Lord Rennard’s Experience

We are thankful to Lord Rennard for sharing his story about Foot Drop as a complication of Diabetes. Lord Rennard also discusses the use of an ankle foot orthosis to help with Foot Drop.

My interest in diabetes is long term and personal. My father was one of the first people to benefit from the development of insulin in the 1920s; he developed diabetes probably as a result of the shock he experienced having a leg amputated following injuries to it during the First World War.

Because of insulin he was able to live quite a long life for someone born in 1889. I was born in 1960, when he was 71. His survival for so long was testament to the effectiveness of insulin in saving lives and helping people to live with a condition that, until then, had been known to be fatal for thousands of years.

I was diagnosed with type 2 diabetes at the relatively young age of 34, almost 25 years ago. My lifestyle, related to my work in politics, was extremely poor for a long period. By the time that I was 45, I was on insulin as well as tablets. In my late 40s, I was warned that even the maximum levels of every form of medication available would not sustain me into my 50s unless I changed that lifestyle fundamentally. I have been fortunate to receive great support from the diabetic team at St Thomas’ Hospital. I am pleased that my long-term control, as measured by my HbA1c blood glucose level, has remained at 7.2 for my last three tests. It has been helped by changes in lifestyle, including those that have resulted from a GP referral for some physical fitness training (which I certainly needed) the acquisition of my Fitbit monitor and recognition that I needed to eat more healthily and consume fewer products filled with sugar which for many people is a very addictive ingredient.

My own poor diabetic control some ten years ago is probably responsible for the fact that both my feet now suffer from a condition called foot drop. This means that I need to wear ankle foot orthoses, known as AFOs, and, like all other diabetics, I know that I need to take great care of my feet. It has not been straightforward getting the right devices for them, and the otherwise excellent St Thomas’s Hospital was not very good in relation to Patient Appliances.

I was fortunate in that I do some work for the British Healthcare Trades Association (BHTA), a Trades Association representing the manufacturers of medical devices. When I was presenting their award for lifetime achievement last year, I met William Munro of Munro Rehab, whose brother Ken won the award. William helped me to identify Allard Toe-OFFs as the most appropriate AFO for my feet. Prior to using them, I was not walking well, and alternative devices had not proved to be so good for me. Without any devices, I had a few falls.

I also fortunate to be referred for specialist help to the excellent Christian Pankhurst at the NHS Bowley Close Rehabilitation Centre in Crystal Palace who provided AFOs and appropriate insoles.

As a member of the House of Lords, I speak occasionally about issues connected to diabetes. I took part in a recent debate about ‘flash glucose’ meter monitoring and how it is helping some people with type 1 diabetes to improve their control.

People with type 1 diabetes find it much harder to maintain good control. They need to test their blood with finger-prick tests eight or more times per day and can observe their blood sugar levels increasing rapidly or falling dramatically, sometimes without any apparent explanation. The emergency services are too often called out to assist someone who has collapsed, with some people thinking that they are drunk, when in fact they are suffering from a “hypo”. I experience hypos very rarely, but type 1 diabetics are much more vulnerable to them. Diabetes UK said recently that some 500 people with diabetes die prematurely each week. I regularly read distressing accounts of how more than 6,000 foot amputations per year result from diabetic-related conditions, many of which are preventable. If not managed effectively, poor diabetic control results in loss of sight, kidney disease and a much greater prevalence of strokes and heart disease. People between the ages of 35 and 64 living with type 1 diabetes are three to four times more likely to die prematurely than those without the condition, whilst those in the same age range with type 2 diabetes are up to twice as likely to die prematurely.

Lord Rennard