More people than ever are having parts of their legs amputated because of diabetes complications, figures have revealed.
More than 27,000 toe, feet and lower leg amputations were carried out by the NHS between 2015 and 2018.
This is 3,000 more than in the three years prior and is down to cases of type 2 diabetes – a weight-related illness – soaring.
The number of patients suffering from the illness has doubled since the mid-90s, putting hundreds of thousands at higher risk of stroke and heart disease.
Doctors are having to amputate more people’s toes and feet because of complications of type 2 diabetes, which is triggered by obesity and now affects more than 3million Britons (stock image)
Figures revealed by Public Health England show the scale of the ‘devastating’ operations.
The government body recorded hospital admissions and amputations among patients with diabetic foot disease, a condition caused by nerve damage in the legs.
Diabetes leads to high levels of sugar in the blood, which can damage nerves, and reduced circulation, which cuts off oxygen supply, potentially harming tissue.
Both slow the healing of wounds and allow them to spiral out of control and eventually lead to an injury or infection so bad only amputation can help.
The number of people with type 2 diabetes in England and Wales is around 3.4million, with more than 200,000 diagnosed in 2017.
In comparison, just 1.4million people had diabetes diagnoses in 1996, about 90 per cent of them with type 2.
The figure is expected to surpass 5.5m by 2030, Diabetes UK said – the condition is closely linked to being overweight, inactive and consuming too much sugar.
In total, England had 27,465 lower limb amputations among patients with diabetic foot disease between 2015 and 2018.
The figure was a rise from 24,181 in 2012-2015.
HOW CAN DIABETES LEAD TO FOOT AMPUTATIONS?
People with diabetes are far more likely to need their toes or feet amputated because their injuries do not heal normally.
High blood sugar can cause nerve damage which means patients cannot feel their skin as well and may not know when they have a wound, or feel how serious it is.
And diabetes restricts circulation in the legs, which slows down healing because oxygen and nutrients are in short supply.
The combination of these two factors means it can take longer for people to get over injuries and the healing time means there is more opportunity for it to become infected or for flesh to die because of gangrene.
If an injury becomes too infected or untreatable the affected part of the body may have to be cut off.
Source: American Podiatric Medicine Association
Some 7,545 of those in the most recent three years were major, meaning above the ankle, while 19,920 were minor – below the ankle.
Campaigners said action must be taken to curb rising diabetes rates and help people avoid the drastic surgery.
The statistics confirmed the number of amputations is rising because more people are being diagnosed with type 2 diabetes – the individual risk for a diabetic person is not significantly increasing.
Nikki Joule, policy manager at Diabetes UK said: ‘The number of people with diabetes experiencing a lower limb amputation continues to rise as the number of people living with the condition grows.
‘It’s vital that action is taken to prevent as many people from developing type 2 diabetes as possible so fewer people are at risk of a devastating, and often avoidable, amputation.’
The rate per person of major amputations did not increase, but there was a slight increase in minor amputations.
Figures showed the areas worst hit by these operations, which involve removing part or all of the foot.
The area covering north, east and west Devon was worst affected, with 420 people having the ops – up from just 72 between 2012 and 2015.
It was followed by Somerset, with 404 between 2015 and 2018, and Birmingham and Solihull with 395.
Dr Jennifer Smith, diabetes expert for Public Health England said: ‘It’s a tragedy that so many people are unnecessarily having to face the life-changing consequences of diabetes, such as amputations.
Survival rates and quality of life for people following such major surgery can often be poor. This shouldn’t be happening when the condition is preventable.’
She added: ‘Type 2 diabetes remains the greatest health challenge in this country and many adults are in danger of developing this deadly but preventable disease.’
Diabetes UK’s Ms Joule added: ‘People with diabetes also need to ensure they are attending their free annual NHS foot check, and if they notice any issues with their feet, immediately see a healthcare professional.
