17 November, 2022
Diabetes is a long term condition causing the blood glucose level to be too high. There are 2 main types of Diabetes;
Potentially reversible diabetic conditions are referred to as prediabetes and gestational diabetes. Prediabetes happens when blood sugar levels are higher than they normally should be, but are not high enough to be called diabetes. Prediabetes can lead to diabetes unless steps are taken to prevent it. Gestational diabetes happens during pregnancy, but may go away after the baby is born.
Insulin is the method by which glucose is taken from the blood and into the body cells to be used for energy. If insulin is not produced or is ineffective this can lead to high levels of sugar in the blood. The management of diabetes depends on the type of diabetes that you have.
However, no matter what type of diabetes you have, it can lead to excess sugar in the blood, which in turn can lead to serious health problems. If blood sugar is not managed effectively through medication and/or lifestyle changes, it can increase the risk of developing heart problems (heart attack/stroke), eye problems (retinopathy), Kidney problems (nephropathy) and foot problems.
Some claims arise whether there has been a failure, often by a GP, to spot the symptoms of diabetes and refer for testing and potentially treatment.
Serious foot complications can develop in diabetes because of nerve damage (neuropathy) and circulation problems (peripheral arterial disease) and can lead to foot ulceration, infection and amputation.
The body's ability to heal wounds and fight infection can be impaired and prompt early identification and management of such foot problems is necessary to avoid amputation.
The National Institute for Health and Care Excellence (NICE) has issued guidance on the appropriate treatment and management for diabetic foot. The guidance states that patients with diabetic foot should receive care within 24 hours of either being admitted to hospital, or detecting diabetic foot problems. This should include a referral to the hospital's multidisciplinary foot care service within 24 hours of the examination.
The NICE guidelines also set out that each care provider or hospital should have a clear pathway for the care of those suffering with diabetic foot issues. This includes across emergency care settings and general practice. It is important to attend regular appointments for foot screening (usually on an annual basis) to identify any symptoms of nerve damage or circulation problems to enable appropriate education to be given to protect your feet. There are a number of risk factors that could indicate you are at an increased risk of developing diabetic foot problems. These are neuropathy, calluses, inflammation, foot deformity and gangrene, amongst others.
If you do develop a cut or blister to your foot and it doesn't heal properly, you must seek help immediately from a health professional who will refer you to an appropriate member of the foot protection team with appropriate knowledge and skills in the management of complex diabetic foot problems. The foot protection team should be led by a podiatrist, but with input from clinicians from diabetology, biomechanics, orthoses and wound care.
Serious diabetic foot problems, that could potentially be life-threatening, include foot ulceration with fever or signs of sepsis, ulceration with ischaemic limbs (poor blood flow), concerns that there are deep-seated soft tissue or bone infections and gangrene.
If an ulcer is present, the size, depth and position of the ulcer should be recorded. The severity of the ulcer will also be recorded, noting whether there are signs of infection. Treatment of foot ulcers includes dressing the wound, debriding the wound (cleaning and removing all dead tissue), controlling the infection, and reducing the pressure on the ulcer by moving the patient's foot or leg.
If a diabetic foot infection is suspected and a wound is present, a tissue or bone sample should be sent for examination. Sometimes an X-Ray will be used to work out how bad the foot issue is. If the sample test confirms that the wound is infected, a course of antibiotics should be started as soon as possible.
If a diabetic patient suffering with foot ulcers also has mobility issues, it is very important that the other limb is also well managed. The fact that foot issues have developed on one side of the body mean that it is increasingly likely that similar issues will develop on the other foot. If the other foot does not appear to be at significant risk of developing foot ulcers, it should still be relieved of pressure and frequently moved. This will ensure that pressure on one area of the foot is not constant, reducing the risk of the other foot developing problems.
Claims relating to diabetic foot problems can often arise where the screening and risk assessment process has not been followed properly, or where the management of the issues after they have developed has been inadequate. If you or a loved one has suffered with diabetic foot problems that you believe were not managed correctly, contact our team of clinical negligence solicitors to see whether you may have a claim. Find out more about diabetes compensation claims due to negligence here.
For more information contact Leonie Millard in our Clinical Negligence department via email or phone on 01254 770517. Alternatively send any question through to Forbes Solicitors via our online Contact Form.
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