Four years ago Chris Witt took a walk on a late summer holiday in Tenerife. He wore a new pair of sandals and after the walk he noticed that they had given him a small blister on the big toe of his left foot.
"I have not thought about it," said the retired export salesman from St Austell, Cornwall.
Unfortunately, today, Mr. Witt has a constant memory of that moment. That little blister turned into an infection that spread in the bones in his foot.
The 64-year-old, who was diagnosed with type 2 diabetes in 1999, hoped he was just overweight & # 39; would be
When antibiotics did not treat it, surgeons operated to amputate the foreleg – the front part including all the toes.
What are the symptoms of type 2 diabetes?
Symptoms of type 2 diabetes include:
- pee more than usual, especially at night
- feeling thirsty all the time
- lose weight without trying
- itching around your penis or vagina, or repeatedly getting thrush
- cuts or wounds take longer to heal
You are more likely to develop diabetes type 2 if you:
- are more than 40 – or 25 for South Asian people
- be a close relative to diabetes – such as a parent, brother or sister
- are of South Asian, Chinese, African Caribbean or Black African descent – even if you were born in the United Kingdom
The 64-year-old, diagnosed with type 2 diabetes in 1999 – when he admitted he was slightly overweight & # 39; was – had hoped that that would be. But the wound did not heal and 18 months after the operation he was back in the hospital to discuss further treatments.
"I spoke with the surgeon and told him that I had planned a vacation the following week and that I was going on a cruise the following month," said Mr. Witt. & # 39; I said: & # 39; I come back and then look at the music. & # 39;
He looked at me and said: & # 39; You can not possibly go anywhere. You have a serious infection that you could kill. & # 39; & # 39;
The next day Mr. Witt had a second operation, this time to remove the left leg below the knee. "I was going to lose a blister on my big toe to a leg," he said.
& # 39; You realize how vulnerable you are when something like that happens. & # 39;
The sad truth is that throughout the country, those of their vulnerabilities & # 39; to learn in the same way as Witt, have reached epidemics. Every week, 169 people undergo amputations caused by diabetes, a rate equal to one every hour of the day.
The figure has risen by 20 percent in just four years and is attributed to the obesity epidemic, where the number of diabetes victims has doubled from 1.9 million to 3.7 million in the last two decades.
After Christmas, when so many of us are filled on the gills with rich food, puddings and lashing of festive drinks, they are sobering figures.
Chris the Yachtsman: An enthusiastic sportsman, Witt suffered a knee injury at the age of 21 and was well able to continue playing rugby and basketball, which led to his ballooning with weights.
Approximately 90 percent of patients suffer from the type 2 form of diabetes related to lifestyle and nutrition.
Another five million people in the UK are living with prediabetes, or 'borderline diabetes', where they have increased blood sugar levels but are not yet considered as full type 2. Apart from affecting the health of patients, broader society can not be underestimated.
Diabetes costs the NHS nearly £ 9 billion a year with one in six hospital beds that are now occupied by someone with the condition. On top of that is an invoice for an invalidity benefit.
More worrisome is the concern that costs will get out of hand if the nation loses its battle with obesity.
A report from the World Health Organization in October showed that the UK was the third-biggest in 53 European countries.
And last month showed that the number of young people with type 2 diabetes almost ten times higher than previously thought, with about 7,000 under the age of 25 who are affected by the condition.
Traditionally, lifestyle-related illness was observed only in older adults. But with more than a third of children in England, classified as obese or obese by the time they leave elementary school, the fear is that the problem is only getting worse.
Diabetes costs the NHS nearly £ 9 billion a year with one in six hospital beds that are now occupied by someone with the condition
"At the turn of the century, when obesity really started to hit the headlines, nobody did anything to spread this ticking time bomb," said Tam Fry, president of the National Obesity Forum.
"The result was that the obese people progressed to diabetes and that they progressed to the other two horrific conditions, amputation and blindness. People may be surprised, but it was clear ten years ago that this would happen and it will only get worse. & # 39;
The latest figures from Public Health England, analyzed by charity Diabetes UK, show that in diabetics, lower limb amputations – defined as those below the ankle, including the loss of toes – have increased by 26.5 percent in four years.
Large amputations of the lower limbs – defined as below the knee – have increased by 4.1 percent. The total figures for smaller transactions amount to 19,073 for 2014/15 to 2016/17, with 7,305 important procedures.
A person living with diabetes is 20 times more likely to have an amputation than someone without the condition.
Both type 1 and type 2 diabetes cause poor circulation because high blood sugar levels can damage the blood vessels. This affects how blood flows to the feet and legs and can damage the nerves and lead to a loss of sensation in your limbs, such as your feet, known as neuropathy.
As in the case of Witt's widower, unhealthy ulcers and foot infections are the main cause of amputations related to diabetes.
As in the case of Witt's widower, unhealthy ulcers and foot infections are the main cause of amputations related to diabetes. Eighty percent of the diabetes-related amputations of the lower limbs are preceded by a diabetic foot ulcer. & # 39; If your nerves are damaged, you are less able to feel a cut or wound, and if it is in a place that you can not see on the sole of your foot, then you might not notice it at all. , says Dan Howarth, from Diabetes UK.
An untreated wound can easily become infected, which can lead to amputation. About half of the people who experience an amputation die within five years. This is because an amputation generally indicates other problems in your body.
& # 39; If your blood vessels are not working properly, you run the risk of cardiovascular disease or stroke.
The charity says that most amputations can be avoided if people with diabetes receive the necessary care and calls on the NHS to continue investing in specialized foot care programs.
It says that the Diabetes Transformation Fund has been successful in reducing the number of amputations – even if the total number of amputations continues to rise as a result of an increase in those with the disease.
