Reversing Diabetes Is Possible… But It’s Rare

From healthline.com

Researchers in Scotland say people with diabetes can reverse their disease by losing weight, but most aren’t aware that this is possible

Being diagnosed with type 2 diabetes can be difficult, especially since the disease is perceived as incurable.
But experts say diabetes can be reversed early on.   

“If you follow the advice of your doctors and nutritionist and make an effort to lose weight, diabetes can be reversed by normalizing your blood sugar levels without medication early in the course of the disease, that is the first three to five years,” Dr. Sangeeta Kashyap, endocrinologist at Cleveland Clinic, told Healthline.

Researchers at the University of Glasgow in Scotland agree and want to promote this message.
In a recent study published in The BMJ, Scottish researchers report that patients and doctors may not be aware that type 2 diabetes can be reversed.
They said that weight loss of around 33 pounds often produces total remission of the disease, yet remission is often not coded in medical records.
They point to a U.S. study that found remissions in less than 1 percent of 120,000 patients who were tracked for seven years.   

Similarly, a database that includes all patients in Scotland shows less than 1 percent of type 2 diabetes coded as being in remission.

The researchers argue that greater awareness, documentation, and surveillance of remissions would improve health outcomes and reduce healthcare costs.

Just a honeymoon period?

Researchers say that the reasons why remission isn’t coded may be due to medical professionals’ disagreement on criteria and guidance as well as the fact that few patients are trying to gain remission or actually achieving remission.
Dr. Ashwin Patel, the chief medical officer of InquisitHealth who also sits on the Community Leadership Board of the American Diabetes Association, agrees.
“There’s a ‘fixed’ criteria for the diagnosis of diabetes, so it makes diabetes seem like it’s a very clear, binary diagnosis. In that, either you have it or you don’t,” Patel told Healthline. “Importantly, not only is there ongoing debate on what the right criteria should be, there is a growing realization that diabetes, especially type 2, isn’t binary physiologically. It’s much more of a continuum.”   

Another reason, Kashyap points out, is that even if blood sugars reach normal levels due to weight loss achieved by dieting, exercising, or surgery, they may not stay normal for a long period of time.

“Blood sugars can come back into the diabetes range, and so some people feel like this isn’t reversing diabetes, [but rather] silencing the disease,” said Kashyap. “I call this a ‘honeymoon period,’ meaning the blood sugars normalize, there’s no meds needed, and things look great, but we don’t know how long that will last.”
She notes that in up to 60 percent of people who have bariatric surgery, their diabetes comes back within 15 years.
“I tell people it’s a nice vacation from their disease and we hope it does slow down developing complications from diabetes, such as heart, eye, kidney, and nerve disease,” said Kashyap.
Why does diabetes come back?   

The reasons aren’t known, but it may be due to weight gain or genetics.
“Part of the reason that the pancreases fails to produce insulin over time is genetic. Also, as you age, your pancreatic function declines. That’s why it’s common to see diabetes in people in their 60s and 70s,” Kashyap explained.

Worth the psychological boost

Whether or not a person stays in remission from diabetes long term, researchers say that noting their remission is still worth it.
“When someone works really hard to lose 15 percent of their body weight, they’ve put a lot of work in. If blood sugar is normalized and they’re not on medications, it can be a big psychological boost to put in their chart that they are in remission,” said Kashyap. “It reinforces the message that if you work hard to lose weight you can see results.”
Think of someone with breast cancer who undergoes treatment and then goes into remission. When this occurs, remission is almost always documented in their records.   

“This gives the person hope. They may even forget about cancer for a while,” said Kashyap.

