RISING numbers of diabetes patients are needing to have their limbs amputated as the country's obesity epidemic grows, figures have revealed.
A total of 683 people underwent NHS Scotland surgery to remove their feet and legs last year, an increase of 32 per cent from two years earlier when 521 had the operation.
The official figures also reveal that 139 people suffering from diabetes or a build-up of fat in the arteries have died in theatre in the last four years.
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The health service has spent almost £230 million in three years on drugs to treat the conditions.
NHS Greater Glasgow and Clyde was the health board with the highest number of amputations in 2013, with 132 treatments. It was followed by Grampian, with 93.
Last year's statistics suggest that nearly 250,000 people, or five per cent of the population, have diabetes.
Dr Jean Turner, executive director of the Scotland Patients Association, described the epidemic highlighted by the figures as a "ticking time bomb" with bad diets, smoking and lack of exercise to blame.
She said: "As the nation gets heavier there is a higher prevalence of diabetes and so more and more people need amputations. The problem is spiralling out of control.
"Some people can't cut their toenails and they have poor circulation. If they get a cut and they have diabetes then they are highly likely to get an infection.
"If more people are losing limbs then this means a much greater cost to the health service, not just the expensive operation, but the prosthesis, cost of a wheelchair and the physiotherapy needed to learn how to walk. They are also much less able to look after themselves."
The former GP highlighted the need to educate youngsters about the importance of leading a healthy lifestyle.
"Children need to be taught from a very young age that taking regular exercise and eating a balanced diet is absolutely crucial," she said.
"They need to be able to spot the danger signs of diabetes."
Diabetes is a lifelong condition that causes a person's blood sugar level to become too high over a prolonged period. Excessive body weight and lack of exercise are often thought to cause Type 2, but the cause of Type 1 is unknown.
Total amputations due to complications from diabetes and peripheral vascular disease have increased by 20 per cent, from 1,062 in 2011 to 1,267 in 2013.
Peripheral vascular disease develops when a build-up of fatty deposits in the arteries restricts blood supply to leg muscles.
Scottish Conservative health spokesman Jackson Carlaw said: "This is another reminder about just how huge a challenge illnesses linked to lifestyle are becoming.
"Diabetes is one such condition, and we know that in many cases a healthier diet and more active lifestyle could have helped ward it off.
"While the NHS and Scottish Government have to work hard on awareness issues, it also comes down to personal responsibility."
More than 268,154 people were diagnosed with diabetes in 2013, up from 258,570 in 2012.
The Government said it had successfully rolled out a system that identifies diabetes patients at the highest risk of developing foot problems, and expected the number of amputations to fall over the coming years.
Type 2 diabetes sufferer Steve Graham, 75, had a toe and part of his foot amputated in 2002.
Mr Graham, of Aberdeenshire, said there are still mixed messages from the authorities about the need for suffers to take exercise.
"This type of problem is just going to get worse and worse if something isn't done about obesity," he added.