Demand for Endocrine Care Is Increasing in South Africa: What the Evidence Shows

The demand for endocrine care in South Africa is no longer a niche healthcare issue affecting a small number of patients with unusual hormonal conditions. Diabetes, obesity, thyroid disease, metabolic disorders, osteoporosis, adrenal conditions and other endocrine diseases collectively touch a growing portion of the population, while the country’s demographic profile is changing at the same time. The most recent national mortality data make the issue particularly difficult to dismiss. Statistics South Africa’s report on deaths occurring in 2023, published in March 2026, found that diabetes mellitus was the leading underlying natural cause of death nationally, accounting for 27,692 deaths, or 5.8% of all recorded deaths. Among women, diabetes accounted for 7.5% of deaths, while among adults aged 45 to 64 it was responsible for 7.0% of deaths and ranked first in that age group. At the same time, the International Diabetes Federation estimates that approximately 2.32 million South African adults aged 20 to 79 were living with diabetes in 2024. These figures do not mean that every person with diabetes requires an endocrinologist, nor should specialist care replace strong primary healthcare. They do show, however, that South Africa is dealing with a growing metabolic disease burden that inevitably creates greater demand for screening, treatment, complication management and specialist endocrine expertise.

Why Endocrine Care Matters More Than Many People Realise

When people hear the word endocrinology, they may picture obscure hormone tests or uncommon glandular disorders. In reality, the endocrine system acts rather like the body’s internal communications network. Hormones help regulate blood glucose, metabolism, growth, reproduction, bone strength, blood pressure, stress responses and numerous other processes, which means endocrine disease can affect several organ systems at once. The South African Qualifications Authority describes endocrinology as covering diseases involving structures such as the thyroid, pituitary, adrenal glands, pancreas, parathyroids, ovaries and testes, as well as the wider metabolic disorders associated with them. Its registered endocrinology qualification specifically identifies diabetes, obesity, dyslipidaemia, thyroid disease, endocrine hypertension, growth disorders and metabolic diseases as areas creating healthcare need in South Africa. This breadth explains why rising demand for endocrine care cannot be measured simply by counting diabetes consultations. A patient may begin with unexplained fatigue and eventually be diagnosed with hypothyroidism; another may fracture a vertebra before osteoporosis is identified; another may present with difficult-to-control hypertension caused by an endocrine disorder. Endocrinology therefore sits at the intersection of everyday chronic disease management and highly specialised medicine. As the number of people living longer with chronic illnesses increases, the importance of having effective pathways from primary care to specialist endocrine services increases with it.

What Is Driving the Rise in Demand for Endocrine Care?

Several trends are converging in South Africa at the same time, rather like multiple lanes of traffic feeding into one increasingly busy intersection. Diabetes prevalence is significant and the absolute number of people affected is projected to rise. Obesity, which is strongly associated with metabolic disease, has increased substantially. The population is also gradually ageing, bringing more people into age groups where type 2 diabetes, osteoporosis and several other endocrine conditions become more common. South Africa’s 2025 to 2030 National Department of Health strategic plan reports that WHO age-standardised adult obesity prevalence rose from about 16.1% in 1990 to 30.8% in 2022. The latest 2026 population estimates from Statistics South Africa place the population at approximately 63.52 million, with 6.79 million people, or 10.7%, aged 60 years or older. Diabetes adds another layer: IDF data estimate 2.32 million adult cases in 2024 and project roughly 4 million by 2050. None of these indicators alone proves how many additional endocrinology appointments South Africa will require each year. Taken together, though, they provide strong evidence that the underlying pool of patients requiring metabolic, hormonal and bone-health management is expanding. That creates pressure not only on endocrinologists, but also on general practitioners, physicians, nurses, dietitians, diabetes educators and other professionals who share responsibility for endocrine care.

Indicator	Latest relevant evidence	Why it matters for endocrine care
Adults living with diabetes	About 2.32 million in 2024	More long-term metabolic care and complication management
Adult diabetes prevalence	7.2%	Large chronic-care population
Projected diabetes cases	About 4 million by 2050	Suggests substantial future growth in caseload
Adult obesity prevalence	30.8% age-standardised in 2022	Raises metabolic and diabetes-related care needs
Population aged 60+	6.79 million, 10.7%, in 2026	Ageing increases demand for diabetes, bone and metabolic care
Diabetes share of deaths	5.8% of deaths in 2023	Shows the seriousness of the national disease burden

Sources: IDF, WHO, Statistics South Africa and the National Department of Health.