‘[This] could be the difference between keeping and losing a foot.’
|NHS area||Minor amputations 2015-2018||Minor amputations 2012-2015||NHS area||Minor amputations 2015-2018||Minor amputations 2012-2015|
|NHS Northern, Eastern And Western Devon CCG||420||72||NHS Mansfield And Ashfield||86||89|
|NHS Somerset CCG||404||81||NHS Canterbury And Coastal CCG||86||65|
|NHS Birmingham and Solihull CCG||395||66||NHS Southwark||85||89|
|NHS Bristol, North Somerset and South Gloucestershire CCG||384||35||NHS North Durham CCG||85||N/A|
|NHS Kernow CCG||353||113||NHS Newham||83||69|
|NHS Leeds||299||33||NHS Brent||80||69|
|NHS Liverpool CCG||294||25||NHS Bromley||80||88|
|NHS Dorset CCG||264||82||NHS North East Hampshire And Farnham CCG||80||102|
|NHS Gloucestershire CCG||257||103||NHS North Hampshire CCG||80||36|
|NHS West Hampshire CCG||235||51||NHS Thanet CCG||80||96|
|NHS Sheffield||224||78||NHS Ealing||78||31|
|NHS West Kent CCG||213||96||NHS North Derbyshire||78||189|
|NHS Cambridgeshire and Peterborough CCG||208||31||NHS North East Lincolnshire||78||76|
|NHS Sandwell And West Birmingham CCG||207||79||NHS West Essex CCG||78||102|
|NHS Doncaster||191||36||NHS Hartlepool And Stockton-On-Tees CCG||77||137|
|NHS Coastal West Sussex CCG||179||73||NHS Oldham CCG||76||107|
|NHS Wiltshire CCG||179||69||NHS Heywood, Middleton And Rochdale CCG||75||100|
|NHS Shropshire||175||62||NHS East Leicestershire And Rutland CCG||74||65|
|NHS North Cumbria CCG||167||49||NHS West Cheshire CCG||74||46|
|NHS Manchester CCG||167||24||NHS Warwickshire North CCG||74||61|
|NHS Nene CCG||165||69||NHS Hastings And Rother CCG||73||124|
|NHS Wirral CCG||158||91||NHS North Tyneside CCG||72||36|
|NHS Vale Of York||157||42||NHS Scarborough And Ryedale||71||87|
|NHS South Devon And Torbay CCG||153||62||NHS Bassetlaw||70||65|
|NHS Hull||152||45||NHS South Sefton CCG||70||60|
|NHS East Riding Of Yorkshire||146||30||NHS Greater Preston CCG||70||175|
|NHS Coventry And Rugby CCG||146||74||NHS Hillingdon||69||51|
|NHS East Lancashire CCG||145||38||NHS Cannock Chase||69||83|
|NHS Buckinghamshire CCG||144||42||NHS East Staffordshire||69||103|
|NHS Northumberland CCG||143||28||NHS North Lincolnshire||69||54|
|NHS Swindon CCG||143||53||NHS Wandsworth||68||80|
|NHS Mid Essex CCG||140||31||NHS Lincolnshire East CCG||68||70|
|NHS Oxfordshire CCG||136||46||NHS Isle Of Wight CCG||67||81|
|NHS Croydon||135||63||NHS Hounslow||66||32|
|NHS Southampton CCG||135||37||NHS Waltham Forest||66||103|
|NHS Walsall CCG||135||46||NHS South Cheshire CCG||66||45|
|NHS East And North Hertfordshire CCG||134||115||NHS Bury CCG||66||79|
|NHS Medway CCG||134||62||NHS Surrey Downs CCG||66||39|
|NHS Barnsley||133||78||NHS Tameside And Glossop CCG||65||126|
|NHS Durham Dales, Easington And Sedgefield CCG||133||86||NHS Harrow||63||49|
|NHS Newcastle And Gateshead CCG||133||107||NHS Herts Valleys CCG||62||53|
|NHS Stoke On Trent||129||59||NHS Halton CCG||62||N/A|
|NHS Nottingham City||126||23||NHS East Surrey CCG||62||33|
|NHS South Eastern Hampshire CCG||126||28||NHS Milton Keynes CCG||61||N/A|
|NHS Bolton CCG||125||125||NHS South Tyneside CCG||60||N/A|
|NHS Berkshire West CCG||125||93||NHS Airedale, Wharfdale And Craven||59||N/A|
|NHS Telford And Wrekin||123||143||NHS West Norfolk CCG||59||99|
