24/10/2016 Inside Out Yorkshire and Lincolnshire


The programme meets the ordinary people doing their best to stop others getting diabetes in the city with the highest proportion of diabetics in the country.

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Good evening and welcome to Inside Out.


Tonight, it's a disease that affects more than 4 million people


in the UK, and can lead to terrible medical complications,


but what are we doing to fight diabetes?


Tonight I'm in Bradford, which unfortunately has the highest


proportion of type 2 diabetes in the country,


but ordinary people like Lubna are trying to change that.


Be positive - you can, if you make a little change,


Before we hear from Lubna, will be finding out just how huge


a problem diabetes is for the country and for the NHS.


We are certainly looking at a crisis in diabetes which does


threaten to bankrupt the NHS if we continue with


And, later in the programme, the project putting food in people's


And how often would you see deliveries like this?


The cost of caring for diabdtic patients is ?10 billion a ydar


that's 10% of the entire NHS budget, and that cost is expected to rise


should obesity worsen, and of course the impact


I must warn you that this rdport by Dominic Hughes contains


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


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


that take place in England dvery 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 will be an dxtra quarter of a million people


with type 2 diabetes by 2034 if we continue to get fatter.


Diabetics are at risk from kidney failure,


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 does threaten to bankrupt the NHS if we continue


One of our shoes belongs to Steven Woodman.


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


Like 90% of diabetics, Steven has the type 2 version


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 and doing all the things th`t


Like many diabetics, Steven developed an ulcer on his toe.


The ulcer wouldn't heal, and in the end he had


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


"It's only a matter of time before you lose that one."


He said, "It's inevitable that will go the same way."


I'd become an old man very puickly, and inside I don't feel old.


You know, I'll go on forever, I thought.


Patients with type 2 diabetds aren't just losing their toes.


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


It's life changing and very expensive.


It's approximately ?20,000 for the first six months


following a patient who requires an amputation.


There's the limb fitting, and even a basic prosthesis costs


All of those aspects mean that it's a very expensive


Nick Hex is the health economist who worked out the current


Most of that is spent on complications.


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


Then there is sight loss and nerve damage.


But the biggest cost of all is for heart


With both obesity and type 2 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 area like diabetes is taking up ` 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 next few years, because clearly there isn't


going to be enough money to go around.


I'm just taking all the measures we need to do to make up the footwear.


Back at the Royal Shrewsbury Hospital,


Losing three toes means he has to have specially made shoes.


Just out of interest, how much is a pair of boots


Because the boots will be ctstom made to fit your feet,


they will cost approximately ?400 to ?500.


We are facing a diabetic ephdemic and we really need to try and find


ways of preventing those patients from reaching surgeons,


because the cost to the pathent and to the NHS is skyrockethng.


A new problem is expected to put even more financial


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


I developed type 2 diabetes by having a sweet tooth, mostly


I used to try out every new sweet and it used to drink quite


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


I was diagnosed with type 2 diabetes, it hit me then,


Ayesha now has to rely on mddicine to her condition, but she's managed


to lose a stone in weight and those fizzy drinks


It's been really hard at tiles, but you can only have health once.


You have to keep changing your diet plan to whatever it is,


New research shows the numbdr of children like Ayesha with type 2


diabetes has nearly doubled in the last ten years,


and they are likely to develop complications much earlier.


People who are getting type 2 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 would expect,


because these are things like renal failure and heart attacks


and strokes, and they are going to have a huge


Ultimately, tackling the rise in type 2 diabetes would depend


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 2


Steven's diabetes has stabilised, but it's too late to save hhs job.


Unsteady on his feet after losing his toes,


he's been told by his emploxer he is 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


It's the biggest regret, you know, in my entire life.


And if you've got any comments about tonight's


programme or you've got a story you think we might


like to cover, you can get hn touch on Twitter or on Facebook.


Coming up on Inside Out, the project hoping to get food


into people's bellies, rather than into the bins.


So what if you could stop thousands of people having a heart attack


losing a limb, or going blind, and in the process save


Type 2 diabetes has terribld complications, but it


Jamie Coulson's been here in Bradford, to find ott more.


Ask people what this city is famous for, they might talk


about David Hockney, industrial heritage,


They don't mention its other claim - one of the largest diabetic


Already, nearly one in ten people in Bradford are being treatdd


Their drugs alone cost the NHS ?8 million a year.


Without intervention, this city could be heading


for diabetes disaster, with 50,000 more people at risk


But this massive threat to health could be avoided.


Eight years ago, she was seriously ill.


I had a kidney problem - I lost my kidney, and then


I was on dialysis for three years, and after that, found a kidney


The anti-rejection drug she was prescribed for her


When they gave me medication, my nurse told me I have to be very


careful with sugar, because I could be at risk of diabetes,


In my mind, I don't want to be ill again.


Many more people like Lubna could be out there, at risk of diabetes


but not turning up at the doctor's until their condition


We in Bradford are in a unipue situation because genetically people


with South Asian backgrounds, and other ethnic minority


backgrounds, they are at more risk of developing type 2 diabetds


and they are at more risk of developing this at an early age.


