PITSO MOLEMANE

Living with both HIV and diabetes presents a complex and challenging mix of physical, emotional, and social difficulties. As both conditions carry heavy stigma, they create unique struggles – ranging from the increased risk of complications and adverse drug interactions, to the emotional toll of daily management.

If left uncontrolled, the coexistence of HIV and diabetes can lead to severe health problems such as cardiovascular disease, blindness, kidney failure, and amputations.

Despite these challenges, it is possible to live a fulfilling life with both conditions – often with strong support systems, proper medical care, and consistent self-management. Effectively managing HIV and diabetes requires a personalised approach to diet, exercise, and medication, which can be overwhelming for many.

Prof Mbulelo Dyasi, a theologian, human rights advocate, and faith leader, has lived with HIV and diabetes for over a decade, and at some point landed in hospital. “During my time in the ICU, I was later transferred to another facility because of mental health challenges,” he said.

“I was prescribed Epilim and medication for high blood pressure. The experience was incredibly frustrating. I was far from home, isolated, and only my colleagues came to visit. I also worried that my employer might use my health conditions to justify a constructive dismissal, especially since NGOs at the time lacked unions to protect workers’ rights.”

He spoke about the stigma that persists in black communities regarding chronic illnesses such as diabetes. “There’s a pervasive belief that if you struggle with diabetes, your partner might leave you,” he said.

“Myths link issues like erectile dysfunction and epilepsy to witchcraft. These misconceptions are dangerous; they contribute to depression, and even suicide. The stigma surrounding HIV and diabetes leads to prejudice, blame, and discrimination.”

Dyasi said living with both conditions required a complete lifestyle adjustment. “You need a glucose monitoring machine at home, and must prick your fingers two to four times a day. You have to learn to cook healthier meals, quit alcohol, exercise regularly, and take multiple medications. There’s no room for negotiation.”

Managing a dual diagnosis of HIV and diabetes is a continuous struggle that affects physical health, mental wellbeing, and daily life. Both conditions demand lifelong commitment, careful medication management, and emotional resilience. “I come from a family where diabetes runs deep,” he said.

“My late grandmother and mother battled it, along with several aunts. I’ve seen its toll first-hand – some family members died from complications despite adhering to their medication and diet."

In his recent book, Dignity in the Darkness, Dyasi writes about how diabetes is misunderstood in communities and expresses concern over how it is managed in SA. “Many people, especially those from disadvantaged backgrounds, can’t afford glucose testing machines, and must wait for clinic check-ups,” he said.

“People need education to prevent diabetes, and those living with it need love and support. I’m fortunate to have a supportive wife who cooks healthy meals every day.”

Dyasi urged the government to strengthen diabetes care similarly to how it manages HIV. “I wish the government could enhance diabetes treatment – perhaps by introducing multivitamins for people whose nutrition isn’t optimal. It’s also important to work with the food industry to stabilise prices, especially for healthy food,” he added.

Adopting a nutritious diet, taking medication consistently, and engaging in regular physical activity can significantly improve the quality of life for those living with both HIV and diabetes.

Healthcare professionals, including doctors and dietitians, play a crucial role in creating personalised care plans to help patients manage these lifelong conditions with dignity and hope.