For most of medical history, type 2 diabetes was something you worried about in your 70s. Not anymore.
At our latest Think Tank Thursday, Dr Musa Nyembe opened with a warning that landed hard in the room: he is treating diabetes and its complications in young adults and even children. What used to be a disease of old age has become one of the fastest-growing health threats facing young South Africans, with an estimated five million youth across sub-Saharan Africa now affected.
The Minister of Health has put it plainly. For years, HIV was our biggest killer. Today, diabetes holds that title. It is not the next epidemic, it is the current one.
Here’s what every young person should take from the session.
It’s mostly about how we live
Type 2 diabetes is largely a lifestyle-driven condition. Sedentary routines, low-fibre and highly processed diets, the same few takeaways on repeat, and an unhealthy relationship with alcohol all raise the risk. Dr Nyembe’s line stuck: eat to live, don’t live to eat and eat a genuine variety of foods rather than one staple, day after day.
He was honest about the socioeconomic reality too. When affordability limits choice, a single staple becomes the whole diet. That’s part of why South Africa fortifies staple foods, but fortification doesn’t change the bigger picture.
Know the early signs
Roughly two-thirds of people aged 18–39 can’t name a single symptom of type 2 diabetes. The earliest signs are worth memorising:
• Constant thirst
• Needing to urinate often, especially waking at night to go
• Always reaching for water
Catching it here, before organ damage sets in, changes everything.
The complications are serious and they start earlier
Left unchecked, diabetes damages the body’s smallest and largest blood vessels: heart attacks at a young age, kidney failure, vision loss (diabetic retinopathy), and nerve damage that means you can’t feel an injury to your feet until it’s severely infected. Some of those journeys end in amputation. Diagnosed young, the damage simply has more years to compound.
The good news: early on, it’s reversible
This was Dr Nyembe’s most hopeful message. Caught early and met with real lifestyle change, the trend can regress and the pancreas can recover. Prevention sits at the base of the pyramid, and it’s within reach: move your body (aim for 150 minutes of vigorous activity a week — home workouts count), eat a balanced and varied diet, cut back on salt and alcohol, and look after your mental health.
A word on Ozempic
With GLP-1 medications everywhere right now, Dr Nyembe was direct: he does not recommend them for weight management. These are powerful metabolic medicines made to treat a condition, and using them without proper testing, prescription and monitoring is drug abuse with real risks. If weight or metabolic health is the concern, start with a dietician and a physician, not an unauthorised supplier.
You don’t have to do this alone
Mental wellbeing and physical health are deeply linked, and the psychological load young adults carry — careers, relationships, finances — is part of the story.
youth@WORK’s Wellness Centre offers psychosocial support. Youth on our programme can call our hotline on 060 749 1927. Prevention is always better than cure. Small, consistent choices, starting today, are the most powerful medicine we have.
Watch the full Think Tank session on our YouTube channel:
