Man with diabetes undergoes amputation to preserve his life

“It’s a massive thing to choose to have a limb removed… but I was in a very dark place.” Glen Paterson, seated in his hospital chair in Cardiff, detailed how the anguish stemming from diabetes-related complications compelled him to make the “massive” decision that would permanently alter his life but ultimately save it. He is one of hundreds of individuals with diabetes in Wales who require drastic medical intervention, and NHS personnel and charitable groups are cautioning about a potential “wave” of amputations amidst increasing rates of the disease. Four years prior, when he developed a minor wound on his heel, the 55-year-old from Caerphilly had no inkling it would nearly prove fatal. That “small crack” failed to heal, and his condition rapidly deteriorated. “The infection was bubbling away and before I knew it I had sepsis.” This life-threatening blood condition rendered him so ill that he was hospitalized multiple times and experienced constant pain. He recounted that enduring that “hole in your foot” for almost four years “took me to a very dark place on more than one occasion.” He elaborated, “It’s the mental pain of sitting down and looking at a wall, you’ve watched everything on all the streaming services… you don’t want to listen to music, turn on the TV or do anything.” Mr. Paterson, who works as a counsellor assisting vulnerable families, has type 2 diabetes, a condition that causes a person’s blood sugar level to become excessively high. It can also diminish blood supply to the feet, damage nerves, and lead to a loss of sensation. Consequently, an individual might not detect an injury, which can result in ulcers, infections, and even amputations. Mr. Paterson stated: “To have to sit down and think – do I have my life taken or do I save it? Do I lose a limb to save my life?” At the University Hospital of Wales’ vascular ward, where Mr. Paterson is recovering, staff are expressing concern about a significant increase in diabetes-related amputations. Ward manager Rhiannon Joseph noted that the majority of the 22 diabetic patients had issues with their feet and circulation, and in some weeks, doctors were performing six or seven amputations. “We’re seeing a lot of patients coming through that are leaving it too late,” she observed. “I think there will come a point when the system becomes overloaded, without a doubt.” For some patients, like Mr. Paterson, the prospect of limb removal can bring relief, but for others, it can be a distressing shock. “If you’ve come into hospital because your toe has gone a funny colour and you’ve got an infection and suddenly we’re telling you your leg has to be amputated… that’s life-changing and it can have a huge impact on patients,” Ms. Joseph explained. Approximately 8% of adults in Wales have diabetes—the highest rate of any UK nation—and if current trends persist, it is estimated that by 2035-36, this could rise to one in 11 adults, affecting between 260,000 and 300,000 people. The number of amputations linked to diabetes in Wales reached 656 in 2021/22. Each procedure costs about £17,000, with an average hospital stay of 20 days, and diabetes accounts for approximately 10%—£500m—of the NHS’s annual budget. Mathew Norman, Diabetes UK Cymru’s deputy director for Wales, indicated that diabetes, if not managed, could be “life-altering.” Apart from losing a limb or vision—another complication—individuals might require guide dogs, crutches, or a wheelchair. People with diabetes are entitled to a series of checks to monitor for complications, but the charity is concerned about a relatively low uptake, with only about 40% of eligible people undergoing them. While type 1 diabetes is a lifelong condition, type 2, which accounts for about 90% of adult cases, typically develops later in life. Individuals cannot make lifestyle changes to lower their risk of type 1, but healthy eating and exercise can reduce the risk of type 2. The Welsh government stated it was investing in various initiatives to help people lead healthier lives but expressed worry about the increase in type 2 diabetes. Dr. Keith Reed, the Welsh government’s deputy chief medical officer for public health, remarked that roughly half of the people with type 2 diabetes “could potentially not have diabetes if they had behaved differently, if the environment had been different or if they had followed a different path.”