Blighted lives: The true cost of diabetes

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www.bbc.com/news/health-37694768?yptr=yahoo

Health
Blighted lives: The true cost of diabetes
By Dominic Hughes
Health correspondent, BBC News
24 October 2016
From the section Health
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Steven Woodman
Image caption
Steven Woodman was diagnosed with type 2 diabetes more than 25 years ago
Steven Woodman walks like an old man.
He needs a stick to maintain his balance as he hobbles forward.
Steven is only in his late 50s, but the loss of three toes on one foot means he's unsteady on his feet.
It is type 2 diabetes that has led Steven to where he is now.
More accurately, it's ignoring the warnings and advice around diabetes that has left him facing a life of disability.
He was diagnosed with type 2 diabetes, closely linked to lifestyle and weight gain, when he was still a young man.
Steven, who lives in Shrewsbury, freely admits that, at the time, he ignored his GP's advice.
"I was in denial. I never took it that seriously, so I carried on eating, going to the pub - doing things people of my age did.
"Of course, now I know different."
'Numb to pain'
There are two main kinds of diabetes.
Type 1 is an auto-immune disease that usually develops when people are young, and which accounts for around 10% of cases in the UK.

Media captionPaul Dibbins cut off two toes when they went gangrenous.
But the other 90% have type 2 which can be affected by where you come from and your family history, but in most cases is associated with being overweight.
One effect of the disease is poor blood circulation, particularly in the extremities of the body such as the feet.
It also affects the nerves, so the feet become numb to pain.
That meant that when Steven developed an ulcer on his toe, he didn't notice at first. And then it wouldn't heal.
It became dangerously infected - gangrenous - so much so that it presented a threat to Steven's life.
Steven Woodman
Image caption
Steven Woodman must undergo regular check-ups on his feet if he is to avoid losing any more toes
As he explains, that was just his first amputation.
"My surgeon did say to me when he was taking my third toe off, it's only a matter of time before you lose that one. It's inevitable that will go the same way.
"I've become an old man very, very quickly and inside I don't feel old.
"I'll go on forever, I thought."
Diabetes 'epidemic'
Steven is far from alone.
Each week, there are a shocking 140 amputations associated with complications due to diabetes in England alone.
Kate Merriman is a vascular surgeon at the Shrewsbury and Telford Hospital NHS Trust who has the grim task of carrying out amputations on patients like Steven.
She is alarmed at the growth she has seen in the number of operations she is performing - and the costs that go along with that.
"It's approximately £20,000 for first six months following amputation.
"There's the limb fitting, and even a basic prosthesis costs thousands of pounds. All of those aspects mean it's a very expensive process for the state."
She added: "We're facing a diabetic epidemic, and we need to find ways of preventing those patients from reaching surgeons because the cost to the patient and the NHS is skyrocketing."
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Diabetics like Steven don't just face an increased risk of amputations, but also kidney failure, blindness and even premature death.
And caring for the growing number of people diagnosed with diabetes is costing the NHS in England alone around £10bn every year, nearly 10% of the entire budget.
There is concern at what impact that will have on the future financing of the NHS.
Chris Askew, chief executive of Diabetes UK, says there are clear implications of what he calls a "diabetes epidemic".
"As things stand we are certainly looking at a crisis in diabetes which threatens to bankrupt the NHS if we continue with these current trends.
"I believe we're facing a crisis and we really need concerted action right across society for us to fund more research, provide best possible care and crucially prevent so many cases of type 2 in the future."
The other development that is worrying experts is that the age profile of those being diagnosed with type 2 diabetes is falling.
It used to be the case that most new cases were found in those aged over 65.
But now a small but growing number of children are also being diagnosed with type 2 diabetes.
Aisha is 15 and a keen footballer and runner.
Aisha
Image caption
Aisha, 15, has worked hard to lose weight and bring her type 2 diabetes under control
But a love of sweets, treats and fizzy drinks saw her weight increase.
She says: "I developed type 2 diabetes by having a sweet tooth mostly. I used to try out every new sweet in the store and I used to drink quite a lot of sugary drinks.
"When I was taken to the hospital, it hit me then because I started crying and it was a shock."
Aisha now has to rely on medication to control her condition, but she has lost a stone in weight and the fizzy drinks are a thing of the past.
"It's been really hard at times, but you can only have health once and you can't buy your health. You have to keep changing your diet plan to keep fit and healthy."
Hard lessons
A diagnosis of type two diabetes is life changing, but there is some evidence that suggests it can be reversed, or at least put into remission.
In Newcastle, research is under way into a very limited calorie controlled diet; some surgeons argue that "gastric band" operations can be an effective way of stopping the condition.

Media captionAll the shoes in this shop represent a dark, diabetes secret
But the impact on the lives of those who develop type 2 diabetes is not to be underestimated.
While Steven Woodman's condition has stabilised, he has lost his job as a security guard.
He is too unsteady on his feet and his employer says he's no longer fit to work.
His advice is clear and uncompromising: "For God's sake, take it seriously. Don't make the mistake I did.
"It's the biggest regret I've ever made in my entire life. It's a dreadful nasty disease. It takes no prisoners. It's a terrible thing."