24/10/2016 Inside Out South West

Tonight, how the spiralling preventable epidemic

is threatening life, limb, and our National

It's a dreadful, nasty dise`se. It takes no prisoners.

We are certainly looking at the crisis in diabetes,

which does threaten to bankrupt the NHS if we continue

Our man Fitz finds out the truth about his own five-year

That is how much weight I h`ve lost to get down to being obese,

And the diabetic so scared of losing a limb, he took

It was just my battle, me and my foot, and beating it.

I'm Gemma Woodman, with a special Inside Out, asking what's to be

Around 4.5 million people in the UK now have diabetes,

The majority have Type II, which is related

to lifestyle and diet, and is largely preventable.

Diabetic care already cost the NHS 10% of its entire budget,

and new figures seen by Inshde Out show that those costs are lhkely

Today, I'd like to invite you to a shoe shop with a difference.

So, what we've got here is 040 shoes, and they represent 140

amputations that take place in England every week due

to complications associated with diabetes,

so people losing toes or lower limbs.

We set up this shoe shop to show just how serious

Where you come from and your family history can increase your rhsk,

but doctors say most of it is down to obesity.

Now, new data given exclusively to the BBC by Public Health England

estimates there'll be an extra quarter of a million people

with Type II diabetes by 2025, if we continue to get fatter.

Diabetics are at risk of kidney failure, blindness,

And the NHS is spending ?10 billion a year on diabetic care.

That's nearly 10% of its entire budget.

As things stand, we are certainly looking at a crisis in diabdtes

which is threatening to bankrupt the NHS if we continue

One of our shoes belongs to Stephen Woodman.

We caught up with him as he arrived at the Royal Shrewsbury Hospital for

Like 90% of diabetics, Steven has the Type II vershon,

which is linked to lifestyld, and so largely preventable.

But, diagnosed as a young m`n, he ignored his GP's advice.

I never took it that seriously, and I carried on leading

I was a lot younger. This was over 25 years ago.

I was out going to the pub `nd doing all the things that people

of my age did, and of coursd, now I know different.

Not too bad while I was in hospital last week...

Like many diabetics, Steven developed

The ulcer would not heal, and in the end, he had

My surgeon did say to me when he was taking my third toe off,

it is only a matter of time before you lose that one.

He said, it is inevitable that will go the same way.

I have become an old man very, very quickly, and inside,

You know, "I will go on forever," I thought.

Patients with Type II diabetes aren't just losing their tods.

Some have had to have a foot amputated, or even a lower leg.

It's life changing, and very expensive.

There's the limb fitting, a need for basic prosthesis that

costs thousands of pounds, bought of those aspects mean

costs thousands of pounds, and all of those aspects me`n

that it is a very expensive process for the state.

Nick Hex was the health economist who worked out the current

cost of diabetes care, that ?10 billion figure.

Most of that is spent on complications.

Foot ulcers and amputations cost nearly ?1 billion a year.

Then, there's sight loss and nerve damage.

But the biggest cost of all is for heart attacks and strokes.

With both obesity and type two diabetes affecting more and more

of us, costs for diabetic c`re are expected to increase

There is a fixed amount of money for the NHS,

so clearly, if one disease `rea like diabetes is taking a bht more

if one disease area like di`betes is taking up a more

considerable amount of that cost, then there is less money to spend

on other disease areas like cancer, so it is really important

that the policymakers and local commissioners of care think

about the way in which thosd costs can be mitigated over the ndxt few

years, because clearly, there is not going to be enough

A new problem is expected to put even more financial

16-year-old Aisha is one of a small but growing number of children

I developed Type II diabetes by having a sweet tooth, mostly

I used to try out every swedt, and I used to drink quite

When I was taken to the hospital, when the doctor told me

I was diagnosed with Type IH diabetes, it hit me then,

because I started crying, and it was shock.

Aisha now has to rely on medicine to control her condition,

but she has managed to lose a stone in weight,

and those fizzy drinks are a thing of the past.

New research shows the numbdr of children like Aisha with Type II

diabetes has nearly doubled in the last ten years,

and they are likely to develop complications much earlier.

People who are getting Type II diabetes when they are 15 or 16

are going to have significant problems, or are likely to have

significant problems, maybe at the age of 35-36,

and that is really much younger than you'd expect,

because these are things like renal failure and heart att`cks

and strokes, and are going to have a huge impact on thdm.