Diabetes Is Already a Major National Health Burden

Diabetes provides perhaps the clearest example of why endocrine and metabolic care in South Africa deserves greater attention. The IDF’s 2025 Diabetes Atlas estimates that South Africa had approximately 38 million adults aged 20 to 79 in 2024, of whom about 2.324 million were living with diabetes, producing an estimated prevalence of 7.2%. Mortality statistics tell another part of the story. Stats SA recorded diabetes as the leading underlying natural cause of death in 2023, representing 5.8% of deaths nationally, and it was the leading cause among people aged 45 to 64. These numbers must be interpreted carefully because diabetes prevalence estimates and mortality registrations measure different things, and neither tells us how well every individual patient is controlled. Yet they point in the same direction: diabetes is not a peripheral condition in South Africa’s disease profile. Effective care is also much broader than prescribing medication. Patients may require cardiovascular risk management, kidney monitoring, retinal screening, foot care, nutrition support, glucose monitoring, insulin education and treatment adjustments as the disease progresses. Many uncomplicated cases can and should be managed effectively at primary-care level, but complex cases, difficult glycaemic control, unusual diabetes types and serious complications can require specialist input. When millions of people are living with a condition, even a relatively small percentage requiring specialist assistance translates into substantial demand for endocrine expertise.

Diabetes Could Affect Around 4 Million South African Adults by 2050

The future projection is where the scale of the challenge becomes particularly clear. According to the IDF Diabetes Atlas 11th edition, South Africa had approximately 2.3 million adults aged 20 to 79 living with diabetes in 2024 and is projected to have around 4.0 million by 2050. That represents an increase of roughly 1.7 million people, or about 74% when calculated from the rounded IDF figures: (4.0 million minus 2.3 million) divided by 2.3 million, multiplied by 100. The exact future number is not guaranteed, because projections depend on demographic assumptions, epidemiological trends and the effectiveness of prevention and treatment. It is nevertheless a powerful planning signal. Imagine a healthcare service that is already busy, then add hundreds of thousands of additional people requiring ongoing blood tests, medication reviews, glucose monitoring, cardiovascular risk assessment and management of complications. Some will remain stable under excellent primary care. Others will have type 1 diabetes, complicated type 2 diabetes, pregnancy-related endocrine problems, kidney disease or other conditions requiring more specialised expertise. The challenge is therefore not to funnel every diabetic patient toward an endocrinologist. It is to build a healthcare system with enough capacity at every level, while ensuring specialist services remain available when cases become difficult. That distinction is crucial if South Africa wants to manage the coming increase efficiently.

Obesity Is Increasing Metabolic Risk

Obesity is another major force changing the endocrine landscape. WHO’s South African country data give an age-standardised adult obesity prevalence of 30.8% in 2022, while a WHO feature published in March 2025 reported that more than half of South African adults were living with overweight or obesity and that the proportion exceeded two thirds among women. The same WHO report stated that costs associated with overweight and obesity accounted for around 15% of government health spending. Obesity is not simply a matter of appearance or willpower. It is a chronic, complex disease associated with metabolic dysfunction and increased risks of conditions including type 2 diabetes, cardiovascular disease and other health problems, which is one reason modern endocrine and metabolic practice increasingly includes obesity management. South Africa’s National Department of Health has recognised the need to expand obesity services, with Deputy Director General for Primary Care Dr Jeanette Hunter telling WHO that “obesity care and treatment are also critical.” Importantly, she argued that services need to reach patients at primary-care and community level. That is the right scale of thinking. If obesity care exists only in a handful of specialist clinics, the system will never reach everyone who could benefit. Specialists instead need to support a broader network in which prevention, primary care, dietetic support, appropriate medication and referral pathways work together.

South Africa Is Getting Older

Ageing is quieter than an epidemic, but its effect on healthcare demand can be just as important. Statistics South Africa’s latest mid-year population estimates put South Africa’s 2026 population at approximately 63.52 million, with around 6.79 million people aged 60 years or older, representing 10.7% of the population. Just a year earlier, the estimate was 6.61 million people aged 60 or older, and Stats SA’s broader healthy-ageing analysis shows that the number grew from about 3.6 million in 2002 to 6.6 million in 2025. That long-term rise matters because ageing changes the mix of conditions that healthcare services must manage. Older adults are more likely to live with multiple chronic illnesses simultaneously, and endocrine conditions frequently form part of that picture. Diabetes may coexist with cardiovascular disease or kidney impairment; declining bone density may lead to osteoporosis and fractures; thyroid abnormalities can require investigation and ongoing monitoring. An older patient can therefore need more complex care than a single diagnosis suggests. The ageing trend does not mean that South Africa has suddenly become an old society. Three quarters of the population remain below 60. It does mean that the absolute number of older patients is large and growing, so services designed around yesterday’s population structure may struggle with tomorrow’s case load unless workforce and referral capacity expand alongside it.