When it comes to diabetes, recognizing remission may also give a person a sense of control since weight and diabetes are strongly tied.
“Weight is the root cause of people developing diabetes at a young age. More than 82 percent of people with type 2 diabetes are overweight,” said Kashyap. “Now we have a lot of tools to help people to lose weight, such as nutritionists, exercise physiologists, medications, and surgery. You can’t control your age or who your parents are, but you can modify your weight.”
From the physician’s perspective, documenting remission is a way to back the importance of lifestyle changes.
“Like The BMJ article said, we physicians often push drugs, but give lip service to lifestyle modification. This is a way to not do lip service. By putting it in the chart, we’re recognizing patients’ efforts and keeping them motivated to keep it up,” Kashyap said.

If lifestyle changes are implemented successfully during the early stages of being officially diagnosed with diabetes, and if medications are no longer required, Patel says documenting diabetes “remission,” diabetes “being reversed,” or simply that someone’s diabetes is now “diet-controlled” can have impact beyond the patients themselves.
“These might seem like semantics, but they have real downstream implications for research, budget/cost analyses, and most importantly, for the individuals having, or not, the potentially stigmatizing label of diabetes,” noted Patel.

https://www.healthline.com/health-news/diabetes-reversal-possible-but-rare#5

New Device Could Help People with Diabetes Lose Weight

From healthline.com

The EndoBarrier procedure is similar to gastric bypass surgery, but its supporters say it’s less expensive, less intrusive, and can be removed after a year in place.

People in England fighting “diabesity” — late-onset diabetes associated with obesity — may soon have an alternative to gastric bypass surgery.
Advocates say the device called the EndoBarrier — a 60 centimetre long tube-like liner or “sleeve” inserted into the intestines to stop the absorption of food — can help overweight people with type 2 diabetes.   
The sleeve can be implanted under anesthesia through the person’s mouth in less than an hour.
Dr. Robert Ryder, consultant diabetologist and chief investigator for the Association of British Clinical Diabetologists’ studies with the EndoBarrier, presented his findings at the annual meeting of the European Association for the Study of Diabetes (EASD) in mid-September in Portugal.
The research indicates that the new, nonsurgical, reversible weight loss device is safe and effective and could be introduced across Britain’s National Health Service (NHS).
The procedure’s intent is to kick-start lifestyle changes and to help people achieve better health.

How the device works

Officials at GI Dynamics Inc. in Boston, which manufactures the EndoBarrier, said its device isn’t approved for sale in the United States and is limited by federal law to investigational use only in this country.

   

To explore whether this new therapeutic method could work on a large scale, Ryder and his colleagues at City Hospital in Birmingham created a small NHS EndoBarrier clinic.
They opened it in October 2014 to work with patients who were hardest to treat.

Sixty-five people were accepted for treatment and 50 now have the EndoBarrier implanted successfully.
“We translated our research program into an inaugural NHS service, which demonstrates EndoBarrier to be highly effective in patients with refractory [resistant to treatment] diabesity,” Ryder told Healthline. “There are high patient-satisfaction levels and an acceptable safety profile.”
“After we removed the EndoBarrier,” he added, “65 percent of the patients were able to sustain the benefits achieved in blood sugar and weight control, and in insulin-dose reduction. They also reported considerable improvements in well-being, energy, fitness, and exercise ability. Endoscopy units are ubiquitous, so our service could be readily disseminated, and the registry would be useful for ongoing monitoring nationwide and worldwide.”   
In such a procedure, a small part of the stomach is used to create a new stomach pouch about the size of an egg.
This smaller stomach is connected directly to the middle portion of the small intestine, bypassing the rest of the stomach.
This reduces the amount of fat and calories the body absorbs from the foods consumed.

The EndoBarrier prevents the body from digesting food in that area, so absorption occurs farther down the intestine. This causes people to feel full after just a small meal.
The procedure is similar to a gastric bypass, Ryder said, but is far less invasive, less risky, and less expensive. The device can also be removed, usually after one year.

The first 31 patients — between 28 and 62 years of age — have had their EndoBarriers removed after up to one year.

These people had lived with obesity and type 2 diabetes for an average of 13 years and more than half (17 people) were taking insulin.
While the device was implanted, Ryder said he and his physician colleagues regularly encouraged their patients to change their diets and lifestyles, and to exercise.
The researchers also established a secure online registry to monitor outcomes.

