Birchall Blackburn Law – specialists in claims and compensation for poor treatment of diabetes

Can you claim compensation for poor treatment of diabetes?

Diabetes is a growing medical problem in England and Wales, and it is a difficult condition to diagnose, treat and monitor. The issue of diabetes is further complicated by an underfunded, understaffed and undertrained NHS struggling to cope with growing demand and an aging population. Under these circumstances omissions and errors can occur, which can result in a breach of duty of care and serious injury.

A person who has suffered a serious injury as a result of an error or omission by a medical professional may be able to take legal action to claim compensation.

Clinical (or medical) negligence is a serious breach of the duty of care that medical professionals ethically and legally owe their patients. The breach of care must have caused or materially contributed to the person’s injury.

In cases of diabetes a breach of care could include:

Delay in diagnosis

If doctors and nurses do not heed signs and symptoms of diabetes, this can lead to a delay in diagnosis and the condition going unchecked and therefore untreated. Any delay in diagnosing diabetes, or any misdiagnosis, can lead to a patient developing complications, which can be life-changing.

Poor care and management

Quick diagnosis of diabetes is crucial, but adequate care and management of the condition can make the difference between remaining healthy and developing serious side-effects. Medical professionals must provide advice and treatment that allows diabetic sufferers to stay safe in order to prevent injury.

And if complications develop, such as problems with their feet caused by the blood being restricted, then medical professionals must provide a good standard of care to avoid an amputation.

Inadequate care in the community

Some diabetic patients require care in the community to manage their diabetes and any related conditions.

Vulnerable adults may need regular visits from district nurses in their own home in order to keep them safe. Elderly people within a care home environment will need a good standard of care to manage their diabetes. It is a complicated condition that requires the measuring of blood sugar levels, administering the correct amount of insulin, providing the right diet, and monitoring for infections. Diabetes management is further complicated if the elderly person also has dementia and other medical conditions.

Care homes and community health services are widely regarded as underfunded and understaffed. These pressures will impact on care quality. Temporary or undertrained staff will be used to plug the gap, which is when errors, omissions and neglect can occur.

How much compensation can you expect for a diabetes-related claim?

The amount of compensation a person receives can vary greatly. It will depend on many factors, such as the severity of the physical injuries, psychological and emotional trauma and anxiety, medical expenses incurred, pain and practical impact on the person’s social and financial life, and future care needs.

Depending on the individual’s circumstances some patients will claim compensation for thousands of pounds, while a more severely affected patient – for example, amputation as a result of poor treatment – will require compensation that can amount to millions of pounds.

What is diabetes?

Diabetes is a condition caused by too much sugar (glucose) in the blood. The high blood sugar (glucose) levels develop because the person’s body is not producing enough insulin or the body’s cells are not responding to the insulin properly.

Insulin is naturally produced by the body in the pancreas and is a hormone that converts carbohydrates, like sugars and starches, into energy. It is released into the bloodstream when we eat.

There are two main types of diabetes. Type-1 diabetes is where the body’s immune system attacks and destroys the cells that produce insulin. Type-2 diabetes is where the body does not produce enough insulin, or the body’s cells do not react to insulin.

Currently, 4 million people in the UK have Type-2 diabetes, which accounts for around 90% all adults with diabetes. The number of people with Type-2 diabetes is growing rapidly and is expected to reach 5 million within the next 10 years.

What causes diabetes?

Diabetes can be caused by many factors depending on the individual and their circumstances. Causes can vary from genetic makeup, family history and ethnicity, to lifestyle, health and the environment. Certain drugs have also been associated with the causes of diabetes.

The following may trigger Type-1 diabetes:

  • Underlying genetic disposition
  • Viral or bacterial infection
  • Chemical toxins
  • Unidentified component causing autoimmune reaction

Any or some of the following may increase the risk of Type-2 diabetes:

  • Obesity
  • Living a sedentary lifestyle
  • Increasing age
  • Bad diet
  • Pregnancy or an illness

What are the symptoms of diabetes?

Common symptoms of undiagnosed diabetes include:

  • Feeling very thirsty
  • Urinating more often than usual
  • Increase hunger
  • Dry mouth
  • Feeling tired and lethargic
  • Blurred vision
  • Slow healing wounds
  • Nausea
  • Itchy groin area

The signs and symptoms for Type-1 diabetes will develop quickly and noticeably but Type-2 diabetes symptoms develop slowly, which means the body can be damaged before anything is done to treat the condition and keep it under control.

How is diabetes diagnosed?

If a person is showing any signs of the diabetes symptoms they should see their GP as soon as possible. It is important that a diagnosis is confirmed and treatments start quickly.

Diabetes is diagnosed with blood and urine tests.

The patient’s urine is tested for glucose. If the person’s urine contains glucose, which is should not in normal circumstances, a blood test known as glycated haemoglobin (HbA1c) can be used to confirm a diabetes diagnosis.

How is diabetes treated?

There is no cure for diabetes and symptoms must be minimised by controlling blood glucose levels through diet, exercise and insulin. It is important to keep blood glucose levels at a normal level otherwise serious damage can be done to the body’s organs and serious problems can develop as the person gets older.

Type 1 diabetes is caused by a lack of insulin. This means a person will have to be given insulin to keep glucose levels normal. Insulin is injected directly into the blood steam and there are various ways this can be done depending on the needs and preferences of the person. They will also have to monitor their own blood sugar levels and adjust what they are eating accordingly.

