Diabetes in young people: Why South Africans in their 20s and 30s should be concerned

For a long time, diabetes has been associated with older generations. It was the illness people worried about when their parents or grandparents started experiencing health complications. But that perception is becoming increasingly outdated. More young adults are finding themselves confronted with a diagnosis that many would never have expected to receive in their twenties or thirties.

And South Africa has reason to pay attention.

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How food poverty and empty pockets are driving South Africa’s diabetes crisis

According to the International Diabetes Federation (IDF), an estimated 2.32 million South African adults aged 20–79 were living with diabetes in 2024, representing a prevalence of 7.2%. That is approximately one in every 14 adults in this age group. Diabetes Network+1

While these figures do not tell us exactly how many young South Africans are affected, they point to a significant national health burden. There are also indications that younger age groups are increasingly encountering the condition.

In November 2025, the City of Cape Town raised concerns about the growing risk of Type 2 diabetes among younger people. Its City Health clinics recorded 132,518 diabetes screenings among people aged 18–44 during the previous financial year, an increase of just over 4%. The screenings also identified 425 new diabetes clients in this age group. City of Cape Town

These are figures from Cape Town's public health facilities, not a national count of new diagnoses. However, they highlight why diabetes screening and awareness should not be conversations reserved for older adults.

Why are more young people at risk?

Type 2 diabetes develops when the body becomes resistant to insulin or does not produce enough insulin to maintain healthy blood glucose levels. Insulin is the hormone responsible for helping glucose move from the bloodstream into the body's cells to be used for energy.

Although genetics and family history play a role, several lifestyle and environmental factors can increase a person's risk of developing Type 2 diabetes.

Unhealthy diets, frequent consumption of sugary drinks, limited physical activity and excess body weight are among the contributing factors. These risks can also be influenced by the environments people live in, including the affordability and availability of nutritious food and opportunities to exercise.

For young people navigating demanding work schedules, university life, financial pressures and increasingly sedentary routines, healthy habits can easily fall to the bottom of the priority list.

But it is important to understand that diabetes is not simply the result of eating too much sugar. It is a complex condition influenced by several factors, and people who maintain a healthy weight and active lifestyle can also develop it.

It is equally important to distinguish between Type 1 and Type 2 diabetes. Type 1 is an autoimmune condition in which the body's immune system attacks the insulin-producing cells in the pancreas. It is not caused by lifestyle choices and cannot be prevented through diet or exercise. Type 2, on the other hand, is associated with insulin resistance and a combination of genetic, lifestyle and environmental factors.

How can young South Africans lower their risk?

The good news is that there are practical steps people can take to reduce their risk of developing Type 2 diabetes. Prevention does not have to mean an expensive gym membership, restrictive diets or completely changing your lifestyle overnight.

Rethink your drinks: Swap sugary cooldrinks, energy drinks and excessive fruit juices for water more often. Frequent consumption of sugar-sweetened beverages can contribute to weight gain and increase the risk of Type 2 diabetes.

Move your body: Aim for at least 150 minutes of moderate physical activity each week. Walking, dancing, cycling, swimming and playing sport all count.

Make balanced food choices: Include vegetables, fruit, legumes, whole grains and fibre-rich foods in your meals. Reduce your intake of highly processed foods and excessive amounts of saturated fats and added sugars.

Prioritise your health checks: If you have a family history of diabetes, are overweight or have other risk factors, speak to a healthcare professional about screening. Diabetes can develop without obvious symptoms.

Build sustainable habits: Consistency matters more than perfection. Small changes to your daily routine can contribute to better long-term health.

These measures can help lower the risk of Type 2 diabetes, but they are not a guarantee against developing the condition. People already diagnosed with diabetes should follow an individualised treatment plan with their healthcare provider.

Know the signs before they become serious

One of the biggest challenges with diabetes is that people can have the condition without experiencing noticeable symptoms, particularly in its early stages.

However, some warning signs to look out for include:

Feeling unusually thirsty.
Urinating more frequently than usual.

Persistent tiredness or fatigue.

Unexplained weight loss.

Blurred vision.

Increased hunger.

Cuts and wounds that take longer to heal.

If you experience these symptoms, visit your nearest clinic or healthcare professional for an assessment and appropriate blood glucose testing. Do not wait for symptoms to become severe before seeking help.

This November, make your health part of the conversation

November is recognised as Diabetes Awareness Month, with World Diabetes Day observed on 14 November. It is an opportunity to move beyond simply sharing awareness messages and encourage meaningful conversations about prevention, screening, treatment and living with diabetes.

For young South Africans, the message is particularly important: being young does not make you immune to chronic illness. Understanding your family history, recognising the warning signs and taking advantage of accessible screening services can make a difference.

Diabetes is not a diagnosis that should come with shame, blame or stigma. It is a manageable chronic condition, and people living with it can lead full, healthy and active lives with the right treatment and support.

The conversation should not begin when someone receives a diagnosis. It should begin much earlier, with the everyday decisions, health checks and access to information that help people protect their health.