Some risks, some success

The EndoBarrier isn’t without risks.

“There is the possibility of serious adverse events, such as gastrointestinal hemorrhage and liver abscess — usually resolved by removal of the device,” Ryder said.

These patients reported that the device helped them to lose weight and improve their health.
On average, Ryder and his colleagues said, their patients lost 33 pounds, had improved blood sugar control, lower blood pressure, and less liver fat.
Participants on insulin were able to reduce their dose from 100 units per day to 30, he added.
“Participants also reported considerable improvements in well-being, energy, and the ability to exercise,” Ryder said.
Around 94 percent said they would recommend the service to their friends and family.
A leading American diabetes researcher is encouraged by Ryder’s success with the EndoBarrier.
“Obesity is the main cause of type 2 diabetes, and obesity makes blood glucose levels harder to control in people with type 2 diabetes,” Dr. Thomas A. Buchanan, told Healthline. “If people with type 2 diabetes can lose weight, they usually have better blood sugar levels, which lowers their risk of long-term diabetic complications like vision loss, kidney damage, nerve damage, heart attack, and stroke.”
Buchanan, chief of the Division of Endocrinology and Diabetes at the University of Southern California Keck School of Medicine, is co-director of the USC Diabetes and Obesity Research Institute.
“Lifestyle changes can help reduce obesity, but the effects are generally mild and not sustainable over long periods of time,” he said. “Surgical approaches are much more effective, but they have significant complications.”
“This sleeve approach offers a less invasive way to help people lose weight and keep it off. This study shows that it works in even longstanding, hard-to-control cases of type 2 diabetes.”

Maintaining improved health

“For lifestyle changes alone, 95 percent of patients return to their pre-intervention weight by five years,” Buchanan said. “Old habits are tough to break over time. For this device, we need to see what the long-term weight loss pattern is. One year is pretty short. Lifestyle changes work well for that period of time, too.”
Early studies showed some incidence of the EndoBarrier sleeves slipping out of place, Buchanan noted.
“I am not sure if this version has that risk,” he said. “Also, longer studies are needed to see if the device creates any nutritional deficiencies. I doubt it, but it is possible.”
Many people living with diabetes remain overweight with poor diabetes control.
By the time someone first develops type 2 diabetes, they already have incurred 10 to 20 years of damage to the insulin-secreting cells in their body, Buchanan said.
Much of that damage is the result of obesity. And that damage continues to occur over time if people remain obese.
“Lifestyle approaches simply don’t create sustained weight loss,” Buchanan said. “Most medications we use lower blood glucose levels. But with one or two exceptions, they don’t stop the ongoing damage to insulin-secreting cells, so the blood sugars go back up again eventually.”
“Surgical approaches are used relatively late, usually for severe obesity,” he added. “The horse is out of the barn by then. We need approaches that can fix obesity for long periods of time. And we probably need to use them earlier and for lesser degrees of obesity than is the current practice. This [EndoBarrier] sleeve is a new approach that has great potential in that regard. We just need to see how it does over the long term.”

https://www.healthline.com/health-news/new-device-could-help-people-with-diabetes-lose-weight#5

