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A study on pre-diabetes in the era of ‘diabesity’

Nomusa Mzimela with her poster presentation at the society for Endocrinology Metabolism and Diabetes of South Africa’s (SEMDSA) recent congress. Picture: Supplied

Nomusa Mzimela with her poster presentation at the society for Endocrinology Metabolism and Diabetes of South Africa’s (SEMDSA) recent congress. Picture: Supplied

Published Oct 22, 2023


When Nomusa Mzimela picked her path of study she chose to focus on pre-diabetes prevalence because the dreaded disease was “close to home”.

Outstanding for Mzimela, who is pursuing the qualification with the University of KwaZulu-Natal, was learning that the pre-diabetes stage could be reversed with good diet and exercise.

Mzimela, 38, was also amazed at the rate of pre-diabetes prevalence in people between the ages of 25 and 45, and living in Durban, which ranked the highest in the province.

Mzimela said her colleague was doing a pre-diabetes prevalence scan and made the find.

Nomusa Mzimela with her poster presentation at the society for Endocrinology Metabolism and Diabetes of South Africa’s (SEMDSA) recent congress. Picture: Supplied

“I understand the findings. That’s because of the food, lifestyle choices and the environment we live in. Durban lifestyles meant that due to the number of franchise restaurant options available, you end up eating out often, without realising the food might be more unhealthy than meals cooked at home. You then place yourself at risk of contracting the disease.

“Also, in Durban, I noticed that at tuck-shops, children and students were eating food like ‘vetkoeks’, which were not good for the body.

“It fills stomachs. People can’t help themselves because they can’t afford healthy alternatives.”

Mzimela, who was born and raised in Empangeni, said that unhealthy living trends had also extended to rural areas.

“Another researcher said that there is an increase of pre-diabetes in rural areas because of food choices and affordability.”

She said the environment you lived in was important because if your family could not afford healthy food, it could become a factor.

“I also had family members who had diabetes. Therefore, this study is close to my heart.”

Mzimela’s studies showed her that the disease could be beaten through lifestyle changes and eating choices, instead of dying oblivious to it.

“That sparked my interest.

“I focused more on immunity and haematology. At the back of mind, I have an idea that the immune system is like a bridge to diabetes, cancer, HIV ,TB and other diseases that people get infected with.

“Therefore, the immune system is something you need to care for. It can easily be suppressed because of the food you eat, the medication you take in.”

She said a suppressed immune system could lead to infection.

“I‘m really keen to explore more how the immune system works in a pre-diabetic person. I strongly believe there will be a way forward based on that.”

Mzimela also got to make her findings known recently at the 56th Society for Endocrinology Metabolism and Diabetes of South Africa (SEMDSA) Congress in Johannesburg, where researchers and doctors collaborated to find solutions to diseases affecting people.

Mzimela used the opportunity to raise awareness on pre-diabetic conditions and gather knowledge from other presenters.

“I think the pre-diabetic phase is of critical importance because at the laboratory we found that most abnormalities were traced to this stage in rat specimens we used.”

She was now applying the finishing touches to her PhD studies and would be ready for submission next week.

“I’m nervous, but I’m looking forward to the response from the examiners.

“My brothers are also excited about me completing my PhD since my parents are late. They were the ones who motivated me to do this and have been my support structure,” said Mzimela, who holds a BSc in physiology and biochemistry from Unisa, a BSc Honours in the medical sciences and Master of medical sciences in human physiology from UKZN.

She was grateful to her supervisor, Professor Andile Khathi, for her progress thus far and the confidence to explore and learn.

“He also gave us opportunities to communicate with him about our research struggles,” she said.

Professor Khathi said Mzimela started with her study before the Covid-19 outbreak. This greatly impacted the collection of samples from the hospitals, but she continued to produce work of good quality, which is evidenced by it being published even before she submitted her dissertation.

“I think it helped that she had a really good idea of the type of work that she wanted to do even before she began the study, which is relatively new. I helped her with the best way to achieve her study goals.”

Khathi said he was also initially shocked with her study results but over time it made sense. “Durban is urbanising quite rapidly which gives access to high-calorie, highly-processed foods often in the form of takeaways. It also explains why so many people develop type 2 diabetes mellitus later on in life,” he said.

Dietician Radha Joshi said much has changed since the Covid-19 pandemic for most people globally.

“This is not only due to physical implications but mental health has also been compromised. The rate of depression and other mental health illnesses has skyrocketed, resulting in younger people facing type 2 diabetes mellitus as a post-Covid complication, and a sedentary lifestyle culture of caloric surplus and digitalisation.

“We are now living in an obesogenic environment and dealing with another pandemic coined as ‘diabesity’, leading to other chronic diseases and a downward spiral,” she said.