Diabetes care in South Africa: A tale of two sectors

'It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness, it was the epoch of belief, it was the epoch of incredulity, it was the season of light, it was the season of darkness, it was the spring of hope, it was the winter of despair, we had everything before us, we had nothing before us ... '. These famous words penned by Charles Dickens in 1859 captured the spirit of the Age of Revolution in Europe in the late 18th century. However, they could also be used to describe the disparate provision of diabetes care in present-day South Africa. Some of our patients have access to most of the new therapeutic agents, are provided with home blood glucose testing apparatus, and have access to multidisciplinary diabetes care teams. Many others are less fortunate. As will be discussed, the 'where' of diabetes care has a powerful influence on outcomes.