Living With Type 1 Diabetes: My Love-Hate Relationship With Food

From diabeteshealth.com

I love carbohydrates, and sometimes, I hate carbohydrates.
I think part of my love/hate relationship with food goes back to the days just before my diagnosis of type 1 as a teenager. At 18 years old, I was suddenly eating everything in sight as the hunger from my high blood sugar, due to undiagnosed diabetes, kicked in.  I lost more and more weight and became skin and bones, regardless of all the extra food I was eating.  Something was wrong.
Enter my type 1 diabetes diagnosis. I was in shock. Every time I ate I felt as though I was being punished as I watched my blood sugars continue to rise. I began limiting carbs like they were poison and exercising like a fiend to try to combat the glaring high blood sugars on my glucose meter.
At first the doctors didn’t know if I was a type 1 or type 2, so they tried giving me pills to lower my blood sugar. This didn’t work and since I didn’t understand diabetes yet, I thought limiting my food to cheese, eggs, and lettuce would help fix me right up. I couldn’t have been more wrong and by the time the doctor figured out I needed insulin I had such a hate relationship with food that it was hard to get back to normal eating.
I felt so deprived during that time that even today, 18 years later, I panic at the thought of having to restrict my diet too much. I freak out if someone tries to take away my carbs, like a dog protecting its bone. It happened once, after all, and it was a very difficult and confusing period of my life.
Ironically enough, my husband restricts his carbs. He doesn’t have diabetes, but he feels that it helps him stay at a healthy weight along with his daily exercise. As a person with diabetes it’s funny to watch a person without diabetes counting their carbs. Sometimes I want to point at him and yell “Imposter!” Thankfully he has a good sense of humour because I may have done this once or twice.
I have to admit, his way of eating has helped me improve mine. I do acknowledge the fact that carbs aren’t evil and that they may get a bad rap, but they’ve actually saved my life more times than I can count. I simply try to choose what carbs are important to me and to limit the others. If I’m going to take insulin for it, then in my opinion it should be worthy of that shot.
While I don’t eat a diet super low in carbs, I do try to choose smart carbs. For example, I have a breakfast smoothie that helps me add fruit and healthy protein into my diet early in the day. This helps me make better choices throughout the day and I am noticeably less hungry late mornings than I used to be. I use unsweetened almond milk instead of regular milk so I can enjoy adding fruit without worrying about too many carbs.
I’m trying to heal my food issues and feel good about the way I eat. I am glad to have the choice today to eat the carbs I choose to. Insulin gave me back some of the normalcy that I took for granted before my diagnosis, and for that I am forever thankful.

https://www.diabeteshealth.com/my-love-hate-relationship-with-food/

Diabetics can now test their blood sugar levels with a mobile device

From qz.com

People living with diabetes have to prick their fingers to check their blood sugar levels anywhere from one to seven times a day.
But now, there’s a better way to monitor blood sugar. This week, the US Food and Drug Administration approved the first at-home, needleless system for continuously monitoring glucose for people with diabetes. The system, called FreeStyle Libre Flash, and manufactured by the DC-based Abbott Laboratories, allows users to forgo finger-pricking for up to 10 days at a time.
The Flash is essentially a small, circular plastic sensor that sits on top of the skin and detects blood sugar from a small wire that goes under the skin beneath the sensor. People can insert themselves using an applicator that works sort of like a rubber stamp.
Once people have applied the sensor on their arms, they can wave a mobile device a little smaller than a smartphone in front of it to read glucose levels. It takes about 12 hours for the wire to become adjusted to the person’s body, but afterward the device takes continuous data that tracks blood sugar over time for over a week. Afterward, you peel the sensor off slowly, and apply a new one.
Ideally, this would encourage people with diabetes to check their blood sugar more routinely, Jared Watkin, senior vice president of Abbott’s Diabetes Care unit, told Reuters. Often, people will forgo checking their sugar levels as often as they should because finger pricking can be such a nuisance. Right now it’s only marketed for adults, but the company hopes to receive approval for children under 18 as well.
Abbott already has one needle-free blood sugar monitoring system available for the public called the FreeStyle Libre Pro. However, users have to make a special trip to the doctor’s office to have the wire placed under the skin every two weeks. The convenience of using the Flash entirely at home is a significant upgrade, although people will still need to visit their doctor’s office for an initial prescription.
Already, the FreeStyle Libre Flash is available in 41 other countries, the Chicago Tribune reports. There’s no word on how expensive it will be for patients, but in Europe they go for about $69. Abbott says they hope to start selling these devices to the public by the end of the year.

https://qz.com/1090683/blood-glucose-tests-for-diabetes-no-longer-require-finger-pricks/

Can This Be Causing the Rise in Obesity and Diabetes?

