As of recently, the United Kingdom has seen an influx of amputations. This has been due to the rising rate of obesity in the region, as the United Nations (UN) Food and Agriculture Organization states that 1 in 4 British adults are obese.
Official statistics have revealed that the number of amputations performed has reached a record high, with the procedures totaling over 8,500 in the last year, all of which were the result of diabetes. Figures reported by Public Health England have shown that 23 amputations are performed each day. This trend has seen a significant increase in the last three years, relative to the amount of amputations previously conducted. The ultimate question behind this surge in amputations is how is it that the English population has gotten to this point?
The ultimate hypothesis surrounding this question is two-fold. The first of the two reasons identified by medical professionals is the fact that England has seen a rise in obesity rates in recent years, as previously mentioned. This may be due in part to a new-found acceptance towards more overweight individuals. The growing commonality is the source of various new tendencies seen in not only the UK, but a wide variety of other developed nations. More citizens are reliant on motor transportation than ever, a large difference relative to times in which it was not uncommon to walk to work or other functions. Another large factor, as stated by the England National Health Service, includes the fact that adults are said to spend an average of 6 hours a day participating in what are known as “sedentary pursuits,” or low-energy activities, such as watching television, reading a book, or spending time on a computer or personal device.
Although, this may be the case, with the population ultimately getting overly complacent, it does not reverse the frightening statistics in regards to this epidemic. A National Health Service report stated that in 2013, the United Kingdom had the highest rate of obesity in western Europe. Some approximations have been made as to how much worse this trend may become over time, with an estimate of over half of the British population becoming obese by the year 2050.
The obesity problem alone is not enough to cause an increase in the amount of amputations performed. This growing occurrence is in fact linked to diabetes, a common result of prolonged obesity in any individual (such would commonly be type 2 diabetes). The rise in diabetes has not been uncommon across the globe, and has come about from a wealth of uninformed citizens, specifically with healthy eating and living education in schools, as well as society.
Why Are Amputations Necessary?
To understand why it is diabetic individuals are required to undergo amputations, it is first necessary to know a basic foundation of what exactly diabetes is. Diabetes is a disease that is grouped into four categories, but the two that are most commonly discussed are Type 1 and Type 2 diabetes. Type 1 diabetes is significantly less common, as it is seen in about 10 out 100 people whom have been diagnosed. With Type 1, the body’s immune system progressively rids of the cells responsible for releasing insulin, and eventually stops the production of these cells altogether. Insulin’s function includes the absorption of glucose, or sugar, and if the cells are not capable of absorbing the body’s sugar intake, the individual is not able to produce the energy needed to help the body function smoothly.
Type 2 diabetes is significantly more common than Type 1, due to the fact that it accounts for roughly 90 to 95 of 100 people who suffer from diabetes. In the case of Type 2 diabetes, the body is not able to properly use insulin, which is known as insulin resistance. Over time, it is possible for the pancreas to create less and less insulin, which is referred to as insulin deficiency. With this specific type of diabetes, it is often seen in adults, but as of recently, the occurrence in children with Type 2 diabetes has been increasing.
In addition to the reduced ability to produce insulin, the body may react to diabetes in other, more serious, consequences: amputations. The point at which this is necessary is when the disease causes severe nerve damage, as well as poor blood flow. The nerve damage is known as peripheral neuropathy, which in more severe cases can cause one to not be able to feel pain. This brings serious issues, as someone with peripheral neuropathy may not be able to feel wounds or ulcers developing on their feet. Continuing to not notice the damage and putting pressure on the affected region can worsen the condition, to the point of needing an amputation.
As far as the poor circulation, this is due to what is called peripheral artery disease (PAD). The blood vessels within the body begin to narrow and reduce circulation due to PAD, which can ultimately slow the body’s natural ability to heal its own wounds. This inability for the wounds to heal can lead the way towards tissue damage, with any existent infection making its way to the bone. Of the diabetes-related cases, the most common amputations are seen in the toes, feet, and lower legs.
How to Solve the Epidemic
When asked about the problem surrounding the growing number of diabetes-related amputations, head of care for Diabetes UK, Dan Howarth, states, “This is in part linked to to the growing number of people living with Type 2 diabetes, which is closely linked obesity and so, in most cases, can be prevented by maintaining a healthy lifestyle.” This being said, a good diet and consistent workout plan can prove to be the solution to preventing these diabetes-induced amputations. Although this may be true, it is important to understand how a community can further their health by remaining active. Professor Susan Jebb of Oxford University makes the point that “Your likelihood of being active is shaped by the environment you live in. For example, you’re more likely to ride a bike if there are safe and convenient cycle lanes.” For the United Kingdom to make significant progress in this present crisis, taking into account the accessibility for exercise will be of the utmost importance. This can mean the development of more walking trails, biking lanes, as well exercise gyms, within accessible limits for citizens.
One of the most imperative ways in which diabetics have the opportunity to cease amputations also consists of diligence when it comes to identifying growing ulcers and sores. This can be as simple as routine checks every day on the aforementioned limbs of one’s body, such as feet, toes, and the lower part of the legs. Although the process appears easy on the surface, it can make a huge difference in preventing further damage due to peripheral artery disease or peripheral neuropathy.
With this unfortunate trend in the UK, there is still hope. If entities such as the government are able to step in and shine more light on this epidemic, the population can be very well prepared to reverse the rising amputations performed every year. Although this may prove to be a daunting task, with the right resources being utilized, this western European region can conquer this problem one case at a time.