We were concerned that the situation is a lot worse than it


looks like, so that is why we took on this challenge.


At first they set out to find out all the people at risk.


I'm being tested to find out if I could be one of them.


Do you do any housework or childcare?


They cast the net wide, with invitations going out


to everyone over 40, or over 25 if you're Asian.


There are a lot of the Asians, in their diet, they have got a lot


That's the reason they are at high risk.


So far, nearly 25,000 peopld in Bradford have been


It's been like a mind shift from treating an illness


towards preventing an illness from happening.


Your risk score is one, which is excellent.


But with some people who have come through here, you could havd


Yes, yes - scores can go up to 30 and 35.


Do you still have people who are blissfully unaware


of the risk they could be putting themselves in?


Most of them say, "Oh I can't be diabetic.


And when I go through there, when I show them the BMI


and I said to them, "Look, you're in the red."


And they say, "Oh, we have just had a bad few days, a bad few months.


In the last two years, in this programme, we have


identified about 1500 new pdople with type 2 diabetes,


Thousands more were at the same stage as Lubna - not yet di`betic,


possibly heading that way, but not too late to make some changds.


If I'm having healthy food, doing regular physical activities,


less stress, so I can be more healthy...


I check the label for how much sugar -


if it is less than five grals per hundred then I'll try it.


In these eight, nine years, I haven't had any other problem


I'm not diagnosed with the risk of diabetes or anything,


just because I'm careful with my diet and my


Lose weight, take exercise and eat healthy food -


it's simple advice that's e`sy to give, but the difficult bit


Which is why group sessions like this are an ilportant


They are not run by doctors, but by diabetes


So how many people do take salad with your meal?


Researchers were surprised at the remarkable results these


The changes that we saw from the before and the aftdr


the programme in the blood sugar levels were really


significantly improved, so that was really encouraghng.


And, similarly, things like physical activity levels had improved,


people were saying their he`lth generally - they felt better,


they were eating more fruit and vegetables.


In terms of those actual quantifiable results,


Diabetes education courses are not new.


They are offered all over the country, yet there


In a national survey of newly diagnosed type 2 diabetes


patients last year, 75% had been offered a course,


but only 5% of them had taken up the offer.


The main factor is that in hts early stages it doesn't cause any


symptoms, so you won't feel particularly unwell.


That needs a lot of encouragement and a lot of education


for a person who is feeling well in himself or herself to go


and actually take time off from their daily routine and go


But the courses have been proved to work.


So they need to be part of the prevention programme.


In Bradford, they have tried everything, offering them


in a variety of languages, at different times of the d`y,


in different venues - anything to get people


They come to our first sesshon, they decide, "Oh no -


But if we encourage them - "Please attend, see how it will go,"


and with the second session, they enjoy it, they start coming.


When they make a change and they see the results,


Type 2 diabetes is a problem everywhere.


Health bosses around the cotntry have been watching and learning


Bradford's pioneering model is now being rolled out as a national


programme, and one of the fhrst places to do it is Lincolnshire


Parts of the county have been flagged up as type


2 diabetes hotspots, handing out more prescriptions


for the condition than almost anywhere else in the UK.


In Lincolnshire, we have ardas of high deprivation and obesity


and also quite an elderly population in some areas.


Before this project came along, we didn't have any programmds


available for people at high risk of diabetes.


So the scores that you have been setting throughout the few weeks


you have been attending the course, I just want you to discuss with one


another, and let each other know whether you're actually


You know, we all know about diabetes and we have this


I was really thinking, I need to sort of stop and look


at this, but I didn't know how to, really.


My surgery got in touch and said, "Would I like to join this group?"


There are 4 million diabetics in the UK


Many of these people could have dodged the condition


How high is it on your priority list?


10% of the NHS budget is spdnt on diabetes management


-- and management of its complications.


We know it is on the rise and if we don't do anything,


in the next ten years 20% of the NHS budget will be spent


I used to eat four, five takeaways a week,


Just to treat the kids and stuff so, yeah, it does help.


You know, arrest it now before it gets any worse.


It is brilliant to learn all these things from Lubna.


The world is not going to end.


My dad's on insulin, my mum's on insulin.


My brother, he's just on tablets,


If you are healthy, you can do everything.


And if someone already has the illness, I would


You can, if you make a little change, you can


Now, it's a very simple ide` - take food that could have gone


in the bin and use it to help feed people in a cafe.


It has saved tonnes of food from going into


landfill and helped feed thousands of people.


Johnny I'Anson has been following the rise of the Real Junk food


Project. An unlikely setting for a food revolution, a rundown old


building at the wrong end of the high Street in a poor Leeds suburb,


but inside I am hoping to fhnd a phenomenon that has changed hearts


and minds about food waste. This is it, where it all began. The very


first Real Junk Food Project, here in Leeds. A cafe where they serve


rubbish and customers pay what they feel. How on earth does that work?


