At best, someone is diagnosed early with type2 diabetes and manages it through diet and exercise. At worst, people turn up at the emergency departments of Sunshine and Footscray hospitals after a heart attack, with no circulation to limbs that require amputation, with kidney failure, or blind.

"We find out later they've known for years that they've had diabetes and done nothing about it," Associate Professor Hamblin said. "We had a recent case of someone working in their garage and a nail or screw went through their shoe. He's lost half his foot and we're worried he'll lose more."

On any one day, a third of patients across Western Health's three sites have diabetes.

Hospital admission data shows that in the west one in four people with diabetes will develop a diabetes-related foot complication, and of this group 25per cent will get a foot infection, putting them at high risk of amputation.

There are additional complications in working with emerging ethnic communities.

The newest communities to experience high rates of diabetes are the Burmese and Sudanese.

Associate Professor Hamblin said Western Health worked hard to educate patients and GPs on the best ways of managing the condition and ran outreach services to community centres, but it could not keep up with demand.

"The approach [to deal with the epidemic] needs to be broad and right across the spectrum, because we're at the bottom of the cliff trying to catch people and we need someone to put a fence up at the top to stop people from falling."

He estimated that, conservatively, the health system needed two to three times more funding to cope with the diabetes epidemic.

"The magnitude of the problem is so great that if we don't tackle it in a comprehensive way now we'll be paying three, four times the cost [later on] through dialysis and heart disease [treatments]."