From bigthink.com

In 1998 the Firman Bear Report, based on research conducted at Rutgers University, revealed startling data concerning nutrient make-up in organic versus conventional farming. According to the research, tomatoes grown organically contained 1,938 milligrams of iron per hundred grams of dry weight, compared to a single gram in pesticide-laden tomatoes. Potassium was 148.3 mg vs 58.6. Spinach was equally lopsided: 1,584 mg of iron vs 19 mg; 71 mg of calcium vs 16. 

A recent graduate of Rutgers, I was working as a reporter for a Princeton newspaper at the time. For my story I chatted with a local restauranteur, Himanshu Patel, whose wife held a nutrition degree. He was passionate about organic produce. Patel told me that in the fifties American farmers had 22 inches of topsoil to work with, compared to an average of nine inches in the nineties. He concluded: “If it ain’t in the tomato, it ain’t in the sauce.” 

The nutritional benefits of the food we eat is not the result of varied nutrients we can isolate at will, just as our brain is an emergent system: the combination is what matters. Sure, the hippocampus might be where memories are processed, but without the rest of the system it’s rather useless. Yet nutrient composition of food is relevant. If you’re iron deficient and reach for a tomato, soil makes a difference. 

A 2004 study of forty-three garden crops revealed that nutrients suffered greatly over the last half-century. Iron, yes, but also vitamin C, calcium, and protein levels were down. The blame was placed on a familiar culprit: monocropping, a popular agriculture method that yields large amounts of a single crop, season after season, which certainly depletes the soil. Yet some were sceptical this told the whole story. 

Many of the people I talked to in the Princeton region knew the nutritional value of food was plummeting. Yet my story predates a 2002 paper written by Princeton University postdoctoral fellow Irakli Loladze, now a math biologist at Bryan College of Health Sciences in Lincoln, Nebraska. He argues that rising carbon dioxide levels directly affect human nutrition, a stance that was widely rejected at the time. But times have changed.

When Politico recently contacted a number of nutrition experts about this topic, most were perplexed or ignorant of the premise. Loladze speculates that carbon dioxide levels in the atmosphere are increasing carbohydrate levels in plants, which has a direct effect on our nutritional intake as well as obesity and diabetes levels. 

What Loladze is hypothesizing is effectively a biological version of environmental climate change. We might think we’re eating a balanced, plant-heavy diet while we’re actually starving our bodies of the micronutrients we need. At the same time we’re boosting sugar intake thanks to the uptick in carbohydrates, a fascinating and frightening example of interdependence. The faces of climate change might be polar bears and ice calving, but the proof is much closer to home. Inside of our homes, in fact.

Which means the products in your crisper are nutritionally more like dehydrated fruit and vegetables than the freshly picked produce of old. A 2014 study investigating crops in Japan, Australia, and the United States found unnerving drops in iron, zinc, and protein. Loladze responded with his own paper. In it the editor notes that two out of every five calories around the planet come from rice and wheat, and the malnutrition occurring from elevated carbon dioxide levels “lead to reduced growth in childhood, to a reduced ability to fight off infections, and to higher rates of maternal and child deaths.” 

Loladze uses data to ask questions he believes nutrition experts and governmental agencies need to be pondering:

Will rising CO2 concentrations—one of the most certain and pervasive aspects of global climate change—alter the quality of crops and wild plants? Will the CO2-induced stimulation of carbohydrate synthesis increase the carbohydrates-to-minerals ratio in crops? Can such shifts in crop quality affect human nutrition and health?

Give the data he compiles, it is apparent that a spike in carbohydrates is not doing our bodies any good. Is this the root cause of increased obesity and type 2 diabetes we’re witnessing in America and, increasingly, around the world? As stated, the problem is multifactorial. But given the research emerging from this field, we might be in the midst of chronic changes in our physiology. 