Beyond Diabetes: Endocrine Conditions Needing Specialist Care

Diabetes receives the most attention because of its scale, but endocrinology extends far beyond blood sugar. The endocrine system includes the thyroid, pituitary, parathyroid and adrenal glands as well as hormonal and metabolic functions involving the pancreas, reproductive organs, bone and other tissues. This matters when discussing healthcare demand because a specialist endocrine service must remain capable of managing both high-volume metabolic disease and uncommon but complicated hormonal disorders. South Africa’s recognised endocrinology training framework reflects exactly that breadth. SAQA lists expertise in diabetes, obesity, dyslipidaemia, thyroid disease, endocrine hypertension, growth disorders and related metabolic diseases as part of the rationale for specialist training. The same qualification requires specialists to be able to recognise endocrine disease, interpret specialised investigations and manage endocrine and metabolic emergencies. In other words, an endocrinologist cannot simply become a “diabetes doctor” because the surrounding caseload remains diverse. This creates a difficult balancing act. As diabetes and obesity consume more clinical time, sufficient specialist capacity must still exist for patients with pituitary tumours, adrenal insufficiency, thyroid disorders, calcium disorders, osteoporosis and less common endocrine diseases. A strong healthcare system therefore needs both scale and depth: scale for common chronic metabolic conditions, and specialist depth for cases where diagnosis or treatment requires expertise that primary care cannot reasonably provide.

Thyroid Disease Often Overlaps With Diabetes and Ageing

Thyroid disorders demonstrate how endocrine conditions can quietly coexist with other chronic diseases. A recent South African clinical audit published online in 2026 examined 290 adults aged 45 or older with type 2 diabetes attending the diabetic clinic at Helen Joseph Hospital. Researchers found that 6.9% had previously known hypothyroidism, while 17% had an elevated thyroid-stimulating hormone, or TSH, although the study did not find newly diagnosed overt hypothyroidism among the audited patients. Only 20% of those with known hypothyroidism were achieving the study’s TSH targets. These findings should not be interpreted as national thyroid prevalence figures because the sample came from one hospital diabetes clinic and involved a selected group of older adults with type 2 diabetes. They are useful for a different reason: they illustrate the clinical overlap that endocrine services routinely face. A patient attending for diabetes may also require thyroid monitoring; a patient with fatigue or weight changes may have several plausible explanations; and treatment must account for the person’s wider medical profile rather than viewing one hormone in isolation. This is part of what makes endocrine medicine complex. The symptoms of hormonal conditions can be subtle, overlap with common illnesses and sometimes develop gradually. Better awareness among frontline clinicians, appropriate testing and clear referral thresholds can therefore help ensure that patients who genuinely require specialist endocrine assessment reach it without overwhelming specialist clinics with cases that can safely be managed elsewhere.

Osteoporosis and Bone Health Deserve More Attention

Bone disease is another area likely to become increasingly important as South Africa ages. A 2025 study from a tertiary academic centre in Johannesburg analysed 2,264 patients referred for dual-energy X-ray absorptiometry, or DEXA, scanning between 2006 and 2021. Researchers found osteoporosis in 880 patients, or 38.8% of the referred group, with prevalence increasing with age. Among osteoporotic patients for whom vertebral fracture information was available, the study also found a substantial burden of vertebral deformity. These figures should not be described as the prevalence of osteoporosis in the general South African population. The researchers themselves noted the potential for selection bias because the dataset consisted of people referred for DEXA at a tertiary hospital, which naturally creates a higher-risk population than the public at large. Even with that limitation, the findings matter because they show the type of workload already appearing within specialist services. Osteoporosis can develop silently until a fracture occurs, and patients may require assessment of bone density, calcium and vitamin D status, secondary endocrine causes and appropriate treatment. With the number of South Africans aged 60 and older continuing to rise, bone health can no longer be treated as an afterthought. Preventing a fracture is very different from trying to restore independence after one, making earlier risk identification increasingly important.

