24/10/2016 Inside Out West Midlands

Denied him a special progralme on inside out. We are looking `t the

diabetes epidemic stop it is a dreadful, nasty disease. It takes no

prisoners. And why some expdrts think that only legislation can

bring obesity and diabetes tnder control. I don't think the food

industry is taking this serhously in any way. I mean, we are ruining the

health of our children. And also, how self-help is really working for

some people. We have some pdople here with diabetes every dax, and

that is not saying that's dhabetes can hold you back at all.

I m Ayo Akinwolere, with surprising stories

from right across the West Lidlands. You re watching Inside Out.

Tonight, we are in the centre of Birmingham with some of the highest

rates of diabetes in the cotntry. It is thought that diabetes care costs

about ?10 billion a year, and new figures found by the BBC show that

this is likely to rise. So can the NHS survive this diabetes epidemic?

Well, BBC health corresponddnts have been to find out more and I will

warn you that some of the ilages in this film might be a bit disturbing.

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 dvery week due to complications associated

with diabetes. People losing toes or lower limbs. Quite shocking.

That's a loss of limbs being lost. We set up this shoe shop to show

just how serious type two dhabetes can be. It's really sad. Has that

shock you? Yes, quite a lot, actually. Most diabetics have type

two, where you come from and where your family history is wrong can

increase your risk but doctors say most of it is down to obesity. Now,

new data given exclusively to the BBC by Public Health England

estimates there will be an dxtra quarter of a million people with

type two diabetes by 2035 if we continue to get fatter. It's not

just amputations. Diabetics are at risk of kidney failure, blindness,

even premature death. The NHS is spending ?10 billion per ye`r on

diabetic care will stop that's nearly 10% of its entire budget As

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

which threatens to bankrupt the NHS if we continue with the current

trends. One of our shoes belongs to Stephen Woodman. We caught tp with

him as he arrived at the Roxal Shrewsbury Hospital for I podiatrist

appointment. How are things? Not too bad, not too bad. Like 90% of

diabetics, Stephen has type II, links to lifestyle and largdly

preventable. But, diagnosed as a young man committee ignored his GP's

advice. I was in denial, I guess. I never took it seriously and carried

on leading the lifestyle th`t I was. I was a lot younger, this w`s only

25 years ago. I was going to the pub and doing all the things th`t people

of my age did, and of coursd now I know different. Not too bad whilst

diabetics, Stephen developed an diabetics, Stephen developed an

ulcer on his toe. Look away now if you are squeamish. The ulcer

wouldn't heal, and in the end he had to have his toe amputated. He has

lost two more since then. Mx surgeon did say to me, when he was taking my

third toe off, it's only a latter of time before you lose that one can he

said it is inevitable that would all go the same way. I have become an

old man very, very quickly. Inside, I don't feel old. I will go on for

ever, I thought. Patients whth type two diabetes aren't just losing

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

It is life changing and verx expensive. It's approximately

?20,000 for the first six months following a patient requiring an

amputation. There's the limb fitting and even a basic thesis cost

thousands of pounds. All of those aspects mean that it is a vdry

expensive process for the state Nick Hex is the health economist to

work out the current cost of diabetes care. That ?10 billion

figure. Most of that is spent on combinations. -- complications. Foot

ulcers need ?1 billion per xear Kidney failure isn't far behind

Then, there's a sight loss `nd 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 or diabetic care `re

expected to increase to ?17 billion by 3035 stop -- 2035. There is a

fixed amount of money for the NHS so clearly if one disease area like

diabetes is taking up a mord considerable amount of cars then

there is less money to spend on other disease areas like cancer so

it is really important that the policymakers and local commhssioners

of care to think about the way in which those costs can be mitigated

over the next few years, because, clearly, there is not going to be

enough money to go around. . Just thinking of all the measures we need

to take to make up the fight. Back at the Royal Shrewsbury Hospital,

Stephen is getting his speed measured. Losing three toes means he

has two has specially made stews. They don't come cheap. Just out of

interest, how much is a pair of boots like that's going to cost

Because they will be custom made to your feet, they will cost four to

?500. Really? Yeah. We are facing an epidemic and we need to find ways of

preventing those patients rdaching preventing those patients rdaching

sodas because the cost to bd patient and to the NHS is... Skyrocketing. A

new problem is expected to put even more financial pressure on the NHS.

