>>Dr Jonathan Valabhji: Here at Imperial we've had a focus on diabetes on diagnosis and
treatment and care for people with both type 1 and type 2 diabetes for a number of decades.
Diabetes over many years can damaged nerves so the people develop numbness in their feet
they can no longer feel their feet so imagine if you're walking down the street and you
get a stone in your shoe it hurts and so you do something about it. If you don't feel
that stone in your shoe you carry on walking until the stone potentially makes a hole in
your foot. The fact is that people can in the worst-case scenarios lose a limb, lose
a leg
>>Linda Bloomfield: So this is their primary lesion that we've been treating Mr. Mcready
for since September. It’s certainly a lot small and less deep than it has been and it
has been and it currently shows no sign of infection. As podiatrists what we have to
do is keep on top of the callus formation, that span the lesion if we allow that develop
and it can cause and further breakdown beneath it. That’s why we often see Mr Mcready
twice a week if not certainly once a week; for wound dressing and just to make sure things haven’t
deteriorated.
As specialist podiatrists we are very much involved in the treatment and assessment of diabetic
foot complications. With ulceration we are particularly concerned about the development
of infection which can be a precursor to an amputation which is what we're very much trying
to avoid. We will be reviewing him with our modern disciplinary team in a few weeks’
time which includes our vascular surgeons, just to review if there is anything further we
can and should be doing to promote faster healing. An open wound can always become
infected so we do need to be doing our utmost make sure are healing healing as quickly as
possible.
>>Ken Mcready: I just wasn't aware enough of the dangers of where having a high blood
sugar level the damage it could be doing. Because I have severe neuropathy, certainly
in the amputation of the other toe the other toe I didn't feel it; I never had moments
pain or discomfort however this is the big toe and the effect on that maybe a little
bit more severe on me I don't know.
Literally lose weight and check what you're
eating you know people are not aware of how to analyse what food they're eating because you
have a loaf of bread this got natural sugars but it's going to add sugar already in it.
>>Dr Jonathan Valabhji: We want to reduce the risk of people developing type 2 diabetes
and that's what the NHS that that's what the healthier You: NHS Diabetes Prevention
Programme aims to do. People who have been identified to be in the high-risk category can now be
referred into programmes generally speaking it's a nine-month intervention it involves
at least 13 face-to-face meetings with a health coach or health trainer who will use behavioural
change techniques to inform people about the importance of and how to make changes
in real-life settings around diet so that they can lose weight increase the physical activity
and improve the nutritional quality of their food intake.