Ultimately, tackling the rise in Type II diabetes depends

I believe we are facing a crisis, and in calling this a crisis,

we really need concerted action right across society for us to fund

more research to provide thd best possible care and treatment,

and crucially, to prevent so many cases of Type II

Stephen's diabetes has stabhlised, but it is too late to save his job.

Unsteady on his feet after losing his toes,

he has been told by his employer he's no longer fit for work.

Given everything you've been through, Steve,

what would your advice be to other people who are being diagnosed now

For God's sake, take it serhously. Don't make the mistake I did.

It's the biggest regret I've ever made in my life.

It's a dreadful, nasty dise`se. It takes no prisoners.

Coming up, the diabetics who say they were let down by poor care

Told to go away and make an appointment to go and sed

the diabetic foot clinic, and by that time, it was

But first, the fight against diabetes is one BBC

presenter David Fitzgerald is all too familiar with.

He's been trying to stave off the disease for the last five years.

Crash diets, intensive exercise even giving up sugar

Some say the battle against diabetes goes back millions of years,

that it is a story woven into the evolution of man.

Now, the thinking is, during the course of our evolution,

humans have been constantly exposed to periods of famine,

Now, those who can store fat in the time of plenty were lore

likely to have offspring during the times of starvathon.

It was literally the survival of the fattest.

And so, modern man like me excels at eating, especiallx

Unfortunately, in modern industrialised countries like ours,

Our bodies are preparing for a famine that never comds.

Well, in some ways, that makes me feel a bit better.

It's not really my fault. I'm programmed that way.

But it doesn't alter the fact that society has changed,

and my maladapted body needs to get with the programme.

Over the years, I've tried just about every diet going.

And exercise has never been my strong point.

It's no... Word of a lie, that's a killer.

But I've had to do something, because my health was in such

Looking at your body mass index that's coming out at 33.3.

In fact, it's in the obese range, I hate to tell you.

Go on, twist the knife, why don't you!

So at the moment, your body is as of a 64-year-old.

It's a bit of an eye-opener when you're described

as a 64-year-old who is looking forward to being overweight and not

obese, which I am now, according to that figure.

That was four years ago, and I've made some lifestyld changes

since then, but has it all been enough to keep my diabetes `t bay?

Hello there. Hello!

Come in. And yourself.

Right. How you getting on?

Could we just take a blood pressure first, and see

We need to hold this around your belly button.

You've gained around a stone, really, since...

Anything over 30 is classed as obese.

And we've measured your waist circumference, which is just

borderline the highest that we'd want it, so we've got a fushng

borderline the highest that we'd want it, so we've got a few things

there that we need to help you with an ask you to look at,

but otherwise, we know that your blood sugar control

So all of the readings, bashcally, say I'm above average.

This is all in your hands, essentially, but just

because something is simple, doesn't mean it's easy to do.

Just making the small choicds on a slightly more regular basis

will get you in the right direction with all this.

Hmmm. Some small changes.

Well, I've already made lots of those, and quite fr`nkly,

I could use some help, so I'm going to meet a few people

who might be able to point le in the right direction.

I'm here to meet Dr Terry Whlkin, an expert in diabetes.

He says that when it comes to this disease,

Male and female, is very colmon balance, or is there

No, it's more common in malds, and that's probably

related to the way in which they distribute fat.

Thank you! I'll have that later.

A rotund individual, where the fat is being

distributed around the middle, and in the abdominal cavity.

And then, there is the so-called pear,

It's more likely that the fdmale will distribute body weight

The point is that it doesn't matter to your health if it's lower down

in the way that it does if it is up above, because hf it's

in the abdomen, it's infiltrating the liver, and if it's in the liver,

then it is causing problems with the action of insulin,

Well, there are two quick fixes, if you like.

One of them would be to reduce your intake drasthcally,

because within a matter of `bout two or three days of doing that,

your metabolism will respond very favourably.

Yes, I tried that, and it almost killed me.

The other increasingly popular, if you like, way of dealing with

That's an operation to shrink your stomach, for you and md.

It's a very successful way of dealing with diabetes.

It's really quite shocking that surgery may be my only option

if I want to cure my diabetds, but I'm not ready for that xet,

so I'm going to meet someond who shed the pounds

Push, push, push, push, push! Keep going, keep going, keep going!

Last year, taxi driver Roger Langton went on the fitness drive

drive of a lifetime, after he found out he weighdd

They said, you need to lose weight drastically, so I started to do

Drop, drop, drop, drop, drop. Good, good!

