I was five when diagnosed with Type 1 diabetes in Zambia. The diagnosis gave my family an answer and a new life to learn. Insulin had to be understood, blood glucose checked, food reconsidered and warning signs recognized. Naming the condition was essential, but it was only the beginning.

That matters as we approach World Diabetes Day on 14 November. This year’s WWD theme, “Early action on diabetes”, focuses on recognizing symptoms, diagnosing people sooner and reducing stigma. But early action cannot end at diagnosis. Without affordable treatment, education and follow-up, information has nowhere to go.

For Type 1 diabetes, that bridge can mean life or death. Symptoms may include extreme thirst, frequent urination, weight loss, tiredness and blurred vision. When these signs are missed, someone can develop diabetic ketoacidosis, or DKA, a dangerous insulin shortage requiring urgent treatment.

A recent UTH study, published in Endocrinology, Diabetes & Metabolism, looked at 353 children who arrived at hospital with DKA, a life-threatening complication caused by not having enough insulin. Children who arrived more severely ill stayed in hospital longer. The message is simple: recognizing Type 1 diabetes earlier can help a child receive treatment before DKA becomes severe.

Yet recognizing symptoms is only the start. What happens when that child leaves hospital? Does the family understand insulin, and can they find it consistently? Do they have a glucose meter and enough test strips? Do they know how to treat low blood sugar, manage illness or explain the condition to a teacher? Do they understand that diabetes does not make their child less worthy of education, ambition, marriage or a family of their own?

Cultural fear often enters the room with the diagnosis. Some families fear the child may not survive, become independent or be accepted by a future partner. A prescription cannot answer those fears. It explains the medicine, but not how to live with a condition that changes with meals, exercise, stress, illness, hormones and growth.

I know how much invisible learning diabetes requires. The calculations become part of daily life, but they are not instinctive. Families need repeated information because shock affects what people absorb. They need permission to ask again, and guidance that fits their food, budget, beliefs and household routines rather than advice copied from a life they do not live.

Zambia has made important progress through PEN-Plus, a programme bringing care for severe chronic conditions such as Type 1 diabetes, sickle cell disease and rheumatic heart disease closer to communities. Five facilities offer services in Lusaka, Chibombo, Kapiri Mposhi, Ndola and Chipata, with plans to reach district hospitals. This allows more families to access specialist support closer to home.

But expanding clinics should also expand what we mean by care. Success means uninterrupted insulin, reliable monitoring equipment, health workers who have time to teach and families who know what to do at home. A few weeks ago at CIDRZ (Centre for Infectious Disease Research in Zambia) Tuli Bonse camps, I spent time with young people living with Type 1 diabetes and donated teddy bears collected during my journey. The bears were small, but the message was not. The children saw an adult who had lived with the condition for decades and built a full life. Sometimes care means seeing what remains possible.

Schools are part of early action too. I have seen classrooms where nobody recognizes low blood sugar, a phone receiving glucose readings is restricted, a glucose meter is misunderstood or eating emergency sweets is treated as breaking a rule. The diagnosis may be written in the school file, but the child is still left to negotiate each emergency alone. Medical care cannot stop at the school gate.

The same principle applies to Type 2 diabetes. Screening may identify high blood glucose, but what follows? If appointments are unaffordable, medicines unavailable or advice is reduced to “lose weight and stop eating sugar”, early detection becomes shame without support. Weight loss does not need to begin with punishing workouts or expensive programs. It may begin with something practical and affordable that people can repeat, such as regular walking, simple consistent movement at home and gradual changes to familiar meals.

This also matters to families in the Zambian diaspora. Britain, the United States, Australia or the UAE may offer more technology, but it does not remove the emotional weight of diagnosis or guarantee culturally useful education. Families can leave appointments knowing the medical terminology but not how to apply it to their food, work, faith, travel and family expectations.

WHO’s global target is affordable insulin and blood glucose monitoring for everyone with Type 1 diabetes by 2030. Diagnosis alone is not success. Early action after diagnosis means treatment and support that are available, affordable and understood.

For Zambia, early action should include a clear first-month pathway after diagnosis: plain-language guidance, scheduled follow-up, practical demonstrations, school support and contact with people who understand the condition. This is the gap I am helping to close through my work with families, schools and workplaces, hand in hand with healthcare professionals. Clinical knowledge and lived experience should meet around the same person, not compete for space. This month, that work includes supporting the Health and Wellness Centre’s Diabetes Day, donating copies of my children’s adventure book about living with diabetes, and holding a book signing at Bookworld to help children and families understand diabetes through education and empowerment rather than fear.

This World Diabetes Day, we should teach the symptoms and encourage people to seek help early. But once a person is diagnosed, are we ready to care for the whole person rather than simply treat the condition? The diagnosis opens the door. This year’s call for early action means ensuring nobody is left standing alone on the other side.

Kaajal Vaghela is a sportswear designer and cultural wellness consultant with over three decades of lived experience managing Type 1 diabetes in Zambia and the diaspora. Having previously served as Chairperson of the Lusaka branch of the Diabetes Association of Zambia, she remains a passionate advocate for breaking down myths and building awareness about diabetes. For more personalized coaching or corporate wellness workshops, visit: www.kaajalvaghela.com and for any feedback: [email protected])