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Diabetes can develop quietly. Here’s how a simple blood test can tell you more than your symptoms can.
When was the last time you checked your blood sugar? For many South Africans, the answer may be “never” – despite the fact that diabetes has become one of the country’s most serious health challenges.
The latest Statistics South Africa mortality figures show that diabetes was the leading underlying cause of death in the country in 2024, accounting for 6.1% of all recorded deaths. Among women, it was responsible for 7.9% of deaths, making it the leading cause of death for women.[i]
Even more concerning is how quietly high blood sugar can develop.
Sweet Life, a South African online diabetes community, highlights research from the South Africa Demographic and Health Survey showing that 64% of women and 66% of men fell into the prediabetes range based on adjusted HbA1c levels. This has often been simplified to the striking message that two in three South Africans are in the prediabetes range.[ii]
“Prediabetes is one of those warning signs that is easy to overlook because you may not feel unwell,” says Luvuyo Maloka, from digital health platform Unu Health. “The important thing is that finding out where you stand gives you an opportunity to take action.”
If you are concerned about diabetes, there are three important tests to understand:
- Fasting blood glucose: This measures your blood sugar after fasting for at least eight hours. A result of 7.0 mmol/L or higher is in the diabetes range.
- HbA1c: This is often described as a longer-term blood sugar test because it measures your average blood glucose levels over the past two to three months. An HbA1c of 6.5% or higher is in the diabetes range.
- Oral glucose tolerance test (OGTT): This test measures how well your body processes sugar. A result of 11.1 mmol/L or higher is in the diabetes range. It can also identify impaired glucose tolerance that may not be picked up by a fasting test alone.
Importantly, an abnormal result does not necessarily mean you should diagnose yourself. In someone without obvious symptoms, diabetes generally needs to be confirmed with repeat testing on another day. A healthcare professional can also advise which test is most appropriate.
While increased thirst, frequent urination, unexplained weight loss, fatigue and blurred vision can all be signs of diabetes, Type 2 diabetes can also develop without obvious symptoms.[iii] Testing is particularly worth discussing with a healthcare professional if you have a family history of diabetes, carry excess weight around your waist, are physically inactive, have high blood pressure or cholesterol or have previously had gestational diabetes.
“Type 2 diabetes can go undiagnosed for up to 10 years, because of how quietly the symptoms develop,” explains Bridget McNulty, CEO and co-founder of Sweet Life, South Africa’s largest online diabetes community. “It’s possible to live a healthy, happy life with diabetes – but not if you’re undiagnosed.”
And getting tested is becoming easier. Digital health platforms like Unu Health now allow South Africans to order certain pathology tests from the privacy of their phones, without a referral, with results delivered digitally and a results consultation included. Its current testing options include HbA1c and a diabetes monitoring panel combining fasting glucose and HbA1c.
So, let me ask you again, when last did you check your blood sugar levels?
To book your blood test visit https://www.unuhealth.org/online-medical-services/on-demand-blood-test