This first episode introduces the global and regional landscape of Type 2 Diabetes Mellitus (T2DM), with a focus on its increasing burden in South Africa and sub-Saharan Africa. Dr Tebelele hosts Dr Mashitisho, in a clinically oriented discussion that examines epidemiology, pathophysiology, risk factors, and diagnostic approach to T2DM. The conversation emphasises practical recognition of diabetes in primary-care and community settings, early detection strategies, and the importance of education and prevention to curb rising prevalence.

1. Describe the epidemiological trends of T2DM globally and in the African context.
2. Identify modifiable and non-modifiable risk factors contributing to the rising incidence of T2DM.
3. Explain the diagnostic criteria for diabetes using fasting plasma glucose, HbA1c, and oral-glucose-tolerance testing.
4. Discuss the pathophysiological basis of insulin resistance and beta-cell dysfunction.
5. Recognise opportunities for early intervention and public-health education in diabetes prevention.

• Integrate knowledge of local epidemiology into patient-screening and risk-stratification practices.
• Apply current diagnostic standards accurately in clinical settings.
• Counsel patients effectively on prevention through lifestyle modification.
• Contribute to community awareness campaigns addressing obesity and metabolic disease.
• Support multidisciplinary approaches to the detection and management of diabetes in South Africa.

• Epidemiological overview: Diabetes prevalence is rising exponentially in low- and middle-income countries; the African region is projected to experience one of the steepest increases.
• Urbanisation and lifestyle: Sedentary behaviour, dietary shifts, and obesity are major drivers.
• Genetic and familial predisposition: Family history and ethnic susceptibility are important risk considerations.
• Pathophysiology: Insulin resistance and beta-cell decline form a dual defect leading to hyperglycaemia; the importance of early identification before irreversible damage occurs is emphasised.
• Diagnostic process: Interpretation of fasting glucose, HbA1c, OGTT, and the importance of confirming results in asymptomatic individuals.
• Public-health messaging: Early education, screening in high-risk groups, and the role of primary care providers in prevention and follow-up.
• Call to action: Strengthen awareness, empower communities, and encourage collaboration across healthcare levels to reverse current trends.