Type 2 diabetes does not often require insulin but may be necessary when other medicines stop working.  There are a number of different medicine that help keep blood sugar levels as normal as possible. The type of medicine a person takes and what dosage will depend on the individual. The patient will work with the doctors and nurses to find a medicine and dose that suits. This will regularly be reviewed as diabetes tends to get worse as the patient ages.

A patient will also be asked to keep to a healthy diet and keeping active to help manage their blood sugar level.

What can go wrong?

People diagnosed with diabetes need to look after themselves, adjust their lifestyles and have regular check-ups.

Medical and care professionals also need to be aware of associated complication when treating diabetics, even if they are treating a diabetic for an unrelated illness or injury.

If blood sugar levels are not controlled, regular check-ups missed or poor treatment give there is a risk of serious complications, such as:

  • Heart disease and stroke
  • Nerve damage
  • Foot sores and infections
  • Loss of vision and blindness
  • Miscarriage and stillbirth
  • Kidney problems

Some of the most serious consequences can occur with misdiagnosis, delayed treatment or inadequate monitoring and aftercare of diabetes. These include:

Amputation

Recent data released by Diabetes UK and based on figures from Public Health England reveal 7,370 amputations per year are carried out due to diabetes. It is estimated that 80% of those amputations are avoidable.

It can start with something as simple as a toe infection or eczema. Diabetics must keep a watch for changes in feeling to the lower extremities (diabetic neuropathy). Checks should be made and diabetic ulcers or eczema monitored. If diabetic ulcers or nail and toe infections are not treated the patient can end up losing a toe, or worse.

Studies have revealed that 80% of amputations begin as foot ulcers which are usually treatable if diagnosed and treated promptly.

A severe obstruction of the arteries (critical limb ischemia) can also occur. This can cut circulation off to a limb, which can – if left unchecked and untreated – end with the amputation of the affected limb.

Diabetes UK has called for the NHS and the government to improve treatment for diabetics in order to reduce the number of amputations required after it was revealed that over 20 amputations per day were being performed in England.

 

Blindness

Diabetic retinopathy affects blood vessels in the light-sensitive tissue that lines the back of the eye, called the retina. It is the most common cause of vision loss among people with diabetes and the leading cause of vision impairment and blindness among working-age adults.

Controlling diabetes can prevent or delay vision loss but because diabetic retinopathy often goes unnoticed until vision loss occurs, people with diabetes should get a comprehensive dilated eye exam at least once a year.

Early detection, timely treatment, and appropriate follow-up care of diabetic eye disease can protect against vision loss.

Kidney failure

Diabetic kidney disease (diabetic nephropathy) is a complication that occurs in some people with diabetes. The disease is caused by damage to small blood vessels, which can cause the vessels to become ‘leaky’ – or even to stop working – making the kidneys work less efficiently. Keeping blood glucose levels as near normal as possible can greatly reduce the risk of kidney disease developing as well as other diabetes complications.

A diabetic should have regular blood and urine tests. Urine will be checked for protein particles, called ‘microalbumin’. If these are present then it is an indication of the first stages of kidney disease because the kidneys have become ‘leaky’. Early detection is very important because at this stage the disease is usually treatable.

Urinary Tract Infection

People with poorly controlled diabetes can be more prone to urinary tract infections (UTI) because glucose in the urine provides a breeding ground for bacteria. In some cases, if the infection persists, it can cause serious damage to the kidneys.

Protein in the urine is a sign of a potential UTI and a medical professional should be aware of this. It is important for people with diabetes to have a UTI diagnosed and receive adequate treatment quickly, or risk permanent damage to their kidneys.

Strokes and heart attacks

Diabetic patients are twice as likely to have a heart attack or stroke. This is partly because diabetes increases the chances of a condition called atherosclerosis. The condition is a form of hardening of the blood vessels, caused by fatty deposits and local tissue reaction in the walls of the arteries. Diabetes increases inflammation and slows blood flow, which dramatically accelerates atherosclerosis.

As the hardening of the arteries develops is can lead to poor circulation in the legs, and stroke and heart conditions such as angina and heart attack. Coronary heart disease is recognised to be the cause of death for 80% of people with diabetes

If a diabetic patient complains of pain in the chest, discomfort in arms, back or shoulders, shortness of breath, irregular heartbeat, swelling of ankles or other signs of a heart condition, it is unacceptable for a doctor or nurse to send a patient home without appropriate tests and treatment.

Degeneration of the nerves

Diabetic neuropathies are a collection of nerve disorders caused by diabetes. People with diabetes can develop nerve damage throughout the body and in every organ system, including the digestive tract, heart, and sex organs. Diabetic neuropathies are caused by many of the abnormalities common to diabetes, such as high blood glucose.

Some people with nerve damage will have no symptoms but others can suffer from pain, tingling, or numbness—loss of feeling—in the hands, arms, feet, and legs.

Healthy lifestyle choices with good care and monitoring can prevent or delay the onset of these nerve conditions. The alternative can lead to a diverse range of problems, including gastroparesis, dizziness, incontinence and sexual problems.

Foot care is particularly important. Diabetics should have a comprehensive foot exam each year to check for neuropathy. People diagnosed with neuropathy need more frequent foot exams to assess the skin, muscles, bones, circulation, and sensation of the feet. Loss of feeling in the feet means that sores or injuries may not be noticed and may become ulcerated or infected. Circulation problems also increase the risk of foot ulcers. If these conditions go undiagnosed and untreated then ultimately it can lead to amputation.