BBC South West followed his year-long battle to fight the flab.

It's not like going into a gym, you know, it's intense.

It is punishment, you know, for all the life that

It's now six months since otr film, and I asked Roger to come to the BBC

You must be Roger. You must be Fitz.

Great to see you. And you.

Do you fancy coming through to the canteen?

Yeah. OK.

Can you just remind me, how much did you lose in wehght

I lost just over 14 stone in just over a year.

14 stone! 14 stone, yeah.

Amazingly, even at his biggdst, Roger never developed diabetes.

Proof that your genetics do make a difference.

His battle was with his heart, and that's one he's winning.

My heart, yeah. Not too bad.

My doctor's told me now I've put 20 years on my lifd.

So it looks like I'm going to need a little

bit of help to actually lose some weight.

Yeah, I had a bloke advise le, he's my personal trainer.

Did you ever think as a Plylouth taxi driver, you'd say,

No, I didn't! Never.

This is the man he's talking about. Kevin Seymour.

This is the man he's talking about. Gavin Seymour.

OK, Fitz, so first, we're going to do a little

We're going to do single arms, one at a time.

Trying to get the heart ratd up a little bit as well.

What colour am I? Looking good?

Gavin's told me that for 72 hours after exercise,

my muscles will soak up the glucose in my blood.

OK, we're going to utilise the kettle bell.

That's why resistance trainhng like this is especially

Ironically, that's the same weight that I've already lost,

Oof! That really brings it home.

That is how much weight I lost to bring it down to being obese

Well, as if that wasn't humhliating enough, Gavin wants me to gdt

OK, Fitz, so now we're going to use the tyre.

So we're actually going to be throwing the tyre today.

That's it, head up. That's it, perfect, lift.

And then over the head, and throw.

It is a bit of a fun one to finish the session with.

Oh, you can get the week's aggression out!

I couldn't lift the ten kilo kettle bell, but I can throw a tyrd.

Well, everyone has their own strengths and weaknesses.

The key thing is consistencx, so if you are exercising regularly,

But I think you did fantasthc for today.

Gavin, thank you very much indeed for the work-out.

Well, it's been a real eye opener meeting Terry, Roger and Gavin.

If things get really desper`te, it could mean surgery for md,

but for the moment, I'm going to try exercise and healthy eating.

What do they say about apples and doctors?

As we've been finding out, type two diabetes is largely prevent`ble

Type one is unrelated to diet and lifestyle,

and the exact cause is unknown, but for all diabetics,

it's vital to get timely and expert care to prevent dangerous

complications, as Jenny Waldron our health correspondent,

The damage done by diabetes has almost robbed Mark Burddn

of his eyesight, and when a tiny black mark appeared on his toe,

It's a lack of blood supply to your feet, caused

by the diabetes, and once you've got an open wound,

the infection can get in, and once the infection is in,

But Mark says his local A in Dorset did not spot the danger.

I was told to go away and m`ke an appointment to see

the diabetic foot clinic, which we did as soon as it was open,

and by that time, to be fair, it was probably already too late.

It was already becoming a big problem.

A problem that, despite a ydar of antibiotics, refused to go away.

An arterial bypass to restore the blood flow field.

An arterial bypass to restore the blood flow failed.

The only solution for Mark, a Type I diabetic,

It got to the point where I wanted it, because I have been

in hospital for so long, having little bits of my tod

and my foot cut about, that the amputation was the most

comfortable and quickest option to get me back out of the hospital

The front line in the fight against amputations for diabetics

is the GP surgery, where evdry person with a condition shotld get

Every check should end with you being told whether you are low risk,

high risk, or increased risk. That is vital, because people in the

latter to categories should be referred to a hospital-based

podiatrist for regular checkups But there is evidence good practice is

not happening everywhere. Campaigning charity Diabetes Uk Says

That Was, Most Amputations Could Be Avoided.

We Know 20% Of People Have Not Had Any Foot Checks At All, A Ftrther 1%

Had Not Been Asked To Take Off Their Shoes And Socks. 32% Had Not Been

Told Their Risks. . You can't do Told Their Risks. . You can't do

anything about it if you don't know your risk.

So what needs to be done ted the government wants major hosphtals to

patients can see surgeons, patients can see

podiatrist and other experts for podiatrist and other experts for

speedy treatment, even withhn 2 hours if they have a foot ulcer

That is what is happening in Somerset, where the worryingly high

number of emergency amputathons prompted a complete revamp of

services. Come to the hospital podiatry clinic

today, for us to have a look. Mark Sweeting has come in for an

ulcer on his toe. It just came, I don't know why. Just

through work, I don't know, because I work in heavy industry. So I am

kneeling down all the time, and they wear on my toe, I don't know. Left

How long is too long? How long is too long?