|NHS South Tees CCG||123||36||NHS High Weald Lewes Havens CCG||59||61|
|NHS Southend CCG||123||120||NHS Tower Hamlets||58||60|
|NHS Greenwich||122||90||NHS Newark & Sherwood||58||82|
|NHS South Warwickshire CCG||120||54||NHS Kingston||57||110|
|NHS Bedfordshire CCG||118||76||NHS Norwich CCG||56||89|
|NHS Havering||117||25||NHS Guildford and Waverley CCG||56||121|
|NHS Castle Point And Rochford CCG||116||32||NHS Camden||54||152|
|NHS Ipswich And East Suffolk CCG||116||109||NHS Knowsley CCG||54||20|
|NHS Greater Huddersfield||115||78||NHS Eastern Cheshire CCG||53||195|
|NHS Wakefield||115||124||NHS Horsham And Mid Sussex CCG||53||33|
|NHS East Berkshire CCG||113||147||NHS Redditch And Bromsgrove CCG||53||63|
|NHS Calderdale||112||111||NHS Wyre Forest CCG||53||70|
|NHS North West Surrey CCG||110||54||NHS Hardwick||52||183|
|NHS Bexley||109||37||NHS West London (K&C & QPP)||51||28|
|NHS Herefordshire CCG||109||124||NHS Nottingham North And East||51||82|
|NHS South Worcestershire CCG||108||N/A||NHS Stafford And Surrounds||51||53|
|NHS Lambeth||107||54||NHS Warrington CCG||51||96|
|NHS Southern Derbyshire||107||40||NHS Merton||50||47|
|NHS Fareham And Gosport CCG||107||44||NHS Islington||49||76|
|NHS South Kent Coast CCG||106||99||NHS Hambleton, Richmondshire And Whitby||49||49|
|NHS Swale CCG||106||75||NHS Sutton||48||64|
|NHS Barking And Dagenham||105||205||NHS North Kirklees||48||79|
|NHS West Leicestershire CCG||105||153||NHS Harrogate And Rural District||46||131|
|NHS Salford CCG||104||92||NHS South Lincolnshire CCG||45||74|
|NHS Rotherham||102||106||NHS Fylde & Wyre CCG||45||50|
|NHS Blackpool CCG||102||17||NHS Hammersmith And Fulham||44||48|
|NHS Barnet||101||94||NHS Crawley CCG||44||66|
|NHS North East Essex CCG||100||74||NHS North Norfolk CCG||43||207|
|NHS North Staffordshire||99||62||NHS Chorley And South Ribble CCG||43||43|
|NHS Wolverhampton CCG||99||96||NHS Southport And Formby CCG||42||N/A|
|NHS Lewisham||98||41||NHS Lincolnshire West CCG||41||305|
|NHS Morecambe Bay CCG||98||62||NHS South West Lincolnshire CCG||41||118|
|NHS Dartford, Gravesham And Swanley CCG||98||36||NHS South Norfolk CCG||41||146|
|NHS City And Hackney||97||85||NHS Bath And North East Somerset CCG||41||207|
|NHS Great Yarmouth And Waveney CCG||97||133||NHS Nottingham West||39||298|
|NHS Portsmouth CCG||97||46||NHS Luton CCG||39||412|
|NHS Haringey||96||39||NHS Rushcliffe||37||300|
|NHS Bradford Districts||96||89||NHS Darlington CCG||37||114|
|NHS Leicester City CCG||96||27||NHS Richmond||35||N/A|
|NHS Brighton And Hove CCG||93||56||NHS Erewash||35||156|
|NHS Sunderland CCG||92||42||NHS Bradford City||35||79|
|NHS Dudley CCG||92||196||NHS Ashford CCG||34||71|
|NHS Enfield||91||57||NHS Vale Royal CCG||33||40|
|NHS South East Staffs And Seisdon Peninsular||91||63||NHS Central London (Westminster)||29||183|
|NHS St Helens CCG||91||32||NHS Basildon And Brentwood CCG||29||88|
|NHS Wigan Borough CCG||91||67||NHS Surrey Heath CCG||29||85|
|NHS Eastbourne, Hailsham And Seaford CCG||90||33||NHS Thurrock CCG||28||130|
|NHS Redbridge||88||81||NHS Trafford CCG||28||71|
|NHS West Suffolk CCG||87||78||NHS West Lancashire CCG||24||85|
|NHS Stockport CCG||87||116||NHS Corby CCG||19||50|
|NHS Blackburn With Darwen CCG||87||18||Source: Public Health England|