In other words, his patients would rather continue doing what they're doing and lose their toes than change to a healthier lifestyle! And his patients are probably not unique!
Here's the kicker: type 2 diabetes is caused by diet and lifestyle. Consuming a diet that's high in simple, refined carbohydrates can cause insulin resistance, a condition of type 2 diabetes in which the insulin produced by the pancreas to usher the excess blood glucose into cells to be used for energy and storage stops doing it's job, leaving blood glucose levels high. Since most diabetics tend to be overweight or obese, they are also likely consuming a diet high in saturated fat and cholesterol, increasing their already greater risk of complications, including high blood pressure, heart attack, and stroke, not to mention blindness, kidney disease, and loss of limbs (as this Podiatrist encounters routinely).
It turns out that type 2 diabetes can be prevented and even treated in many cases with a whole food plant-based diet, which is rich in complex carbohydrates and eliminates simple, refined carbohydrates as well as animal-based fats and cholesterol (or at the very least a greatly reduced intake of animal-based foods). As a bonus, this diet also treats obesity (I'm not even addressing the benefits of a whole food plant-based diet on prevention and treatment of other chronic diseases such as cancer, heart disease, and stroke).
So, is eating a whole food plant-based diet really more extreme than having your toes or other parts of your body cut off?