Number of ‘life-changing’ amputations due to diabetes soars

PUBLISHED: 20:13 27 September 2018 | UPDATED: 21:25 27 September 2018

Nigel Bertram. Picture: Ian Burt

Nigel Bertram. Picture: Ian Burt

The number of diabetic people having devastating toe, foot and limb amputations in two of the region’s areas has shot up, shocking figures reveal.

The Norfolk Diabetes Trust founder and president, Richard Greenwood, centre, with, from left, Lucy Webster, CEO; Nigel Bertram, chairman; Kip Bertram, trustee; and Ketan Dhatariya, trustee and consultant in diabetes; celebrating the Trust's 30th anniversary. Picture: DENISE BRADLEYThe Norfolk Diabetes Trust founder and president, Richard Greenwood, centre, with, from left, Lucy Webster, CEO; Nigel Bertram, chairman; Kip Bertram, trustee; and Ketan Dhatariya, trustee and consultant in diabetes; celebrating the Trust's 30th anniversary. Picture: DENISE BRADLEY

Between 2010/11 and 2012/13, there were 142 amputations due to diabetes in Great Yarmouth and Waveney, according to data published by Public Health England.

But by the end of 2014/15 to 2016/17 their had risen to 168 - an increase of 18pc.

There was a similar picture in west Norfolk where there were 55 previously, rising to 64 over the same time period, an increase of 16pc.

Nigel Bertram, who lives in Litcham and is chairman of the Norfolk Diabetes Trust, was one of those affected.

Callum Metcalfe, a practice nurse and diabetes lead at Attleborough Surgery. Picture: Callum MetcalfeCallum Metcalfe, a practice nurse and diabetes lead at Attleborough Surgery. Picture: Callum Metcalfe

Mr Bertram, 70, was diagnosed with diabetes as a teenager and has lost three toes to the condition.

The first was in 2012, with the others being removed in 2014 and the latest within the last year.

Foot problems are the most common cause of hospital stays for people with diabetes.

The disease can cause a loss of blood supply and feeling in the legs and feet, which can in turn cause ulcers and infections.

Mr Bertram said for him losing toes was not too severe but the impact of losing a foot would be “life-changing”. With his most recent amputation, there was a fear the worst could happen.

“Just before Christmas this year I did a silly thing and wore a pair of wellies,” he said.

He said “wellies are a real no no” as they can cause blisters and ulcers, and Mr Bertram found himself with an ulcer on the fourth toe on each foot.

The left toe healed but the right one did not, leading to him contacting the Queen Elizabeth Hospital in King’s Lynn where he had been for treatment.

“It was just not getting better,” he said. “I phoned up to get the results [of tests] on the Friday and I got an answerphone saying there were no podiatrists in. I thought I would have to wait until the Monday but come Sunday I was in so much grief I phoned up one of the consultants involved in the trust on the Sunday morning and he said get yourself into casualty now.”

Mr Bertram was admitted to the Norfolk and Norwich University Hospital, where he had two angioplasties, to widen the vein in his leg.

But he said there were fears it would not work and his foot would be at risk.

He said: “When someone says you might lose your foot, it is a massive impact, life-changing.”

His right toe was removed and two more angioplasties carried out, which seemed to be successful.

But he said he was still looking to modify his home to ensure should he end up needing a wheelchair in the future, there was a groundfloor bedroom and doors wide enough to get through.

Mr Bertram, whose mother Elsie’s efforts to improve the care for diabetics in Norfolk led to the building of the Bertram Diabetes Centre at the then West Norwich Hospital, said through the Norfolk Diabetes Trust he was working with the James Paget Hospital in Gorleston to improve outcomes for those with diabetes and facing amputation in the area.

‘Still work to do’

Charity Diabetes UK said around four out of five amputations could be prevented if diabetics had the right support.

Across England areas with a higher level of deprivation among their population tend to also have a high prevalence of diabetes.

Around 21,200 people in Great Yarmouth and Waveney have the condition, compared to around 17,700 in west Norfolk.

Dan Howarth, head of care for Diabetes UK, said: “The latest figures show that, unfortunately, there’s still a great deal of work to be done to tackle rising number of diabetes-related amputations across England.

“Amputations devastate lives. It’s so important that everyone with the condition has access to diabetes foot services, and the support of podiatrists and foot care protection teams.

“Access remains an issue, however, and the quality and availability of services still varies significantly across England.”

Callum Metcalfe, a practice nurse and diabetes lead at Attleborough Surgery, said the rise in amputation was concerning.

Mr Metcalfe, who is also chairman for the Practice Nurse Diabetes Forum for Norfolk, said: “It is essential that thorough monitoring and education is provided to both patients and staff surrounding the essentials of good foot care. What these figures indicate is how despite numerous national training initiatives, foot care still seems to be lacking throughout the community. These figures identify how healthcare professionals can work across the multi-disciplinary team to ensure that good foot care is promoted.”

He said amputation had a “huge biological, psychological and social impact” on not only the patient but their families and friends.

“All aspects of their daily living are affected and it can often cause people not to only lose their self-esteem but also their identity. The most obvious issue is surrounding mobilisation and how people will be able to adapt to their environments.

“With the Norfolk population only ever growing, the rise in amputation rates identifies how important it is for practitioners to consider the impact amputations have on peoples lives.”

He urged patients to tell healthcare professionals about any foot problems, but also for clinicians to check they were asking about the issue.

Patients need to understand the importance of self care with regards to foot health, as many patients will only see healthcare professionals on average two or three hours per year for diabetes management.”

For more information on the Norfolk Diabetes Trust, click here.

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