The Diabetic Foot
Both forms of diabetes are associated with arterial disease, affecting both large and small vessels. In addition to the vascular problems, diabetic patients can also have a sensory neuropathy. Sensory neuropathy is an abnormality of the nerves, whereby the feet become less sensitive. As a result of decreased sensation in the feet, diabetic patients are more likely to injure themselves from simple blisters due to excessive walking, or trauma, such as standing on a nail or a drawing pin, going unnoticed to the patient.
Increased Risk of Infection
Because diabetic patients are more prone to infection, they have to be treated carefully. When any patient presents with an ulcerated area on the foot or toes, diabetes should be excluded. These patients should then have a full history taken and undergo a proper examination.
If there are signs of arterial insufficiency and these signs include diminished pulses, pallor, pain, signs of slow healing or evidence of uncontrolled infection, then a formal vascular assessment should be carried out.
Treatment and Prevention
If large vessel disease is evident, this can be treated with angioplasty or vascular reconstruction. Treatment with antibiotics and surgical removal of superficial dead tissue should also be used.
Because diabetic patients are prone to injury, great care should be given to their footwear. Careful chiropody and appropriate padding in the shoes should be used. Many diabetic foot problems arise simply due to shearing forces in the foot during walking, which result in tissue disruption beneath the surface followed by a cavity, infection and an ulcer.
Medical Negligence and Unnecessary Amputation
Our specialist solicitors have handled many medical negligence cases involving diabetic patients. One of the single most common complaints is that the patient feels they have undergone an unnecessary amputation and that, with proper treatment, this could amputation have been avoided. Amputation is not an inevitable outcome of diabetic foot ulceration.
If the doctor has failed to examine the limb and failed to note the presence of an underlying circulatory insufficiency, this may well represent unacceptable medical practice. Continuing treatment when the medical records clearly illustrate a deterioration is, again, unacceptable. A delay in referral or a failure to appreciate the urgency of the situation may prejudice the outcome.
If you have suffered from diabetic foot and feel this could have been prevented, please contact our medical negligence team today on 01252 471 219.
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