Diabetes activism and COVID-19: a partnership carrying on regardless

We get updated on the great strides The South African Non-Communicable Diseases Alliance and Diabetes South Africa are making in advocacy.

Fact:  Diabetes is the leading cause of death of SA women – and COVID-19 won’t change that.

Diabetes and COVID-19

Diabetes South Africa (DSA) is a founding member of The South African Non-Communicable Diseases Alliance (SANCDA) but our association stretches back to 2006 to an umbrella health NGO advocacy forum. Through all of the COVID-19 lockdown, SANCDA and DSA continues an essential partnership. Why do we carry on regardless?

We, the people living with diabetes, want access to quality prevention and care. Diabetes, along with many other non-communicable diseases (NCDs), must be prioritised in South Africa. Now more than ever.

What does priority look like? People with diabetes get the needed care without a run-around. Treatment and prevention are taken seriously just as HIV, TB and other communicable conditions are. It means that government takes diabetes and NCD care seriously and puts it at the top of the political hit list without platitudes.

The positive spin-off of the COVID-19 pandemic, if possible, is that, at last, there is recognition of the global neglect of diabetes and other NCDs.

The SANCDA and DSA didn’t just wake up during COVID-19 to these existing problems. Our partnership goes back to 2013, and right from the start, we have demanded fairer and better health services for diabetes and NCDs.

Health and related services must be at the same level (equitable) when benchmarked against those provided for HIV and TB, etc. In all ways.

Diabetes and NCDs policy activism

Our policy demands focus on public sector services where the majority of South Africans receive care. Or not, as the case may be. We engage with relevant and willing stakeholders who are open about their interests and ready to roll up their sleeves to work. Not only is there little or no money for NCDs in the public sector, but the policies that allow for spending are poor and unimplemented.

Unceasingly we hold government at all levels to account for equitable NCDs policy and service delivery. It is not just about “fighting” for rights but also about collaboration and co-production.

Without a doubt, the longest-running example of policy advocacy is the national government’s NCDs National Strategic Plan. After eight long years, its approval is imminent.

During those lonely years, we were often on the outside looking in. In the final phase, the SANCDA was the sole representative of the “people” and civil society giving hundreds of hours of work to get a more equitable deal for NCDs and diabetes. The difference now is that 100 of our “besties” are on the same page, like-minded individuals and organisations.

NCDs – a human rights case

The neglect of diabetes and other NCDs didn’t start with the pandemic. What changed is that, at last, there is recognition for the vulnerability of people living with NCDs. And it is no different from the status afforded people living with HIV.

We followed the steps taken by the HIV activists, holding the government accountable for our constitutional rights. In December 2020, the South African Human Rights Commission officially accepted our complaint against the SA government for “policy” neglect. Our complaint is that The National Development Plan does not consider NCDs a priority, unlike HIV, and this is an inequity to people living with NCDs, including diabetes.

Diabetes helpline during COVID-19

COVID-19 made it clear that people with NCDs, including obesity, are at significant risk of severe complications and death. Hard lockdowns created additional challenges of getting medication, travel and even food.

Early in the pandemic, together with DSA and the National Department of Health, we started a telephone and message service. Its only purpose was to assist people with diabetes to stay healthy. We reconned that simple interventions could do that.

The service is simple, allowing for low levels of technology and encouraging those with limited data access. So, this is how it works: A person sends a message, often as simple as “Hi”. And so, a conversation starts, allowing for information to be shared. The individual’s needs are often clarified over several texts and days, all the while sending information about COVID-19, vaccinations, nutrition, and medicines.

Approximately 10% of the more complex clinical cases are referred on to a diabetes nurse specialist for in-depth interviews and more extended discussion. It could involve changes to meds (including insulin) and perhaps referral to health facilities. The person’s consent is needed for any referral.

Our interventions and solutions uses our vast network of partners, including DSA, all levels of government, other NGOs and caring individuals in society. It takes a community of caring people to run this service. Of course, all of this was backed by years of experience and tested relationships. That is what it is all about.


For more info, visit SANCDA



Dr Vicki Pinkney-Atkinson PhD, RN, Director, SA NCDs Alliance. Person living with diabetes and other NCDs.