Adrenal and Pituitary Disorders Are Rare but Potentially Serious

Not every endocrine condition is common, and that is precisely why specialist capacity remains essential. Primary adrenal insufficiency, for example, is far less prevalent than diabetes but can become life-threatening if an adrenal crisis occurs. A South African physician survey published in PLOS ONE in 2020 gathered clinical experience concerning 811 patients with primary adrenal insufficiency and produced an inferred prevalence of 14.2 per million, while also highlighting major differences in disease causes and diagnostic resources between public and private healthcare. In the surveyed patient group, 15.5% were reported to have presented in adrenal crisis. The researchers cautioned that their methodology was survey-based, so the findings should not be treated as a definitive population prevalence study. Their results nonetheless demonstrate why rare endocrine disease cannot simply disappear from workforce planning. The same principle applies to pituitary disorders and other uncommon hormonal conditions. Primary-care clinicians may encounter these diseases only occasionally, while endocrinologists build experience through repeated exposure, specialised testing and management of complicated hormonal interactions. If specialist capacity becomes completely absorbed by high-volume diabetes and obesity care, patients with rarer conditions risk delayed diagnosis. South Africa therefore needs a model in which routine metabolic disease is managed effectively close to the patient while specialist teams retain enough capacity for diagnostic complexity and endocrine emergencies.

South Africa’s Endocrine Workforce Problem

The demand side of the equation is only half the story. South Africa also faces a specialist supply problem. A current SAQA record for the Master of Philosophy in Endocrinology, registered through June 2027, states explicitly that “South Africa has a critical shortage of qualified Endocrinologists” and describes endocrinology as a scarce skill needed to address diabetes, obesity, dyslipidaemia, thyroid disease, endocrine hypertension, growth disorders and metabolic disease. That is a significant statement because it appears within the country’s formal qualification framework rather than a marketing claim from a private provider. What is much harder to establish is an exact, verified current 2026 national headcount of practising endocrinologists. Publicly accessible sources commonly repeat estimates, but I could not confirm a current 2026 HPCSA national total from a primary registry source during this research, so presenting a precise number as fact would be misleading. The shortage can still be established without inventing one. South Africa has millions of people living with diabetes, more than six million people aged 60 or older, a high burden of obesity and a formal training framework that itself identifies insufficient specialist capacity. The practical response is not merely “train more endocrinologists,” although additional training is important. The country also needs to use the endocrinologists it has strategically, with strong primary-care pathways and efficient referral systems.

Why Specialist Shortages Matter

A shortage of endocrinologists does not mean that every patient with diabetes or thyroid disease is going untreated. Much endocrine care can be delivered safely and effectively by general practitioners, primary healthcare clinicians, physicians and multidisciplinary teams. The problem appears when the number of complex cases grows faster than specialist capacity. Imagine an endocrinologist’s clinic as the narrowest part of a funnel. If straightforward cases that could be managed elsewhere occupy all available appointments, patients with difficult insulin management, complex thyroid disease, pituitary disorders, adrenal disease or unexplained metabolic abnormalities may wait longer for specialist assessment. On the other hand, simply rejecting referrals pushes complexity back toward clinicians who may not have access to the necessary investigations or experience. The solution is therefore not a binary choice between primary care and specialists. It is a shared-care model in which each level manages what it can safely handle, supported by referral criteria, specialist advice and back-referral once patients are stable. South Africa’s own National Department of Health thinking reflects this logic in obesity care, where WHO reports that government leaders want prevention and treatment expanded at primary and community level with referral and back-referral to secondary and tertiary services. The same principle has broad relevance across endocrine medicine because it protects scarce specialist time while keeping routine care closer to patients’ communities.

Public-Private and Urban-Rural Gaps Complicate Access

The availability of a specialist somewhere in South Africa does not automatically mean that every South African can access that specialist. The country operates across very different healthcare settings, and historical South African research has demonstrated differences in resources between public and private endocrine care. A 2018 Johannesburg study comparing specialised type 2 diabetes services at Charlotte Maxeke Johannesburg Academic Hospital and a private diabetes centre documented differences in clinic staffing, electronic patient management, frequency of clinics and access to multidisciplinary resources. Those findings are now several years old, so they should not be presented as a snapshot of every facility in 2026. A separate 2020 study of primary adrenal insufficiency also found disparities in diagnostic resources and management options between surveyed public and private settings. Together, these studies demonstrate a persistent structural issue rather than supplying a current national league table of facilities. Geography creates another challenge. Specialist services tend to cluster around major academic and urban centres, while patients may live many kilometres away and face transport costs, lost working time and repeated appointments. This is why simply increasing national specialist numbers is not enough. South Africa needs distribution, referral coordination, shared-care networks and ways for specialist knowledge to reach clinicians outside major centres. A healthcare service is only truly available when the patient can realistically reach and use it.