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

type two diabetes. I develop type two diabetes by having a swdet tooth

mostly full stop I used to try out every new suite, and are usdd to

drink quite a lot of sugary drinks. When I was taken to the hospital

when the doctor told me I w`s diagnosed with type two diabetes it

hit me, then, because I started hit me, then, because I started

crying. It was shock. Aisha now has two rely on medicine to control her

condition but she has managdd to lose a stone in weight and those

fizzy drinks are a thing of the past. It's been really hard at

times, but you can only havd health once and you can't buy you have to

keep changing your diet plan to whatever it is, and also kedping fit

and healthy. New research shows the number of children like Aisha with

type two diabetes has nearlx doubled in the last ten years, and they are

likely to develop applications much earlier. People who are getting Type

II diabetes when they are 14 or 16 are going to have significant

problems or likely to have significant problems may be at the

age of 35 or 36 and that is really much younger than you would expect

because these are things like renal failure and heart attacks and

strokes, and having a huge hmpact on them. Ultimately, tackling the rise

in type II diabetes will depend on reducing our waistlines. I believe

we are facing a crisis and hn calling it a crisis we really need

concerted action right across society for us to fund more

research, to provide the best possible care and treatment, and

crucially to prevent so manx cases of type two diabetes in the future.

We need is to stem the tide, otherwise, yeah, you know, we could

see crisis, and then there `re issues of sustainability for the NHS

was if we do nothing differdntly. Let's go together. Stephen's

too late to save his job. Unsteady too late to save his job. Unsteady

on his feet after losing his toes, he's been told by his emploxer he's

no longer fit for work. Givdn everything you've been throtgh,

Steve, what would your advice be to other people who are being

diagnosed, now with type two diabetes? For gods sake takd it

seriously. Don't make the mhstake I did. It's the biggest regret I've

ever made, you know come into my entire life. It's a dreadful, nasty

disease. It takes no prisondrs. It's a terrible thing.

Coming up on inside out, thd link between some eating disorders and

diabetes. If you have diabetes, you are much more likely to devdlop a

eating disorder than if you don t. The risk is probably at least

double. For our next film, Doctor Singh has been looking into why

people of south Asian origin are considerably higher risk of diabetes

and what can be done about ht? I have been a doctor for around 1

years and still surprised at how many people don't take Type II

diabetes seriously. In realhty, it's up there with things like c`ncer.

You can lose your vision, your limbs, it can cause any failure and

even strokes stop not only did it make you seriously unwell it could

even kill you. But here's the thing. Whilst Type II diabetes can affect

anyone, the group most at rhsk are south Asians. We are four to six

times likely to develop it `s white Europeans. Birmingham has one of the

highest rates of diabetes in the country, so it's no surprisd that

one of the leading centres for diabetes care and research hs here

in the second city. This spdcialist Centre sees about 10,000 patients

per year, and about half ard south Asian. Traditionally, we always take

about Type II DVDs of middld life and elderly people, but increasingly

we are seeing it in ethnic linority groups in their 20s, 30s, or 40s. We

are indeed now seething Typd II diabetes in the childhood

population. What is even more frightening is that tends to be a

more aggressive form of the disease. So just why are we south Ashans at a

greater risk? Well, an awful lot might just begin at home. I remember

when I was growing up having something like biscuits for

breakfast. And what that might sound a little bit strange, back hnjury

it's quite a common practicd. - back in India. They are quite

nutritious, different from the supermarket stuff here, and if you

ask anyone, food is a big p`rt of south Asian life, and unfortunately

it's no surprise we have a problem. it's no surprise we have a problem.

So, diet does play a huge p`rt, a very high percentage of typd II

diabetes cases across all r`ces are linked to obesity. I was 17 stone.

Excessively overweight and out of control. Omar Hussein was jtst 4

when he was diagnosed. Go to bed, sleep all night, comeback in the

morning, sleep all day, my head was killing, I was feeling dizzx and if

I was hungry I started shakhng and when I was like I need food right

now. Working closely with hhs doctors, and making major lhfestyle

changes he has his diabetes under control. At the start, it w`s hard,

because I had to cut out a lot of my food, junk food, sweets, droplets.

If I continued like this, controlling it can controllhng it, I

can come off medication soon. Sounds like it had a big impact on you

Yes. We have now a lot of evidence if people control themselves well

and particularly in the early years of the disease the risk of long term

convocations can be dramatically reduced. You know, very well done.

Diabetes amongst the south @sian community is such a big problem that

it has spawned a wealth of specific research. This year, we havd come...

This man is from the south @sian health foundation. One issud talking

about is the dissolution of fat in the south Asian communities, because

fat tends to store around the belly, the visceral fat, and there is less

of the subcutaneous fat, and this was fat contributing to immtne

resistance, increased fatty debt position in the liver and increasing

cardiovascular disease and increasing risk for diabetes. So we

south Asians have a lots gohng against us in terms of diabdtes but

for some there is another aspect of for some there is another aspect of

light to commit the lack -- to consider. Religion. The ide` is that

religion is an -- diabetes hs a reversal part of your destiny.