Dr Vicki Pinkney-Atkinson PhD, RN, Director, SANCDA. Person living with diabetes and other NCDs.

Sr Razana Allie, RN, Individual SANCDA member and diabetes nurse specialist.



Sr Razana Allie, RN, Individual SANCDA member and diabetes nurse specialist.

Diabetes and how it can affect your eyes

This Diabetes Awareness Month, Spec-Savers promotes the importance of regular eye tests.

Did you know?

Just one in five adults is aware that an optometrist can detect diabetes-related eye conditions, and even diabetes, during an eye exam.

Diabetes is the primary cause of avoidable blindness in adults ages 20 to 74, so it can be overwhelming to be diagnosed with a diabetic eye disease. The good news is that regular testing can detect these conditions before they affect your eyesight, and there are treatments available that can prevent further damage from occurring.

Diabetes is a condition in which the blood glucose level is higher than normal. If blood glucose remains high for prolonged periods of time, this can damage the blood vessels throughout the body, including the eyes, which contain some of the smallest blood vessels in the body. As a result, people with diabetes are at higher risk of developing specific eye conditions.

What are these specific eye conditions?

Blurred vision

High blood glucose levels can cause fluid to build up in the eyes and cause the lens to swell, making it difficult to focus clearly. To correct it, your blood glucose needs to remain in the target range, but it may take as long as three months for your vision to return to normal. It’s important to advise your optometrist if this occurs, so they can check if this is a symptom of a more serious problem.


The natural internal lens of the eye allows it to see and focus on an image. When that lens gets cloudy, it means a cataract has formed and the eye can’t focus like it should. People with diabetes are at greater risk of developing cataracts and are more likely to develop them at a younger age. Symptoms include blurred vision and glare, and surgery is required to replace the cloudy lens with an artificial one.


People with diabetes have double the chance of developing glaucoma compared to people with normal blood glucose levels. Medication can treat open-angle glaucoma, the most common form, by lowering eye pressure, speeding up drainage and reducing the amount of liquid your eye produces.

For less common forms of glaucoma, treatment can include medicine or special eye drops, or surgery or laser treatments to help lower eye pressure.

Neovascular glaucoma

If you have diabetes, you’re also more likely to develop a rare condition called neovascular glaucoma. This causes new blood vessels to grow on the iris, the coloured part of the eye, which block the normal flow of fluid and raise eye pressure. Primary treatment is to reverse the formation of new blood vessels by using laser treatment or an anti-vascular endothelial growth factor (VEGF) injection to reduce the number of blood vessels and reduce eye pressure.

Diabetic retinopathy

The retina is the layer of the eye that detects light which allows us to see. High blood glucose can damage the tiny vessels at the back of the eye which can result in them leaking, leading to a condition called diabetic retinopathy. If unmanaged, over time this condition can lead to gradual vision loss.

People with Type 1 diabetes rarely develop the condition before puberty. In adults, it’s rare unless they’ve had Type 1 diabetes for at least five years. Keeping tight control of your blood glucose will mean you are far less likely to get this condition.

If you have Type 2 diabetes, you may already have signs of eye problems when you’re diagnosed. Control your blood glucose, blood pressure, and cholesterol to slow or prevent the disease, and if you smoke, try to quit.

Diabetic macular oedema

The macula is the part of the eye responsible for sharp, straight-ahead vision, which we use for driving, reading and facial recognition. Diabetes can lead to macular oedema or swelling, which over time can cause sharp vision to deteriorate.

Save your vision

A full annual eye examination can help detect problems early when they’re easier to treat, which could save your vision.

Spec-Savers’ standard consultations now include a separate diabetic screening using non-invasive artificial intelligence imaging technology at no extra cost. With your permission, your screening results are shared with your ophthalmologist and general practitioner, as they are the most important team managing your condition.

It is essential that, as a person with diabetes, you regularly monitor the status of your eyes for any pathological changes as it provides an immediate monitor of how well you are managing your condition, and is the best way to ensure you have clear vision for life.

For more information or to book an eye exam, please visit www.specsavers.co.za.