What Primary Healthcare Can Do

If South Africa tried to send every person with diabetes, obesity, thyroid disease or osteoporosis directly to an endocrinologist, the specialist system would quickly become overloaded. Primary healthcare is therefore central to meeting rising endocrine demand, not a second-best alternative. South Africa’s National Department of Health has already adopted a population-level approach to diabetes and hypertension through its NCD strategy. The Department’s 2025 to 2030 strategic plan references a 90-60-50 cascade, aiming for 90% of adults to know whether they have elevated blood pressure or blood glucose, 60% of people with abnormal results to receive an intervention, and 50% of those receiving intervention to achieve control. Whether those targets are achieved will depend heavily on primary-care capacity because screening millions of adults cannot be performed by specialist clinics. The same principle extends beyond diabetes. Primary care can identify abnormal thyroid tests, recognise fracture risk, review medications that influence metabolism, detect warning signs requiring referral and monitor stable patients after specialist assessment. The goal is not to turn every primary-care clinician into an endocrinologist. It is to equip frontline services with good protocols, appropriate tests and clear escalation routes. When that first layer works well, specialists receive the patients who genuinely need specialist expertise rather than becoming the first stop for every metabolic problem.

Earlier Detection and Referral Can Reduce Complications

Endocrine disease often rewards early recognition because waiting for a crisis or irreversible complication is usually the most expensive and disruptive way to discover a problem. Diabetes illustrates this vividly. By the time uncontrolled glucose has contributed to kidney, eye, cardiovascular, neurological or foot complications, the patient may require several healthcare disciplines rather than one. Osteoporosis follows a similar pattern: a person can lose bone density without obvious symptoms until a fracture occurs. Adrenal disease provides the more dramatic example, where delayed recognition can culminate in adrenal crisis. South African mortality data give the bigger picture by showing that diabetes was the country’s leading underlying natural cause of death in 2023 and the leading underlying cause among adults aged 45 to 64. That does not mean that every death could have been prevented through earlier referral, and such a claim would go beyond the evidence. It does show why waiting for late-stage disease is a poor national strategy. Screening and early intervention should occur at the most accessible level of care, while referral needs to be triggered by complexity rather than by diagnosis alone. Good referral criteria might distinguish stable type 2 diabetes from recurrent severe hypoglycaemia, or uncomplicated hypothyroidism from unusual thyroid dysfunction. Done properly, this protects patients and specialist capacity simultaneously.

Multidisciplinary Endocrine Care Is Essential

One of the easiest mistakes to make when thinking about endocrine care is to imagine that the solution consists solely of more doctors. Diabetes and obesity show why that view is too narrow. A person living with diabetes may need support from a doctor, diabetes nurse educator, dietitian, podiatrist, ophthalmic service and other professionals depending on their circumstances. Obesity management can involve clinical treatment, nutritional support, behavioural interventions and management of associated metabolic conditions. Bone health may require input from physicians, endocrinologists, radiology services, physiotherapists and other professionals. The 2018 Johannesburg comparison of specialised diabetes services documented multidisciplinary teams that included endocrinologists, physicians, nurse educators, dietitians and podiatrists, with additional disciplines available in the private centre studied. More recent South African research presented at the 2026 SEMDSA Congress also identified nutritional-care gaps among a small surveyed diabetes population: 60.9% of 46 participants reported never consulting a dietitian after diagnosis, while 87% wanted additional nutritional resources. That small sample cannot be generalised to everyone with diabetes in South Africa, but it illustrates why disease management cannot rely on prescriptions alone. Building endocrine capacity therefore means strengthening the entire care team. A scarce specialist becomes more effective when surrounding professionals can provide education, monitoring and ongoing support while escalating complex clinical questions when necessary.