During the reporting of my 1998 story, I chatted with Traute Ringwald, who owned a local natural food store. She put at least part of the blame on the customer:

"The consumer really has done a great injustice to farmers by not supporting them and making them triple crop. So now they don’t replace any of the nutrients in the soil because they must sell their product. But they don’t realize that there are 98 nutrients, not three."

If Loladze is correct, the blame falls on all of us. Humans are not separate from the environment, and how we treat it has a direct effect on our health. The alarming upward trend of obesity and diabetes levels over the last century makes it obvious that we’re not treating our planet, or our health, very well. 

http://bigthink.com/21st-century-spirituality/can-this-be-causing-the-rise-in-obesity-and-diabetes

Diabetes: Adding lifestyle changes to medication can deliver a knockout punch

From Harvard.edu

Plenty of research supports the common-sense notion that a healthy lifestyle can prevent or treat many diseases. A diet high in fruits, veggies, whole grains, and plant protein and low in processed carbs, added sugars, saturated fats; regular physical activity; and emotional well-being are the potent treatments that can prevent the need for or even replace many prescription medications.
Yet lifestyle interventions are still not “mainstreamed” into primary care.

The power of lifestyle changes for diabetes

Here is yet another study supporting intensive lifestyle intervention, this time for diabetes. The study authors seem to downplay their findings, which, frankly, baffled me. I’m happy to enthusiastically report that this study strongly confirms what I’ve often observed over the past 15 years in medicine: the way we live and what we put in our mouths can be way more powerful than many of the pills we’re prescribed.
Basically, the study authors recruited 98 people with type 2 (adult-onset) diabetes who were all pretty similar. They had had diabetes for less than 10 years and their blood sugars were not completely out of control (HbA1c* less than 9%); they were not on insulin; they all had a body mass index between 25 and 40 (that is, they were overweight).
They divided people into two groups for a year. Both groups stayed on their regular medications. The standard care group (34 people) received basic counselling and education in type 2 diabetes, including lifestyle advice by a nurse at the start of the study and again every three months.
The other group (64 people) also received a pretty intensive lifestyle intervention:
five to six exercise sessions per week, consisting of 30 to 60 minutes of supervised aerobic activity, along with two to three sessions of weight training

an individualized nutrition plan with dietary counselling, including calorie restriction for the first four months

a smart watch/step counter and encouragement to be physically active in their leisure time (with a goal of at least 10,000 steps per day).

The lifestyle group did have slightly better overall blood sugar control after a year, but the real kicker was this: 73% of the lifestyle participants were able to decrease the dosage of their diabetes medications, compared to only 26% of the standard care group. And, over half of the lifestyle participants could safely discontinue their medications! As a matter of fact, 44% of the standard care group had to have their medications increased during the study, compared to only 11% in the lifestyle group.
*HbA1C is the abbreviation for hemoglobin A1c, the product formed by the attachment of glucose (blood sugar) to hemoglobin (a protein in red blood cells). A test for HbA1c is a useful measure of blood sugar control over time. An HbA1C level between 4% and 5.6% means that blood sugar has been in a good range over the past few months.

Other improvements in measure of health

In addition, the lifestyle group enjoyed significant improvements in pretty much all their measurements: weight (13.2 lbs. lost, compared to 4.4 lbs.), BMI (31 to 29, compared to 32.5 to 32), and abdominal fat (2 lbs. lost, as compared to 0.2 lbs.), with a gain in lean body mass (i.e. muscle). Over a third of the lifestyle group lost over 10% of their body weight, compared with 3% of the standard care group. And the lifestyle folks also experienced a significant improvement in their physical fitness, as measured by a fancy machine measuring oxygen uptake by the body during intense exercise.
The study authors seemed to emphasize that lifestyle improved blood sugar only modestly better than standard care at 12 months. What was incredibly striking, though, was the trend in the blood sugars over the entire year. At six months, the lifestyle group’s HbA1c levels decreased very significantly, from 6.6% to 6.2%, while the standard care group’s HbA1c increased from 6.7% to 6.9%. At 12 months, both groups drifted closer to where they had started, with the lifestyle group still a bit better than the standard care group at 6.3% as compared to 6.6%.

