Simon Speight: podiatrist on the increase in people losing toes, feet and legs to diabetes

Diabetes is costing record numbers of Kiwis toes, feet and legs.

More than 1200 lower-limb amputations were performed last year alone.

Those with type two diabetes - about 95 percent of the diabetes population - are most affected.

Diabetes Special Interest Group Head, Simon Speight, says GPs focus on managing symptoms to reduce the need for surgery.

"Whether it's the sugar levels, the blood pressure, the cholesterol - just trying to get those levels sorted out right from the get-go, because if any of those proceed 20, 30, 40 years later down the track, that's when these things can happen." 

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Episode Transcript

Speaker 1 (00:00):
There is a worrying rise in amputations amongst diabetes patients
at the moment. Figures show that there's been a fifty
percent increase in amputations since twenty sixteen, with over one
thy two hundred lower limb amputations conducted just last year.
Simon Spate is a p diatrist and head of the
Diabetes Special Interest Group at p Dietary, New Zealand. Hey, Simon, hi.

Speaker 2 (00:19):
Here, how are you well? Thanks? All true? What you say?

Speaker 1 (00:22):
Oh, thank you And you didn't even have to text
end to say first off the blocks, thank you, Simon. Now, Simon,
how is it getting to the point where people are
having to have I mean, they presumably know they've got diabetes.
How are they having to have amputations done well?

Speaker 2 (00:37):
Amputation just means to cut around or literally prune, and
as you say, this is what's going on. But when
they're diagnosed, the GPS always and all the other health
professionals are trying to educate them from their sphere of practice.
They're trying to get good control of the diabetes. It's
the sugar levels, the blood pressure, the cholesterol. Just start

(00:57):
with those three for a kicker, and they're just trying
to get those levels sorted out right from the get go,
because if they let any of those proceed twenty thirty
forty years later down the track, that's when these things
can happen. I'm talking about the type twos, which is
about ninety five percent of the diabetes population. That's the
one where this HiT's really bad.

Speaker 1 (01:19):
Okay, So when we talk about amputations, we obviously go
to the worst place in our minds. But you're saying
it can just be a trimming of a bit of flesh.

Speaker 2 (01:26):
Well, you can just take a toe off and the
patient leads a damn good life. The the circulation can
pack up in a small toe and so it's a
really good operation. And so it's not all doom and
gloom for amputations. They call them minor amputations, but they
can and often are very successful.

Speaker 1 (01:46):
Do you guys do it yourself's pediatrists?

Speaker 2 (01:49):
No, No, But we are the steps so to get
the hospitals are the pediatrists in the hospital or the
DHB or THEATU order around the country. They're the ones
that will rein them into the surgical teams and sometimes
a lot of the time the surgeons are on site
and they have regular meetings monthly or week or whatever,

(02:12):
so that they can send them their way for an
opinion and treatment.

Speaker 1 (02:17):
Now, I mean, we've been speaking quite a lot lately
about the postcode lottery, but it seems to me this
may be another case of it, and that's in some
parts of the country. And I'm thinking, you know, South
and Gisbon they have fewer than five pediatrists for the
whole region. So is that causing a bit of a
problem there.

Speaker 2 (02:32):
Look, there's always going to be resourcing and funding in
various areas that you can't get right. Helen Clark once
said you can never throw enough money at the health vote.
So if you're listening Auntie Helen, it's still correct.

Speaker 1 (02:43):
Longtime listener of the show, actually, Simon, thank you very
much man, it's really lovely to talk to you. Look
after yourself. Simon Spake, pediatrist and head of the Diabetes
special Interest group at p Dietary New Zealand. For more
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