Technology, Telehealth and Shared Care May Expand Reach

Technology cannot manufacture an endocrinologist, but it can make specialist expertise travel further. This matters in a country where patients and clinicians are spread across large geographic areas and specialist services are concentrated in particular centres. A shared-care model can allow primary-care clinicians to manage stable patients locally while obtaining specialist advice when a case becomes difficult, rather than requiring every clinical question to become a physical specialist consultation. Telehealth can potentially support case discussions, follow-up consultations and education, while digital glucose technologies can give clinicians richer information about some patients’ day-to-day diabetes control. The 2026 SEMDSA Congress abstracts provide an example of how technology is already part of diabetes care among selected South African patients: in one small survey dominated by people with type 1 diabetes, 65.2% of participants reported using continuous glucose monitoring. That figure must not be confused with national access, as the sample comprised only 46 participants and was heavily weighted toward specialist-managed type 1 diabetes. The broader lesson is that technological sophistication and access are not the same thing. South Africa needs digital tools that reduce travel and extend expertise without creating a new divide in which only patients with reliable connectivity, private funding or expensive devices benefit. Technology works best as a bridge between levels of care, not as a substitute for healthcare professionals.

What South Africa Should Prioritise Next

The evidence suggests that South Africa needs to approach endocrine demand as a health-system capacity issue, not simply as a request for more specialist appointments. The first priority is prevention and earlier detection of common metabolic disease, particularly diabetes and obesity. The second is stronger primary-care capability so that stable patients are managed efficiently without unnecessary specialist referral. The third is enough specialist training and retention to ensure that genuinely complex endocrine disease can be assessed without unreasonable delay. SAQA’s current qualification framework is unusually direct in describing a “critical shortage” of endocrinologists, while the Department of Health’s NCD strategy explicitly seeks broader detection, intervention and control of diabetes and hypertension. The fourth priority is multidisciplinary capacity, including diabetes education, dietetic services and other allied disciplines. The fifth is better use of technology and consultation networks to extend scarce expertise beyond major academic centres. These priorities reinforce each other. A specialist workforce cannot cope if primary care fails, while primary care becomes vulnerable if there is nowhere to escalate difficult cases. South Africa has already demonstrated in other areas of healthcare that large chronic-care systems can be built when services are organised around accessible community care backed by specialist expertise. WHO’s recent obesity work explicitly argues that this experience can help the country rethink obesity and chronic disease services. Endocrine care needs the same scale of planning.

The statement that demand for endocrine care is increasing in South Africa is supported by several independent trends rather than one headline statistic. Around 2.32 million South African adults were estimated to be living with diabetes in 2024, and the IDF projects the number could reach about 4 million by 2050. Adult obesity has risen substantially, with WHO reporting age-standardised prevalence of 30.8% in 2022. South Africa’s population is ageing, with approximately 6.79 million people aged 60 or older in 2026. Diabetes was also the country’s leading underlying natural cause of death in the latest available national mortality statistics for 2023. At the same time, South Africa’s formal endocrinology training framework describes a critical shortage of qualified endocrinologists. The answer is therefore not to place millions of patients into specialist queues. It is to create a stronger pyramid of care: prevention and screening at community level, capable primary care for common and stable disease, multidisciplinary support for ongoing management, and accessible endocrinologists for complicated cases, rare conditions and endocrine emergencies. If that balance is achieved, specialist expertise becomes a multiplier rather than a bottleneck. If it is ignored, diabetes, obesity, ageing and other endocrine disorders will continue increasing the pressure on an already stretched healthcare system.

Frequently Asked Questions

1. What does an endocrinologist treat?
An endocrinologist is a specialist doctor dealing with diseases involving hormones, metabolism and endocrine glands. This can include diabetes, thyroid disorders, adrenal and pituitary disease, calcium disorders, osteoporosis, metabolic conditions and certain reproductive or growth-related endocrine problems. In South Africa, endocrinology is formally recognised as a medical subspecialty, and specialist training includes the diagnosis and treatment of both common metabolic disease and complex hormonal disorders.

2. Is diabetes increasing in South Africa?
The International Diabetes Federation estimates that approximately 2.32 million South African adults aged 20 to 79 were living with diabetes in 2024. Its latest Atlas projects that the number could reach about 4 million by 2050. Projections are not guarantees, but they provide a strong indication that the absolute number of people needing diabetes-related healthcare could rise considerably over the coming decades.

