Diabetes or diabetic related amputations are on the rise as thousands of cases of the disease continue to go undiagnosed for too long. Every 30 seconds there is an amputation due to diabetes somewhere in the world and New Zealand is not immune. In the past five years alone in New Zealand diabetic amputations have risen by 13 per cent. And there were 989 amputation procedures conducted in 2017. In total 4388 amputations were performed during that five-year period.
The toe is the most common amputation with 399 taken off in 2017 – an increase of 84 toes since 2013.
Diabetes New Zealand chief executive Heather Verry said on average those diagnosed with diabetes was growing by 5000 a year, that included both type 1 or type 2 diabetes.
“What the big issue is that there is about 100,000 that have got it [diabetes] without realising it. Or they potentially think they might have it but they don’t go to the doctor and get diagnosed. And that is when you end up with the complications and that is where the issue is with these with these lower leg amputations and that is why they’re increasing.”
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The sooner people get diagnosed and learn how to manage their health and adopt a healthier lifestyle the less likely they’re to get complications, she said.
“They think they’ve just got to lose weight but they’ve actually got to look after their feet and it’s all because the blood supply reduces as you go down to your feet. They might start off with a foot ulcer or a slow healing wound and if they don’t get those attended to and sorted then that is where the amputations come from.”
Diabetes occurs when the pancreas is no long able to make insulin, or, when the body can’t make good use of the insulin it produces.
Not being able to produce insulin or use it effectively leads to raised glucose levels in the blood known as hyperglycaemia. Over the long-term high glucose levels are associated with damage to the body and failure of various organs and tissues.
Counties Manukau District Health Board had the most diabetes related amputations in 2017 with 137 – up by 30 from five years ago. Waikato follows with 111 amputations and then Canterbury with 105.
The Ministry of Health doesn’t collect data on the cost related to diabetic amputations. But refers to a study in the Journal of Vascular Surgery that said the cost of treating diabetes-related disease in New Zealand is increasing and is expected to reach $1.8 billion by 2021.
The financial burden for the treatment of diabetic foot wounds is difficult to quantify and reported costs vary greatly.
Verry admits there is definitely a stigma when it comes to diabetes. “People with type 2 diabetes don’t want to admit it. So they don’t go and get themselves checked as they feel like they’ve failed.
“Self blame is really destructive and what we are trying to say is that you’ve just got to know your risk. Don’t think I just have to lose a little bit of weight and I will be OK. Go to the doctor and they may need to give you all the information, which may say you are presenting but if you do all this you aren’t going to get it or you may delay it.”
There are more young people getting diagnosed which means their potential for complications is increased. “It’s very sad to think that if someone doesn’t manage it as soon as they can a 40 year old could end up having a lower leg amputation, it’s bad enough in your 70s.”
She does concede that it comes back to the old adage of what we are eating and having a healthy lifestyle, which includes is 30 minutes of activity a day.
“There are those who are pre-disposed, you’ve got ethnicity and genetics predisposition. Indians are predisposed to it and as well as Māori and Pacific Islanders. What I understand is that it seems to present globally in darker skinned people, why I don’t know.”
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Waikato Regional Diabetes Service specialist Dr Ryan Paul said they would love to have more resources to help with diabetes but he understood it was not seen as a “sexy disease.”
“It doesn’t attract the same amount of sympathy and potentially funding as say cancer or heart disease often people think diabetes is your fault. Even though it might not be your fault whatsoever it’s a general misconception.”
He said it was understandable that people were not diagnosed when they should be.
“People have to pay to go see their GP and a quarter of New Zealanders can’t afford to pay to see their GP let alone their scripts. Diabetes is a lifelong disease it requires regular follow ups. You do need be seeing your doctor or nurse regularly and if you don’t have the money to go along then all of a sudden you are on the big back foot.”
adapted from source