Record Numbers of Diabetes-Related Amputations in New Zealand

New Zealand is facing a growing public health crisis as the number of diabetes-related lower limb amputations reaches record levels. According to the Office of the Inspector of Health (OIA), there were nearly 1,200 amputations in the 2023/24 financial year — a significant increase from 764 in 2015/16. This alarming rise has sparked urgent calls for improved prevention and early intervention strategies.

Of the nearly 1,200 amputations, over 70 feet and 800 toes were removed, with more than 300 occurring at or below the knee. Particularly concerning is the fact that 13 of these amputations were performed on individuals under the age of 30, highlighting a troubling trend among younger populations.

The increase is especially pronounced in certain regions, with Northland, Counties Manukau, Auckland, Waikato, and Wellington reporting the highest numbers of amputations. This regional disparity underscores the need for targeted interventions in high-risk communities.

Type 2 diabetes, which is a major contributor to these amputations, can cause severe complications such as poor blood flow and nerve damage. These conditions can lead to a loss of sensation in the feet, making it difficult for individuals to detect cuts or injuries. If left untreated, these minor wounds can progress to serious infections that may ultimately result in amputation.

Podiatrist Lawrence Kingi, who works with patients on two South Auckland marae, describes diabetes as a 'silent killer.' He explains that many patients live with uncontrolled pain and only discover significant issues when it's too late. 'Infections from open wounds can quickly progress to amputation if not managed early,' he says.

Kingi emphasizes the importance of earlier screening and proactive education to prevent complications before they become severe. He advocates for greater access to podiatrists, particularly in high-risk communities, and supports initiatives such as having podiatrists present at dialysis services. He notes that a similar initiative at Middlemore Hospital helped reduce amputations by about 10 percent, but expresses concern that this model is no longer available.

Health New Zealand has acknowledged the severity of the issue and is taking steps to address it. The organization has prioritized early foot screening and is expanding the workforce in high-risk areas. A pilot education program is being developed, along with a graduate-entry master’s program to fast-track health workers into podiatry. Health NZ is also considering granting prescribing rights to podiatrists to enhance their clinical capabilities.

Experts agree that early intervention is critical to addressing the rising rates of diabetes-related amputations. With the right support and resources, it is possible to prevent many of these complications and improve outcomes for patients with type 2 diabetes.