But in addition to healthcare support, experts say it is essential for individuals to understand the risks associated with obesity and developing type 2 diabetes. "People just do not think it will happen to them", says Mr. Fry. & # 39; There are overweight people who fool themselves that they have no problem.
& # 39; They may be short of breath, they may have to wear larger clothes, but in principle they think they are okay. I'm immune, they say, but the reality is that they are not.
Almost all of these amputations can be avoided. & # 39;
The epidemic of obesity is attributed to poor nutrition, lack of exercise and the power of the food giants to push highly processed products laden with hidden sugars and sugars.
Alan Richardson, Dundee also had to have his leg amputated in November due to diabetes
Once diagnosed with diabetes, many patients do not know how dangerous the condition can be. They are points proven by the experience of the 50-year-old restaurant manager Colin Rattray.
He was diagnosed with type 2 diabetes of only 32 years old and enjoys his first days at home, having mastered his right leg amputated seven weeks ago.
Because he was so ill at the time of the operation, doctors could not give him a general anesthetic. Instead, he had a spinal puncture, an injection in the back often used during childbirth. As he anesthetized the lower half of his body, it meant that he was aware during the amputation.
I joked with the surgeon during the & # 39 ;, he says. & # 39; I asked if my mother told me about where I was – that I was a big blunt. & # 39;
A joke aside, Mr. Rattray does not doubt that his former lifestyle is responsible for his predicament. An enthusiastic sportsman, he suffered from a knee injury at the age of 21. Unable to continue playing rugby and basketball, his weight swelled when his career in the catering industry progressed. Standing 6ft 3in, at its heaviest he weighed 27st.
"I stopped training, but continued to eat and drink and overconsumption in general," said Rattray, who lives in Dundee. & # 39; I enjoyed far too many things, such as sausage rolls and pastries, colas & pastries. And a lot of alcohol. & # 39;
A person living with diabetes is 20 times more likely to have an amputation than someone without the condition
After his diagnosis with type 2 diabetes in 2000, his condition with medication was kept under control.
"My only real symptom was a lot of urinating and they have handled that," he says. So even after I was diagnosed, I was still in denial.
& # 39; I had no idea of the long-term effects of diabetes. I rarely went to check-ups because I knew I would probably get a lecture and I was in a place where I thought I was immortal. I had fun and when I was not working, I was socializing – everything in my life was fun. & # 39;
In 2011 he trained the big toe on his left foot. He ignored it for two weeks and then went to the hospital. Rattray recalls: & # 39; The first nurse who looked at it, said: & # 39; Are you a diabetic? & # 39; I answered & # 39; Yes & # 39; and he said: & # 39; Those two toes will come off. & # 39; & # 39;
Even that operation could not change his attitude towards the disease. & # 39; You would have thought that was a sufficiently large bite, & # 39; he said. But I just felt more immortal and I got away with it. & # 39;
Fast forward to February 2018 and after an ulcer developed on his right foot, Rattray, who is single, discovered that he had also broken a bone in it.
In the months that followed, he was in and out of the hospital because doctors tried to treat the infection with antibiotics.
But in November, scans showed that the bones in the foot had suffered a lot of damage. At the same time he also developed sepsis.
With his life in danger, Mr. Rattray had no choice but to agree to the removal of the lower part of his right limb. Currently recovering at the hospital, he has mounted a prosthesis and he accepts that the future will be full of challenges.
Chris is determined that, like nothing else, others learn from his experience
But he is determined that, like nothing else, others learn from his experience. I would just like to think about what you eat, & # 39; he emphasizes.
& # 39; There are so many sugars in so many things. I probably drank three or four cans of Coke per day, combined with three coffees with two sugars, a pack of biscuits and two or three Mars bars.
I would think I gave myself a little bit of sugar. But I was killing myself. Literally. Do not ignore it. Deal with it. Learn from my mistakes. & # 39;
In addition to treating the problems caused by diabetes, the emphasis is more on trying to actually reverse the condition.
This year, the NHS will roll out a new low-calorie soup and shake diet for 5,000 patients who are prescribed a liquid-only diet of 800 calories a day.
NHS England said it would place the regime at the heart of the new diabetes strategy, after smaller studies saw half of the patients go into remission.
Scientists from the universities of Newcastle and Glasgow have been pioneering for several years for the treatment of type 2 diabetes with low-calorie diets.
Both type 1 and type 2 diabetes cause poor circulation because high blood sugar levels can damage the blood vessels
In 2016 they showed for the first time that the condition – long considered incurable – can be reversed with extreme dietary patterns.
Further studies showed that people spent three months on the 800-calorie diet with lasting effects, with a quarter of the participants sustaining a weight loss of at least 2 st 5lb per year. Approximately 46 percent of patients saw their blood sugar levels fall to such an extent that they were no longer considered to be diabetic.
Isobel Murray, 66, was one of the first patients on the liquid diet to reverse diabetes. Her doctor suggested trying the regime as part of the university trial. She started the diet in 2014 with a weight of 15st, but in the next 18 months she lost four stones.
In 2016 she was told that her diabetes was in remission and she no longer needed medication.
Initially she was allowed to use only two shakes, mostly vanilla and chocolate, and two soups, mushrooms and vegetables every day.
After 17 weeks she was able to re-introduce solid food. She reached her target weight after about two years.
The former official, who lives in Largs, Ayrshire, said: "I was absolutely determined to do something about my diabetes.
& # 39; Although it has been hard, it was worth it. I was 18 and went in 20 clothes and I now wear a 12. You can get your life back and be healthy and fit. & # 39;
What, for those who live with the disorder, is the only thing they want to hear.