Why is this?

There are two possible reasons. One was that the lifestyle group had fully supervised exercise and dietary counselling sessions (including calorie restriction) for only the first four months, and after that, supervision was progressively decreased, and as a result people were less likely to stick with the program. In fact, the article shows that participation in the exercise and dietary counselling sessions dropped off over the year.
Another factor is that the participants’ diabetes medication was being adjusted throughout the study for health and safety reasons. If the HbA1c dropped below 6.5%, then their medication was decreased, and if it stayed that low or went lower, the medication was discontinued. Likewise, if the HbA1c went above 7.5%, then the medication was increased. The lifestyle group did have more episodes of low blood sugar than the standard care side, and while that can be dangerous, it also signals that the lifestyle participants needed less medication as time went on.
So, it’s reasonable to speculate that if the exercise and dietary session supervision was continuous throughout the study, and if the medications were not continually adjusted, then the results would have shown even greater improvements for the people in the lifestyle group.
And that jibes with previous studies looking at lifestyle intervention for the prevention and treatment of heart disease. There’s so much accumulated evidence supporting lifestyle intervention as a very effective treatment, that major insurance carriers will now cover such programs.
I do hope that patients will realize that lifestyle changes are as good as, and sometimes better than, prescription medications. Primary care doctors need to help them do just that.

https://www.health.harvard.edu/blog/diabetes-adding-lifestyle-changes-medication-can-deliver-knockout-punch-2017092812468

Obesity epidemic fuels record levels of amputations, official figures show

From telegraph.co.uk

Britain’s obesity epidemic is fuelling devastating numbers of amputations - almost all of which could have been prevented, experts have warned.
Official figures show the number of cases have reached an all-time-high, with more than 8,500 procedures carried out last year as a result of diabetes.
Nine in ten cases of the condition are type 2, which is linked to obesity and inactivity.
Official figures from Public Health England show 23 amputations are carried out every day, with a 16 per cent rise in interventions between 2013 and 2016, compared with the previous three years.
Diabetes UK said the findings were “devastating” and often life-threatening - with up to 80 per cent of diabetic patients dying within five years of surgery.
The charity warned that the trend was being fuelled by soaring obesity rates, with two in three adults now overweight or obese.
People with diabetes have an increased risk of foot ulcers, which can deteriorate quickly.
Tam Fry, from the National Obesity Forum, said he was “numb with fury” about the failure of successive Governments to prevent a growing obesity epidemic.
"People are losing limbs and going blind because of diabetes,” he said.
"Successive governments  have done nothing to reduce levels of obesity in the UK and we are now seeing the tragic consequences. I am left numb with fury that we have got to this stage because we failed to tackle obesity.”

Dan Howarth, Diabetes UK’s head of care, said: “The record rates of diabetes-related amputations we’re seeing are being largely fuelled by increasing numbers of people developing diabetes. This is in part linked to the growing number of people living with Type 2 diabetes, which is closely linked to obesity and so, in most cases, can be prevented by maintaining a healthy lifestyle.”
The charity called for urgent NHS improvements to ensure that all patients with diabetes had annual foot checks.
While most cases of diabetes are in themselves avoidable, four in five amputations could still have been prevented, if the right care had been taken, the charity said, urging those with the condition to carry out daily checks on their feet.
Earlier this month the NHS recommended that every single person aged 40 and over should be offered an NHS diabetes check, with millions ordered to go on strict diets by GPs.
The recommendations from the National Institute of Health and Care Excellence (Nice) say slimming lessons and cookery classes should be routinely offered to those whose weight or habits is jeopardising their health.

http://www.telegraph.co.uk/news/2017/09/28/obesity-epidemic-fuels-record-levels-amputations-official-figures/