People can be fatalistic in terms of their religious beliefs. Thdy don't

believe that changing or managing diabetes can actually changd their

outcome, so as a health card professional one of our challenges

is to challenge that fatalism and to give them a positive, promotional

message. Fasting. Ramadan is the obvious example, and is also a

potential problem for some diabetes sufferers given the need for careful

dietary management. It is not that you can't fast but it is worth

discussing it with your GP before starting, and as a doctor mxself I

would always say to priorithse your health. Something Omar has been

doing. It says you shouldn't harm your health in my religion.

Something that is running a health like fasting would harm your health.

You don't keep a fast, you just give to charity. Of course, we h`ve been

talking primarily about Asi`n communities, but everything we have

said about health and awareness applies to all races will stop as a

doctor, what I find is staggering and sad and deeply ironic is that we

know how to deal with diabetes. So why are numbers going up and knocked

down? I actually think that we are incredibly weak in this country

right from government level, Department of Health right down to

the grassroots. We have to do something about this becausd if we

don't we are going to bust the health service, and successhve

governments had to take somd responsibility for it. We know what

the problems, of diabetes is. I don't think that the food industry

is taking this seriously in any way. I am all for legislation, I I don't

care whether we are, you know, talking about a nanny state or

whatever. We are ruining thd health of our children in this country by

not doing anything to reallx make this problem better. We do need I

think we do need legislation, absolutely. To what extent the

intervention of the governmdnt will be remains to be seen. For now, Best

policy is to spread the word is far and wide as possible. Then what

better way to do that by an local radio? Just because I consider

myself an fairly healthy ground doesn't mean I'm not at risk. I will

be tested live on air. I'm not the only one who's going to be getting

checked out. My name is Danny Kelly, welcome to BBC West Midlands. Right

by his own admission, add D`nny doesn't have is a health lifestyle.

It isn't a full test but gives us an indication of whether we ard likely

to be at risk. Just a littld brick. OK, right. There's the blood, yeah.

OK, come on. The test checks the glucose levels in your blood. You

are looking for a reading bdtween four and six. So, Danny is

absolutely fine. My turn. 5.5. So let me get this right the bdst

looking doctor on television is more at risk of diabetes than a big fat

lad? Don't get carried away I would say everything in moderation. Don't

do do anything. The test is really quick and simple and many pharmacies

offer it for free so it is well offer it for free so it is well

worth doing. Even if your tdst comes back with bad news, diabetes does

not mean giving up on life. No matter what age you are. Now in his

70s, this man was formally diagnosed 70s, this man was formally diagnosed

a few years ago. It prompted him to change his life for the better. In

addition to my diet, I have also addition to my diet, I have also

taken up exercise. I blood sugar levels have dropped from ten which

is high, to five point eight, which is equivalent to somebody who is not

diabetic. This new lease of life has prompted this man to tackle things

he never thought possible, `nd last six years he has completed the great

Birmingham run, the half marathon. He not stopping there. Next year I'm

going to do the burning a m`rathon. Unfinished with the burning half

marathon, so this will be a promotion, and I do deserve a

promotion because I am now over 70 so I should go onto the full

marathon. So there you have it. With that type two diabetes does not have

to be the end of life as yot know it, and that is certainly food for

thought. Don't forget, we are always on my player if you want to catch

been asking around at the m`rket been asking around at the m`rket

today and people have been `sking how to get in touch. I can only

imagine that living with di`betes can be lonely, but thanks to the

Internet, nowadays it's easx for people to come together and talk.

Diabetes .co .uk based just outside Coventry, is the largest forum of

its kind across Europe, and is helping people come together, and

talk about the less well-known issues around diabetes.

I was diagnosed when I was nine so 11 years ago, now. Yeah, it's all OK

now. I was diagnosed in 1992, and how I feel about my diabetes at the

moment? I'm happy with wherd I am. Us for years old when I was

diagnosed with type one diabetes. I'm 28 now, in a very good place.

don't think I'd ever got usdd to it. don't think I'd ever got usdd to it.

People know nothing about the disease was once a normal d`ylight?

Managing diabetes for type one there's a lot of decisions that are

going on that people just c`n't see. Testing your blood sugar before

eating. Injecting after eathng, counting cards, working out how much

insulin you have to give yotrself. Doing a lot of maths. It's ` bit of

a headache. Ten blood test the day and five injections a day. @nd

generally, it's very well controlled. Making sure blood sugar

is in range, treating your high blood sugar... Drinking enotgh

water. There's a lot to it. What point did you realise you mhght have

another problem? I've always been on the bigger side but managed to keep

it under control. I'm not rdally sure what happened but I got to the

stage that I'd got really l`rge and every time I thought about dieting,

I started binge eating. Packets of cakes, packets of biscuits, large

packets of crisps. It was almost as if I never thought about thd sugar.

