28 comments on “Yes, so, and?

  1. Piss poor scientistic diabetes “drugs” that are fucking useless and/or make matters worse likely accounts for the increase (assuming they are not just lying) –and anti-sugar commissars trying to pester folk on to them.

  2. So we need to ban all sugar, fat, and salt; just because a handful of idiots insist on consuming too much. See also: alcohol.

  3. You need to send the NHS to Cuba for training. They have great health care there… And it’s free!

  4. The NHS gives you an annual foot check. People don’t go, or don’t use the drugs to control their glucose. Everything they need is available. The NHS is not to blame for this. Sufferers bear personal responsibility.

    OTOH the NHS doesn’t seem to be very enterprising in the use of newer drugs.

    OTOOH I’d like to know how many of the amputations are people who have had the disorder for a very long time, or are immigrants or BAME, who seem to suffer disproportionately.

  5. Looking at the report linked above and using ken’s numbers there were approx 15000 amputations from those 2.55 million diagnosed diabetics (assuming of course that everyone who had an amputation was already diagnosed) or about 0.58 %

    This had gone up to around 19000 around the time there was 3million diagnosed or 0.63%

    Barely a rounding error

    In the same time period the UK population rose by around 2 million – presumably not all of them were diabetes free

    I smell something….

  6. Do all diabetics, i.e. at all stages of the disease, have an equal chance of requiring amputation?

    I had presumed that it the risk of amputation rises as the disease progresses.

    In that case, the correct denominator to work out if the NHS is doing better at keeping people’s feet attached isn’t “all diagnosed diabetics” but “all diabetics at an advanced stage of the disease”. Which might be growing at a faster or slower at a faster rate than the total number of diagnoses.

  7. (And as a separate issue it would be interesting to know something about the rate of progression of people from mild to severe forms of the disease – if the NHS is getting better at controlling it, then one hopes that the average rate of progression would decrease.)

  8. The NHS gives you an annual foot check.

    Every three months. Although booking the nurse appointment is as easy as you would expect it to be – every slot that can be managed by a working person without using leave is taken before it is technically open.

  9. I was diagnosed T2 3 years ago, so personal anecdotes will now appear…

    I cut most carbohydrates out of my diet. All carbs turn to blood sugar and diabetes is basically an inability to process blood sugar for one reason or another. So limiting the amount seemed logical and has worked for me. Apparently it’s worked for Tom Watson too, and the Chef Tom Kerridge and many other people if you care to look online. for testimonials.

    But, the NHS official line is still to recommend their Eat Well Plate. I asked about carb-restriction on the information sessions you’re invited to when first diagnosed and was told to stick to the Eat Well Plate, which is based around starchy carbs. I did as I was told and got massively worse… I was literally falling asleep at work from hyperglycemia. As soon as I switched to low carb I was immediately so much better.

    The point is this… the NHS is still deliberately ignoring a method of diabetes control that a solid scientific base, is cheap and that works for a substantial proportion of sufferers who try it.

  10. Diabetes isn’t a disease, it’s a condition.And neither is it “progressive”. If kept under control, there’s no reason why diabetics can’t live to a ripe old age. Toe and foot amputations, in general, result from poor management of the condition.

    The rise in reported cases in recent years is mainly due to increased diagnosis. In the past, many people would have gone to their graves without ever realising they had it. My father was diagnosed at the age of 79, and lived for a further 11 years.

  11. “Diabetes isn’t a disease, it’s a condition”

    The person who wrote this ought, if there were a God, to be subjected to a complete range of auto- immune diseases, including rheumatoid arthritis and psoriasis

  12. @Peter

    Glad your father made a good fist of things. I think you’re right both that the number of amputations ought to be an alarm bell for people’s conditions being managed properly, and that there’s also a confusing effect whereby something is deemed a more important priority, followed by an increase in diagnoses now it’s being sought out – including of people who would previously not have been picked up.

    “Diabetes isn’t a disease, it’s a condition.” The US National Institute of Diabetes and Digestive and Kidney Diseases calls diabetes a ‘disease’, as does the Mayo clinic. British sources seem mostly to call it a “condition”. Maybe there’s some tomato/tomato aspect to the distinction.

    “And neither is it “progressive”.” I wouldn’t dispute that many people successfully manage their diabetes. But medical opinion seems pretty strong that diabetes tends to progress to greater severity over time (I’m not an expert on this at all, but from my limited understanding it is to do with cumulative loss of beta cells), and its complications become worse as it does so.

    This NHS site states that “As type 2 diabetes usually gets worse, you may eventually need medication – usually tablets – to keep your blood glucose at normal levels.” This American article points out that “even well-controlled diabetes progresses over time — meaning you may have to adjust your treatment plan more than once.”

    For something more academic, here’s a medical journal article (from the journal “Diabetes Care”) whose first seven words are “Type 2 diabetes is a progressive disease”…but I don’t mean this as a snark at you, the rest of the piece is genuinely interesting.

  13. ‘NHS diabetic foot and toe amputations up 26%, Labour research claims’

    This means nothing without the numbers for how many foot and toe amputations they had for people who didn’t have diabetes. Hmmm?

    Why should they have to have diabetes?

  14. @Gamecock

    Best of luck with it. It does seem to be true that some people can be on the right drugs but still get worse, though, and in fact this seems to be the typical path. From that last paper: “A1C will increase by ∼1% every 2 years even with most therapies”

  15. Gamecock, I suggest you need to read up on auto- immune diseases rather than insult me, a lifelong sufferer of one of those diseases.

    I refrain from using my assessment of your medical knowledge. But you are an idiot

  16. Given that you do not distinguish between types of diabetes, I can only assume that you are ignorant. And no, I am not diabetic, fortunately but I hope you develop rheumatoid arthritis. It might help you attain insight

  17. The neuropathy that causes the amputations and blindness is, as I understand it, a result of elevated blood sugar which is a symptom of the various types of diabetes. Diabetes is an inability to get sugar out of the blood, either through lack of insulin production or through insulin becoming ineffective.

    Most meds and insulin injections work to get the sugars out. But if you can prevent excessive sugars from being there in the first place you can have diabetes but be asymptomatic.

    I know that this can be done because I’ve done it. 3 years after diagnosis I’ve now come off all medication and am managing my diabetes with diet and exercise alone. Might not work for everyone, might not work for many, but it definitely works for some.

    Am I really actually diabetic? Yes, I’m pretty sure about that. On holiday this years I inadvertently drank some fruit juice concentrate that had been mislabelled … I was unconscious within the hour.

  18. Type 2 diabetes (ie not the auto immune disease) is more prevalent in certain efnick communities. This might be genetic or it might be that said communities consume vast amounts of butter in the form of Ghee. If the awful Keith Vaz can say it affects his community we are all supposed to applaud, but if I were to ask for an analysis of this foot chopping statistic by ‘community’ I would be hounded out as ‘waycist’ by the usual suspects. Even though it is likely a key factor. A bit like the sharp increase in aids was not allowed to be explained by ‘importts’ From sub Saharan Africa

  19. I hoped that developing an auto immune condition might cause your mind to develop. Obviously a lost cause. You cannot even imagine your defective brain changing.

    Who is the idiot?

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