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Your guide to diabetic vascular problems

Diabetic

More than one in 17 people in the UK are estimated to be affected with diabetes and around 630,000 people remain undiagnosed.                                                     (Diabetes UK, March 2014)

If you or a member of your family suffers from Type 2 diabetes

Because your blood sugar levels will have been higher than normal, you are also more likely to be affected by vascular disease an abnormal condition of the blood vessels..

If you have Type 2 diabetes and have visited your GP or a doctor complaining of specific symptoms known to be related to Type 2 diabetes

A number of important diagnostic tests should have been carried out to check for vascular disease.

A Delay or failure by a doctor, clinician or a diabetics nurse to correctly diagnose, monitor or provide the appropriate standard of diabetic treatment and care can lead to major, life-changing harm and injury.

The partial or total blockage of an artery can prevent an adequate supply of blood to a part of the body - most often the foot – causing ulcers, infection and, in severe cases, tissue death, which requires amputation of the limb.

Devastating, psychological impact

There can often be a devastating, psychological impact upon both the patient and family if an arm, leg, or even fingers or toes have been removed. This suffering and distress can be further increased if it’s discovered that the loss of a limb could have been prevented if the symptoms of diabetes-related vascular disease had not been missed or treatment delayed.

If you or a member of your family has suffered a preventable amputation, it could take a very long time to come to terms with what has happened, if at all.

We recognise that you may be reluctant to criticise the health professionals who have looked after you or your family, but when a patient receives unacceptable treatment, however complicated their underlying health problems may be, they have the right to have their concerns addressed and to receive compensation if they have suffered a significant injury as a result of that treatment.

Clinical negligence claims need to be conducted by specialist lawyers who understand the complexities of the case. Our dedicated team of specialist solicitors has many years of experience in successfully resolving different types of clinical negligence cases. We can help you find out why the system failed to provide the appropriate care at the right time and, crucially, obtain answers and compensation to ensure that your future financial needs arising because of the negligence are met.  These may include treatment, equipment, support and accommodation.

Insight...

  • Diabetes is the most common reason for lower limb amputation - up to 30 times more likely when compared to the population average.
  • More than 100 amputations are performed every week on those diagnosed with diabetes.
  • More than 6,000 leg, toe or foot amputations are performed each year in the UK as a result of diabetes.
  • 80,000 people (2.5%) with diabetes are estimated to have foot ulcers at any given time.
  • Up to 26% of patients are affected by chronic nerve damage, which reduces sensation in the lower limbs and feet, and contributes to the increased likelihood of ulcers and limb amputation in diabetic patients.

(‘Facts & Stats’ - Diabetes UK, March 2014)

What is diabetic vascular disease?

Known also as peripheral vascular disease – a condition that causes hardening and a subsequent blockage of the arteries.

What causes diabetic vascular disease?

The condition can arise from the onset of Type 2 diabetes and the body’s reduced ability to produce the insulin needed to transport glucose (blood sugar) from the bloodstream into the cells where it’s used to produce energy.

As a result, an excess of blood sugar remains in the bloodstream for a longer period, increasing the likelihood that the blood vessel walls will ‘fur up’ and narrow – a condition known as ‘atherosclerosis’.

A lack of blood flow increases the risk of developing foot ulcers and gangrene which is tissuedeath caused by a lack of oxygen.

If you have Type 2 diabetes

You also have an increased risk of vascular disease if:

  • You are male
  • You have high blood pressure
  • You have high cholesterol levels
  • You smoke
  • You don't exercise
  • You’re overweight
  • You eat a high-fat diet
  • You suffer from stress
  • You have a family history of vascular disease, angina, heart attacks or stroke

Other vascular diseases linked to diabetes

Neuropathy – a nerve condition resulting in a loss of protective sensation in the toes or feet.

The inability to feel a cut or sore could lead to a worsening of the condition and the risk of infection. Damaged nerves supplying the foot muscles may not function properly causing the foot to not align properly. Excess pressure on one area of the foot can lead to foot ulcers.

Retinopathy -  the abnormal growth of blood vessels in the retina, the light-sensitive membrane at the back of the eye.

Nephropathy - a kidney disease caused by damage to the small blood vessels, which reduces their ability to function efficiently or, in some cases, completely fail.

Common symptoms of diabetes-related vascular problems

  • Blurred vision
  • Seeing floating spots– ‘floaters’ – in front of the eyes
  • Swelling of the face or limbs or unexpected weight gain
  • Urine has “foamy” appearance
  • Foot sores
  • Loss of feeling or a burning feeling in hands or feet
  • Pain in the legs when walking
  • High blood pressure
  • Chest pain

Diagnosing a vascular diabetes problem

- what tests should a doctor carry out?

General health - your GP or a doctor should ask questions concerning your general health, medical history, and symptoms.

Blood test – to measure glucose levels, cholesterol levels, urea – waste product in the urine, creatine - supplies energy to the muscle cells, and the rate at which blood is filtered through the kidneys.

Urine test – to detect micro amounts of a protein, which appear at the early stages of diabetic kidney disease.

Kidney biopsy (if necessary) - to confirm the diagnosis or determine the severity of the disease.

Eye test – to evaluate the blood vessels in your retinas and the presence of a retinopathy

ECG testing – to test the heart’s electrical activity by running / walking on a treadmill

ABI (ankle/brachial index) test - to measure blood pressure in the ankle and arm, then compare the two numbers to check if they’re equal. If ankle pressure is half or below arm pressure, it’s likely that the leg arteries have narrowed.

Ultrasound test - to measure the speed of blood flow and structure of leg vessels by using sound waves at a higher frequency than humans can detect, which are reflected back by the arteries and blood cells.

Detecting diabetic foot problems

“...delay in the diagnosis and management of foot problems…..contributes to a higher amputation rate.”                                                                                                              (NHS UK)

You doctor should conduct a regular routine for detecting foot problems, specifically for those diagnosed with diabetes. Care and attention should be paid to the shape, skin condition, foot and ankle pulse, sensitivity to vibration and any deformity or joint rigidity.

If a diabetic food problem is found, a patient should be referred to hospital within 24 hours.

A missed diagnosis, failure or delay to refer a patient to a hospital’s specialist diabetic foot care team can rapidly lead to:

  • Spread of infection
  • Severe deterioration
  • Gangrene
  • Amputation of the affected limbs or digits

How Your Legal Friend can help you...

As experienced medical negligence specialists, we know that investigating a clinical negligence claim may feel like a very big step to take, but we will provide caring support throughout the claims process. Our dedicated team of specialist solicitors have many years of experience in successfully resolving medical negligence claims. We can help you find out why the system failed to provide the appropriate care at the right time and, crucially, obtain answers and compensation to ensure that your future financial needs arising because of the negligence are met.  These may include treatment, equipment, support and accommodation.