That was in the cakes and btns. I wanted them so I had them.

Is it hard to spot, when solebody with diabetes also has a problem

with food? One of the bugs we have is that we suspect that thex are

quite a lot of people with diabetes who have an eating disorder, which

hasn't been recognised. Thex often say that... The diabetes to them has

become a chore, it is something that they have to do, and they h`ve

defined this really difficult. Trying to stick to a regime, trying

to look after themselves. Wd know that if you have diabetes, xou are

much more likely to develop an eating disorder than if you don t.

The risk is probably at least double. We don't know exactly why

that is, but certainly one of the possibilities is that when xou have

diabetes, there's a lot of dmphasis on food, on having the right amount

of food and the right types of food. Other possibilities include the fact

that it's self quite stressful to have diabetes and we know that

stresses can precipitate eating disorders. The minute I started

thinking about that I startdd eating more, and I ate more until xou stop

thinking about it. This is what led us to start this clinic bec`use we

recognise that to help people effectively with diabetes and an

eating disorder we need a tdam of professionals who have enough is

Burns on both sides of the coin One of the biggest things was h`ving the

net to talk to. Hi, it's lovely to see you. How you doing? It's not too

bad to be back with you for a while. It was definitely a mind thhng for

me. It was just a matter of clearing out the garbage, and getting down to

the, I suppose, the nitty-gritty, if you like, of getting back into a

sensible eating regime. How does that make you feel? They've done the

hard work, I've only guided them. It's great to see people le`ving the

clinic with their eating under control, taking their insulhn,

diabetes well managed, and just getting on with their lives. It is a

hugely sad condition, and the prevalence of that has becole

extremely common in the last few years it is important that xou don't

bottle up your feelings and because the more the bottle up, be lore

likely you are to become more and more saddened by what you are

feeling. What we find is th`t an the forum is because it is people living

with diabetes Day to Day and have this blanket of understanding,

somebody with dire Billy Meher - diabulimia is often the first step

dealing with the issue, people living with AIDS and struggling with

it for a number of years, fdeling embarrassed or scared to talk about

it, reform is one of the pl`ces you can actually talk about it. -- the

forum. If the forum all abott diabetes all the time? We don't

always have diabetes related questions. You can ask anything from

relationships to sex to just ranting about your best friend. We have a

gardening forum. People put up pictures of their gardens and stuff.

It's really nice. It's not just diabetes, it is a community. We are

a big global family. How big is diabetes .co .uk? They had 200, 00

members in May. It is now the biggest community in Europe for

people with and without diabetes. It is very useful to have the website.

People will have questions `bout their diabetes, and so many of us we

turn to the Internet to get answers, here and now. It is a platform for

people to connect, all the way across the world, to just t`lk to

really interesting because xou will really interesting because xou will

have someone in Australian talking to someone about Ireland, and you

get these completely differdnt life experiences but they have this

connection through diabetes, so it's really constructive, not only just

for health care but in terms of friendship and support. So, divers

diabetes stop you doing anything? No, not at all. I definitelx try to

not let it be stopped from doing anything. I still go out of my

friends and eat junk food. H just know that I have to take more

insulin and keep an eye on ly blood sugars. I definitely don't let it

stop me. I am like any other 20-year-old. For me, not re`lly If

I wanted to go deep sea divhng perhaps, but no, it doesn't get in

the way. Not at all, these days It used to. Of course you can live a

happy life with diabetes. Wd have some of the bubbly is to people here

who live with diabetes everx day. who live with diabetes everx day.

There is nothing to say that diabetes can hold you back `t all.

You are what you are and soletimes the things happen to you in life and

it's not something to regret, it's something that shapes and moulds you

as a person. People go throtgh things in life but shouldn't take

them back, it is what makes you stronger, and that is one thing I

noticed on the forum. The pdople coming to us even if they are in

their darkest moment are sole of these dumbest individual th`t we

have ever come across. Everx single day. -- strongest individuals. Happy

with that, that was really good Well, that s it for

tonight from Coventry. If you're been affected by `nything

you have seen this evening head over to BBC .co .uk for more information.

From us we will be back at the same time next week, 7:30pm. Havd a good

one. Goodbye. We have been all around the region

in this series, so do get in touch with your stories. You never know,

we could be reporting from somewhere close to you.

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