3. Does everyone with diabetes need to see an endocrinologist?
No. Many people with type 2 diabetes can be appropriately managed by primary-care doctors and multidisciplinary healthcare teams. Specialist endocrinology becomes particularly valuable when diagnosis is uncertain, glucose control remains difficult, treatment becomes complex, severe hypoglycaemia occurs, complications develop or another endocrine disorder is suspected. Strong primary care actually helps preserve specialist appointments for the people who need them most.

4. Why does South Africa’s ageing population affect endocrine care?
Ageing increases the number of people entering age groups in which chronic metabolic and bone conditions become more important. Stats SA estimates that approximately 6.79 million South Africans, or 10.7% of the population, were aged 60 or older in 2026. Older adults may also live with several conditions simultaneously, making clinical management more complicated and increasing the need for coordinated care.

5. Is there a shortage of endocrinologists in South Africa?
South Africa’s official SAQA endocrinology qualification record states that the country has a “critical shortage of qualified Endocrinologists” and identifies endocrinology as a scarce skill needed to address diabetes, obesity, thyroid disease and other endocrine disorders. A reliable current 2026 national headcount of practising endocrinologists could not be confirmed from a publicly accessible primary HPCSA registry during this research, so no unverified numerical workforce estimate has been presented here.

References

1. International Diabetes Federation. IDF Diabetes Atlas, 11th Edition. Brussels: International Diabetes Federation; 2025. Provides 2024 diabetes estimates and projections to 2050. IDF Diabetes Atlas 2025

2. International Diabetes Federation. South Africa: Diabetes Network country data. Reports approximately 2,324,200 adults with diabetes and 7.2% adult prevalence for 2024. IDF South Africa diabetes data

3. Magliano DJ, Boyko EJ, IDF Diabetes Atlas 11th Edition Scientific Committee. Diabetes Atlas. 11th edition. Brussels: International Diabetes Federation; 2025. Africa regional table projects approximately 4.0 million South African adults with diabetes by 2050. NCBI IDF Africa table

4. Statistics South Africa. Mortality and causes of death in South Africa: Findings from death notification, 2023. Statistical Release P0309.3. Published 25 March 2026. Statistics South Africa mortality report

5. Statistics South Africa. Mid-year population estimates, 2026. Statistical Release P0302. Published 30 July 2026. Stats SA 2026 population estimates

6. World Health Organization. South Africa: applying the lessons learned from tackling HIV to accelerate action on obesity. Published 4 March 2025. WHO South Africa obesity report

7. World Health Organization. South Africa country health data. WHO Global Health Observatory. Reports age-standardised adult obesity prevalence of 30.8% for 2022. WHO South Africa country health data

8. National Department of Health, Republic of South Africa. National Department of Health Strategic Plan 2025–2030. Includes obesity trends and the 90-60-50 NCD cascade for hypertension and diabetes.

9. National Department of Health, Republic of South Africa. National Strategic Plan for the Prevention and Control of Non-Communicable Diseases 2022–2027. National Department of Health strategic documents

10. South African Qualifications Authority. Master of Philosophy in Endocrinology, SAQA Qualification ID 97587. Current registration period July 2024 to June 2027. SAQA Endocrinology qualification record

11. Anavi K, Daya R, Bayat Z. The prevalence of osteoporosis in patients referred for DEXA scans at a tertiary academic center in Johannesburg, South Africa. Wits Journal of Clinical Medicine. 2025;7(1). DOI: 10.18772/26180197.2025.v7n1a1.

12. Mofokeng TRP, Ndlovu KCZ, Beshyah SA, Ross IL. Tiered healthcare in South Africa exposes deficiencies in management and more patients with infectious etiology of primary adrenal insufficiency. PLOS ONE. 2020;15(11):e0241845. DOI: 10.1371/journal.pone.0241845. PLOS ONE research article

13. The prevalence of hypothyroidism in people living with type 2 diabetes mellitus attending the diabetic clinic at Helen Joseph Hospital. Journal of Endocrinology, Metabolism and Diabetes in South Africa. Published online 1 April 2026.

14. Quality of care delivered to type 2 diabetes mellitus patients in public and private sector facilities in Johannesburg, South Africa. Peer-reviewed study indexed by PubMed, PMID 30323645. PubMed record

15. Society for Endocrinology, Metabolism and Diabetes of South Africa. SEMDSA 58th Annual Congress 2026: Abstracts. Journal of Endocrinology, Metabolism and Diabetes in South Africa. 2026.

Medical information in this article is intended for general education and should not replace individual assessment, diagnosis or treatment by an appropriately qualified healthcare professional.