According to a recent report by Statistics South Africa (Stats SA), diabetes was the leading underlying natural cause of death in the country for the third consecutive year in 2024. The report revealed that 28,767 people died from diabetes-related complications, accounting for 6.1% of all deaths nationwide. This translates to an average of nearly 79 deaths every day.
The crisis has been described as an unacceptable tragedy by public health specialist and chairperson of the non-profit organisation Diabetes Alliance, Patrick Ngassa Piotie. He emphasised that diabetes is manageable with timely support, allowing people to lead long, healthy lives free from preventable complications. The three-year trend of diabetes being the leading cause of death in South Africa has raised concerns about the country's healthcare system.
Non-communicable diseases accounted for 60.7% of all recorded deaths in 2024, with diabetes, hypertensive diseases, and cerebrovascular diseases frequently overlapping in the same individuals. Piotie argued that managing these interconnected conditions through isolated disease programmes makes little sense for primary care clinics or patients.
The Stats SA report also showed that the diabetes burden is deeply unequal, with women bearing the heaviest loss. In 2024, diabetes was the leading recorded natural cause among women, claiming 17,429 lives (7.9% of all female deaths) and 11,334 or 4.5% of all male deaths. The disease ranked first among people aged 45-64, accounting for 9,364 deaths (7.9% of deaths in this group).
Geographically, diabetes ranked as the top natural cause in five provinces: Western Cape, KwaZulu-Natal, Limpopo, Eastern Cape, and Gauteng. In contrast, hypertensive diseases led in the remaining four provinces. These provincial rankings highlight the need to investigate access to diagnosis, treatment, and quality care across different regions.
Piotie stressed that mortality statistics only provide a partial picture of the crisis, as they do not capture the full toll of diabetes when another condition is listed as the underlying cause. He called for real-time clinical data to help facilities respond promptly and a national diabetes registry to track patient care and outcomes.
To address the crisis, Piotie and the Diabetes Alliance have launched the Johannesburg Declaration for Accelerated Action on Diabetes, which calls for coordinated national leadership, sustainable financing, and direct participation by people living with diabetes. The declaration aims to connect early diagnosis to sustained care, measure quality of care, and address the conditions that shape health outcomes.
Key points
- Diabetes claimed 28,767 lives in South Africa in 2024, averaging 79 deaths per day.
- Women bear a heavier burden, with 17,429 deaths (7.9% of all female deaths) in 2024.
- The Diabetes Alliance has launched a declaration calling for coordinated national leadership and action to address the crisis.
