes in South Africa.


Ubuntu in Diabetes Care

This article about the concept of ubuntu in diabetes care outlines how healthcare professionals and patients can use the concept of ubuntu to better understand how to treat diabetes in South Africa.


Fact sheet: WHO Diabetes & TB

This fact sheet from the WHO (World Health Organisation) details the connection between diabetes and TB from a worldwide perspective.


Is screening for microalbuminuria in patients with type 2 diabetes feasible in the Cape Town public sector primary care context? A cost and consequence study

The aim of this study was to assess the practicality, costs and consequences of introducing a screening test for microalbuminuria into primary care.

Click here to read the research paper