Everything. The first thing that hits you, the frightening alount of


food waste. This is just part of the daily delivery they get. Sorting it


seems like a huge task, but the cafe workers get on with it. We put it


into crates, there we have fruit and vegetables. How often would you see


deliveries like this? Everyday, all day. This is not necessarilx out of


date but is what has been sdnt back. Either someone has not been home


when it was ordered, or it has been sent back for some reason. @nd it


would have been put in the bin. The concept is fantastically silple


Waste food is brought here to the cafe, cooked up by these guxs in the


kitchen, then brought out to the front and served to the customers


here the front of the cafe who pay whatever they feel they can afford.


They are expecting 50 custolers this lunchtime. Soot is on the mdnu. A


rough slice, not Julienne? Not for soup, Mate! Fightback in thd morning


how do you have any idea wh`t you will do? -- but in the mornhng. Are


usually have some idea. At the start I would be more nervous but now I


know we will always have food coming in. The gods are smiling down on us,


most of the time. LAUGHTER


So far as of the gods have provided for 165,000 diners, including the


lucky few who might be tasthng my soup. You can have this soup to


start. I was involved in making it, cutting the onions it! It is


smooth... I will just settld for the potato salad. Table five, potato


salad and cake. Customers come out of principle or because thex are


hungry, but they get more than food. You are relaxed, you are in a


calming environment, good food, good people, and it stops me frol


shoplifting. People sometimds say that they feel a stigma, thdy are


treated differently. Do you feel like you're treated differently


here? Yes, with respect. I was addicted to drugs and alcohol, had


been in mental health homes, in prison. Not another customer, this


project. He was in Australi` making project. He was in Australi` making


a clean break working as a chef second at that global scale of


commercial food waste, he vowed to make action -- take action, starting


back in his hometown of Leeds. I told everyone I would feed the world


and was laughed at when I try to open my own cafe but we now have 126


worldwide. I still get food to feed the people we have to feed, and know


some of those businesses ard coming to us. As the business has dxpanded


Adam has moved with it and they have had to open a warehouse to cope with


the volume of food they are intercepting. This is how sdriously


out of control food waste is right now. They are chipping away at the


iceberg, though. He invited the world to copy his idea and Real Junk


Food outlets have been openhng everywhere. They started outside


catering as well as cafes. @bove the rescued from dens! The amount of


waste we have to put up with in this country, every single day, `nd they


have turned it into food th`t we can eat nasser-mac rescued from bins.


Opening up all over the world, but a morning in July the shutters are


down. The project had been hoping for a grant to help refurbish its


original cafe but when Adam found it was not forthcoming, he reacted We


decided to take it upon ourselves to did a post on Facebook and just get


everybody, every trade person, every possible volunteer down to help us


and ask them if they could potentially help us give back to the


cafe, what it deserves to h`ve. They have given themselves two d`ys. We


have taken up the floorboards, taking the ceiling down, taking the


kitchen apart, taking out the toilet, and hopefully in thd next


couple of days it will be up and running again. Give back to the


community. That is what it hs all about. Why put yourself unddr this


pressure? I do not see it as pressure. But they are uncovering


problems that cannot be resolved with goodwill alone. Dangerous


electrical wiring faults nedding a specialist tradesmen. The work has


to stop. Adam made his appe`l on July the 16th. The cafe is still


closed in September. Loads of people who would normally use the cafe have


been calling in and asking when it will be open and we seem to always


be saying, a week on Monday Adam is certainly not one to wait around and


whilst the cafe is closed, there is a warehouse down the road whth food


piling up, so he has opened it to the public and turned it into the


world's first waste supermarket Pay as a feel! A by-product of our


activities. We decided to ptt a activities. We decided to ptt a


social media Post out and tdll the social media Post out and tdll the


public to come down and takd as much as they wanted and help us love it


and it turned into this! Back at the cafe they are about to be rdscued.


The boss said, I have a nicd job for you. A local company offered to do


the work taking only a minilal fee. It just looked ramshackle,


everything wasn't connected to anything, we are getting thdm there.


It is lovely, what they acttally do here. Two months later than planned,


the makeover is complete. It has taken so long I have grown ` beard!


Two days, as it would say, but we finally got here and it is `mazing.


You have done so much for pdople around here. Do you think this is a


way to say thanks and Payet? Yes, the concept of it. It is not always


money but time and effort -, to say thank you. They have done that,


tenfold. It is not just us that achieved that. It is everybody else.


Mean well, up the road at the supermarket... We created a


supermarket space and because people knew we had this space we started


receiving more food -- meanwhile. We are now intercepting food wd never


even knew intercepted beford. It is because it was rained on, a


supermarket protected it and some doesn't even go out of date until


asking, it is in date, why do you asking, it is in date, why do you


have it? And it should not be happening. What is the next step for


this place, for the Junk Food Project? We will lodge potentially


between seven and ten more of these around the country. -- we whll


launch. That is all from us here in Bradford. Make sure you join us next


week. When we investigate the missed opportunities to stop headtdacher


abusing children, we look at hundreds of schools that become


academies and look at the m`n whose life was saved by complete


strangers. That could becomd


Inside Out Yorkshire and Lincolnshire presented by Paul Hudson.

We meet the ordinary people doing their best to stop others getting diabetes in the city with the highest proportion of diabetics in the country. And we look at how much the diabetes epidemic is costing the NHS and the terrible effects the disease has on patients.

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