The incidence of diabetes is growing at 7 per cent to 10 per cent a year and has resulted in an increase in amputations of 25 per cent in two years, according to Diabetes NSW.
“We talk about this issue as the [medical] tsunami of the modern age,” says Sturt Eastwood, the chief executive of the organisation.
Type 2 diabetes – which can be delayed or prevented in 58 per cent of cases – represents 85 per cent to 90 per cent of all diabetes cases. It usually develops in adults over the age of 45 years but is increasingly occurring in younger age groups.
It is a chronic condition that occurs when the pancreas does not produce enough insulin and/or the insulin does not work effectively to meet the body’s needs. It is managed by lifestyle changes such as following a healthy eating plan and doing regular physical activity.
Meanwhile, type 1 diabetes – previously known as insulin-dependent or juvenile diabetes – occurs when the pancreas is no longer able to produce the insulin the body needs because the cells that produce insulin have been destroyed by the body’s immune system. It is usually managed by daily insulin injections.
Mr Eastwood said the extent of the problem could be witnessed at the foot clinic at the Royal Prince Alfred in Sydney. “It is a high-need area and they have a queue backed up for months,” he said.
Treating diabetes costs about $7 billion a year Australia-wide, he said – which can be doubled if you include productivity loss to the economy.
It takes between 10 and 20 years for complications to emerge from poorly managed type 2 diabetes as it destroys blood vessels and nerve endings, Mr Eastwood said.
“The problem is absolutely going to become worse and worse,” he said. “There is a stigma associated with it, so now people don’t talk about it and are not seeking support … so we are seeing more and more of these complications.
“In a year, or a year and a half, diabetes type 2 will be the single largest burden on Australia’s health system. By the time you turn 50, quite frankly, you should be getting screened annually for diabetes.
“Up until now we have not taken on scare tactics [like pictures on cigarette packets] and I think it is almost time to start shocking government and the population.
Orthopaedic surgeon Gary Fettke has said walking around the wards of the hospital where he operates is ‘like going into a leper colony”.
Patients “are depressed and frightened of this disease that is eating away at them,” he says.
“Twenty years ago in northern Tasmania I was treating diabetes complications with amputations of toes, heels, feet and below the knee once every five to six months,” says Dr Fettke, who is based in Launceston. “Now I am amputating every week and this year, twice some weeks.”
Professor Manny Noakes, Research Director for Nutrition and Health at CSIRO, which last month released a research paper into diet and diabetes, said reducing calories through a low carbohydrate diet was effective in controlling diabetes.
“Any kind of weight loss will make a significant difference to diabetes control,” she said.
Julian’s goal: walk 25 metres
A daily task for most of us is a major goal for Julian Robinson – to walk 25 metres to the letterbox.
Now 47 years old, Mr Robinson developed Type 1 diabetes 13 years ago. He says he wasn’t eating properly, was drinking and smoking and his health began to deteriorate.
“I started losing the feeling in my legs,” he said. “I put on an awful lot of weight, my relationship broke up, then the feelings in my legs got worse. Two years ago, I had the left leg amputated below the knee.
“Now my blood sugars are controlled. My diet’s a lot better. I’ve probably lost 20 kilos. I was such an athletic person. I played football,” he said.
As for his goal of walking again, Mr Robinson says: “I am waiting for rehab with my prosthesis fitting.”
He said that thanks to Dr Fettke, who amputated his left leg, “I have been able to keep my right leg so far.”
Facts and figures
More than 100,000 Australians have developed diabetes in the past year
Around 1.7 million Australians have diabetes. This includes all types of diagnosed diabetes (1.2 million known and registered) as well as silent, undiagnosed type 2 diabetes (estimated at up to 500,000)
36,000 people are diagnosed with type 2 diabetes each year in NSW