Podiatrists says with the right resources and early intervention many amputations could be avoided. (File photo) Photo: JOSE OTO / BSIP
Type two diabetes is leading to record numbers of New Zealanders losing their toes, legs and feet, but experts believe many could be avoided with earlier screening and intervention.
In less than a decade the number of diabetes related lower limb amputations has jumped more than 50 percent, according to an OIA released to Stuff.
The data showed there were nearly 1200 amputations a year in New Zealand - in 2023/24 more than 70 feet were removed and 800 toes, while over 300 amputations happened around or below the knee.
Comparatively, 764 amputations occurred in 2015/16.
Thirteen of the amputations which took place in 2023/24 happened to people with diabetes who were under the age of 30.
Amputation numbers had increased in regions including Northland, Counties Manukau, Auckland, Waikato and Wellington.
Type two diabetes could lead to poor blood flow and nerve damage which can mean cuts and injuries go unnoticed and its harder to fight infections leading to serious complications including amputations.
Podiatrist Lawrence Kingi who saw about 16 patients a day at clinics run through two South Auckland marae, told Checkpoint, early intervention was needed to decrease the numbers of amputations.
Kingi said type two diabetes over time with poor control, could lead to amputation.
"It's the silent killer, where they have no control of their pain so they live with it and it's not until we screen it and find these issues and sometimes it's too late."
Kingi said once infections from open wounds got into the bones, it could lead to amputation.
Diabetes related amputations were a worldwide issue, Kingi said, and for many patients diabetes was hard to manage as it created limitations within the body.
"We need to see them at the top of the cliff rather than the bottom, and need to be more proactive in education."
Kingi said having more podiatrists in New Zealand would reduce the risk for people with diabetes but he believe it was not engaged enough across the board.
"At minimum we should be screening. We need more funding, and initiatives that let us see patients and check their feet."
He said having a podiatrist at dialysis services to manage wounds was one thing he would like to see more of.
"At Middlemore Hospital you'd see patients arriving for dialysis and you could look at their feet and it made a huge difference and reduced amputations by about 10 percent.
"Not sure where that option has gone [now]."
Health New Zealand said early intervention was critical to address diabetes related amputation rates.
It said it was priortising early foot screening and expanding the workforce in high-risk communities.
A spokesperson said a pilot education program was being developed along with a graduate entry masters program to fast-track existing health workers into podiatry.
Health NZ was also considering prescribing rights for podiatrists to expand their clinical capabilities.
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