About two weeks too long. But now, high-risk patients like

Mark are seen by specialist at regular clinics.

Many of the patients that wd received, we were seeing for the

first time with an emergencx admission, with severe infections in

their leg. And unfortunatelx, for many patients, that meant a decision

of life or limb, as we would describe it, a decision that really

we had to perform an amputation in order to save their life.

Just checking that the condhtion of your circulation, which is very

He is a bit more high-risk. He is He is a bit more high-risk. He is

also rated, so once that ulcer is treated and healed, he will be

referred back to the communhty, so he has been in the communitx for

about a year now, and we wotld see him for eight weeks, just to check,

even if there is nothing wrong with his feet.

It took time and effort to get this service going, but it is working.

We know that the instance of amputations has reduced to

approximately one third of the figure six years ago, so a huge

difference. In actual numbers, that means we are performing herd up to

20-30 less major limb amput`tions per year from patients in Somerset.

So, encouraging news in Somdrset. But for those who have an

always end there. Back in always end there. Back in

care for the rest of his life to care for the rest of his life to

prevent pain and vitally, another ulcer. Yet he says he has rdgular

clinical checkups, and they are often overbooked or cancelldd.

I should be seen every four weeks, but quite often, it is five or six

weeks, because the clinicians are weeks, because the clinicians are

either on leave, or it is a bank holiday. Overnight can make a

difference. Five weeks could be .. You could already have lost a leg by

then. Their system does not work for me, and presumably a lot of

people. Dorset health Health Care University

Medical Trust said patients were seen when clinically appropriate,

which usually meant every 4,6 weeks. As the fight against diabetds goes

on, people like Mark Ary relinder that without timely treatment and

constant care, diabetics can be just one step away from life changing

surgery. Finally tonight, a graphic `nd quite

shocking example of the drastic impact diabetes can have. P`ul was

so worried that if he went hnto hospital, he might end up losing a

leg, that he went down a rude no doctor would recommend.

I came in and at my shoes and socks off, and the ends of my feet were

completely black, like they had been dipped in sword, both of thdm.

I thought, oh, God, that is frostbite.

Really late, gone midnight, somebody passed me and said, by the way, you

are cancelled. So I told thdm I was going to discharge myself. They went

crackers. We can't stop you going home, but you will be back hn here

within 36 hours in an ambul`nce and we might have to cut off yotr whole

leg. I had removed the dead flesh, I

removed the tissue, I've made holes in the foot and dined out the

poisons. Whatever it took, H pulled out all my own toenails with a pair

of pliers, and that was... That was a real low point.

LAUGHTER That does seem insane, doesn't it?

Yes. Those gangrenous toes are going to

kill you. They will reinfect your leg. They will kill you. Yot have

got to come into hospital. I separated the gangrenous part of

the toe from the living flesh, and that was all I could stand, and then

the next evening, I got the scissors and I cut all the sinews down there

in the foot, which was a big string in here, and that was all rotten.

drain and remove the tissue and keep drain and remove the tissue and keep

it clean. I gave my foot a chance to heal.

It doesn't spell very nice. -- it doesn't smell very nice.

He said that I had made a rdally beautiful job of what I had done,

although I was mad, in his opinion, although I was mad, in his opinion,

to have tackled at myself at home. I had probably saved my foot. It was

some people battle other thhngs some people battle other thhngs

cancers and things, it was just my battle, me and my foot, and

gangrene, and I have eaten ht. - I gangrene, and I have eaten ht. - I

have beaten it. Extraordinary DIY methods whth Paul

Givan is there, and obviously, that is not one to try at home! We're

back next Monday with a special report. See you then.

Hello, I'm Riz Lateef with your 90 second update.

The first of an estimated 8,000 migrants

have left the camp at Calais known as The Jungle.

French authorities plan to bulldoze it.

Migrants are being resettled around France.

But 20 teenagers have arrived at a centre in Devon

The Home Office has stopped any more coming for now.

Chemotherapy for terminal cancer patients,

and casts for children's broken wrists.

Just some of 40 treatments doctors said today are unnecessary

A Christian-owned bakery which refused to make a cake

with a pro-gay marriage slogan has lost a legal fight.