Delayed Treatment

How common are diabetic amputations due to delayed treatment?

Updated: 14th Nov 2020
diabetic amputation due to delayed treatment
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Medical Negligence Solicitor and Partner - LLB (Hons) University of Mid-Glamorgan

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Diabetes is one of the UK’s biggest health concerns. Today, it is estimated that 4.8 million people are living with diabetes, with 90% of these falling into the Type 2 category. By 2035, it is predicted to affect nearly 10% of the entire UK population.

While huge strides have been made to treat and manage the condition of diabetes, if the diagnosis is delayed or missed by medical professionals, it can lead to a number of ongoing and life-altering complications, including the topic of this article – diabetic amputations.

The NHS states that people with diabetes are 15 times more likely to need an amputation than someone without the condition, and it is believed that, worldwide, someone loses a foot to diabetes every 20 seconds.

An amputation is a highly emotional and challenging experience for someone to go through. They will experience dramatic changes in lifestyle such as becoming accustomed to prosthetics, crutches or wheelchairs and adapting the home to meet these changes.

In this article, we will discuss how delayed treatment plays a factor in amputations caused by diabetes, and what someone can do if this affects them.

How can diabetes result in amputations?

Diabetes can cause those with the condition to experience diabetic neuropathy, which is a loss of feeling, tingling or pain in the extremities, most commonly the feet. This is due to high glucose levels in the blood damaging the small vessels. This may mean that if someone was suffering from a foot injury, they might not be aware of it happening, nor feel discomfort when they would otherwise be in a lot of pain.

In addition, diabetes is linked to people having vascular problems, meaning blood circulation is restricted to parts of the body, especially the limbs. This means wounds do not heal as quickly as they otherwise would, allowing infections or ulcers to develop when an injury does occur.

It is believed that for 80% of all patients who have required a diabetes-related amputation, it started as a completely treatable foot ulcer, the cause of which can be split into three broad categories:

Peripheral Neuropathy

Numbness in the nerves making someone with diabetes more susceptible to cuts, bruises and other injuries to the feet.

Peripheral Arterial Disease

Gradual blockage of the arteries in the legs restrict the flow of blood to these areas of the body and so make healing more difficult.

Charcot Foot

Degeneration of bones and joints in the feet that may be triggered by minor trauma and, if left untreated, can lead to deformities or amputation.

Approximately four-fifths of ulcers are preventable and, if they are left untreated or unidentified, they can become infected or face other complications, which may eventually lead to amputation to prevent infections spreading to other areas of the body.

Due to this heightened potential for foot injuries to be missed by diabetic patients which may then lead to the need for amputation, it is highly recommended that diabetics receive check-ups with a podiatrist. They should also carry out their own foot care routines, including frequent cleaning, wearing comfortable shoes and regularly cutting and filing toenails.

How common are amputations for diabetics?

As highlighted earlier, you are 15 times more likely to require an amputation at some stage of your life if you are diabetic. Between 2015-2018, 27,465 amputations were performed for diabetic patients, with an average of 176 toe, foot or leg amputations taking place every week.

It is important here to distinguish between a minor amputation, which refers to a toe or foot amputation, and a major amputation, which is a leg amputation below or above the knee. In the span of 2015-2018, 7,545 major amputations took place, a rise of 2011-2014’s 6,957 cases. In addition:

  • In England there were 147,067 hospital stays for diabetic foot disease from 2015-2018
  • The number of days in the hospital for these ailments totalled 1,826,734
  • Men were more likely to face major amputations as a result of diabetes

Moreover, if a diabetic patient has an amputation, it increases their risk of requiring further amputations in later life, making the long-term implications of this even more significant.

This demonstrates that diabetic amputations are rising as the number of people with diabetes also grows. Sadly, many of these could have been prevented if earlier action had been taken, and sometimes the lack of earlier action is due to the negligence of healthcare professionals.

Delayed treatment: are amputations caused by negligence?

In an unfortunate number of cases each year, amputations are the result of a GP or other healthcare professional failing to identify signs of foot injuries, not intervening fast enough or delaying treatment due to misjudging the severity of the injury or infection.

For diabetic patients, foot ulcers should never be ignored or treated lightly, as even if the patient does not register any pain or discomfort, this is not a definitive indication that the foot is not badly injured or in need of treatment.

The National Institute for Health and Care Excellence (NICE) has established the guidelines that healthcare professionals should follow to diagnose and treat patients who present with any limb-threatening or life-threatening problem. Treatment may include:

  • Offloading, or relieving pressure on the foot
  • Controlling any infection or ischaemia (reduced blood/oxygen supply)
  • Wound debridement (removal of devitalised tissue)
  • Dressing the wound

Not adhering to these regulations or delaying the referral of a patient could be negligent. It is also important that any treatment is carried out correctly, because using the wrong dressing for a wound can worsen problems for the person affected.

It should also be noted here that delayed treatment resulting in amputation for diabetics does not solely apply to GPs, and claims can be issued against practice nurses, podiatrists, orthopaedic surgeons, and other professionals who should be in a position to recognise and address incidents of a foot injury before amputation is required.

Sadly, instances of professionals failing to refer cases soon enough is not uncommon. It is possible that a healthcare professional might underestimate the severity of cuts, blisters and ulcers present on a patient’s foot, not carry out all the necessary precautionary treatments, or not refer the patient promptly for an assessment by an endocrinologist or vascular specialist.

This can result in warning signs being missed and, so that by the time the situation deteriorates further, amputation is the only option. Other potential delays or missteps by healthcare professionals include:

  • Poor management of infections
  • Delayed diagnosis of any vascular problems
  • Failing to avoid pressure sores (bedsores)

Claiming for amputations caused by diabetes

Not receiving the right treatment at the right time can have devastating consequences for those affected by diabetes. It can be the difference between a patient requiring medicine or a minor surgical procedure, and the need for an amputation or other irreversible outcomes.

Fortunately, the vast majority of care and treatment carried out by medical teams across the UK are performed to the highest standards, minimising the instances of preventable amputations. But, whether as the result of a misdiagnosis or a failure to respond to changing conditions, it is possible for delayed or negligent treatment to result in significant, avoidable harm.

While we can’t turn back the clock, if you have suffered as a result of treatment that came later than it should have, our solicitors are in your corner. With decades of experience across all areas of medical negligence, we will investigate your situation, let you know if you have a claim, and work tirelessly to ensure you receive the justice and compensation you deserve.

Speak to the specialists – contact our team today.


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