World Diabetes Day: Understanding the Impact of Diabetes

Today is World Diabetes Day (14th November) as it is the birthday of Sir Frederick Banting who co-discovered insulin together with Charles Best in 1922.  The theme for World Diabetes Day 2024 is "Breaking Barriers, Bridging Gaps" with the goal being to reduce the risk of diabetes and to ensure that everyone who is diagnosed with diabetes has access to quality care, diagnosis and management.

Most people have heard of diabetes and understand it is a serious condition causing blood glucose levels to be too high. Many people will also be aware that there are different types of diabetes and that it can occur when your body either fails to produce enough insulin, or none at all, or where the insulin it does produce is not effective. Some people will have heard of the two main types of diabetes, Type 1 (when you can’t produce any insulin at all), or Type 2 (the most common) where the insulin you do produce is ineffective or sufficient, but there are many other types including gestational diabetes which some women can develop during pregnancy.   

However, unless you, or someone you know well, happens to be one of the 4.3 million people living in the UK with a diagnosis of diabetes, few people will be aware of the potential seriousness of the condition.  Whatever type you have the impact of the diabetes will be that glucose will build up in your blood and too much glucose can cause a number of symptoms and problems which if not properly managed and treated, can sometimes lead to serious complications, which can be life changing.

High glucose levels, over a sustained period of time can impact every part of the body, such as the brain, the eyes, and the feet, and can also result in serious damage to vital organs such as the heart, and kidneys.  These complications can be chronic (long term and which develop gradually over time) or acute (which can happen suddenly or at any time). Whichever the type of complication careful management and treatment is required by healthcare professionals and can lead to serious and permanent damage when the complications are not addressed properly or at all.

Some of the consequences of even well managed diabetes can be challenging, but they can sometimes be devastating if there has been a misdiagnosis, delay in getting the right treatment, or where the incorrect treatment has been received. Those devastating consequences may include:

• Amputation (arising from diabetic foot problems, including damage from poor circulation making sores and cuts much slower to heal, which can lead to serious infections, sepsis and limb loss)
• Blindness: (eye disease, called diabetic retinopathy, may develop and needs to be picked up and treated to prevent sight loss)
• Heart attacks and Stroke: (high blood sugar over a period of time can damage the blood vessels and can lead to heart attack and stroke).
• Kidney failure: (Diabetes can cause damage to your kidneys – known as nephropathy)

Gestational diabetes can develop during pregnancy even if a pregnant person has not been affected by diabetes before and equally requires careful management and monitoring of both the pregnant person and their baby, during the pregnancy. One reason is that the baby, when born, is likely to be larger in size, and this can give rise to complications such as shoulder dystocia, where the baby’s shoulder get stuck at delivery, making delivery much more difficult.   

This should mean more frequent antenatal appointments, regular blood and glucose tests and more frequent scans of the baby to plot the growth and size, to ensure the pregnancy is managed in the safest possible way for both the birthing parent and child. A discussion should take place regarding the risks, the timing of delivery (by 37 weeks) and the options for delivery including caesarean section. Treatment may also involve medication such as Metformin. Each pregnant person will be different and the treatment options need to be kept under careful to review to ensure safety of the birth parent, and the safe delivery of the baby.    

Once again, the consequences of mismanaged gestational diabetes can be devastating, and can result in the baby suffering severe or significant injuries which may be associated with their increased size and the exposure to increased levels of glucose prior to birth. The devastating consequences may include:

• Erb's palsy, arising from damage to the brachial plexus nerves at birth due to the difficulties which can be associated with delivery of a large baby.  
• Neonatal Hypoglycaemia which is a medical emergency and which can cause seizures and permanent neurological injury to the baby if not treated. Neonatal hypoglycaemia is a serious metabolic complication of new-borns, of a diabetic birth parent.
• Cerebral palsy, which can be associated with delay in delivery, or a difficult delivery due to the size, of the baby. 

Although gestational diabetes is less common than Type 1 or Type 2 diabetes it is on the increase and can affect 4-5 in every 100 women during pregnancy, or 1 in 20 pregnancies in the UK.

It is therefore vital to highlight and to raise awareness about the issues surrounding diabetic conditions, not only on this awareness day, 14 November, but every day. 

We recognise that people who have been affected by diabetic related injuries, will often have significant care needs, which very rarely can be wholly met by the Local Authority/ NHS Services. It is therefore vital to investigate potential claims thoroughly and to consider, with the assistance of appropriate independent experts, whether the standard of treatment received was appropriate.

If you come to us, your case will be investigated by our specialist lawyers, led by a partner. We understand the issues and significant complexities involved with claims relating to diabetic related injuries and the devastating impact upon families where there has been an amputation, or other serious permanent damage. We provide a highly sensitive and supportive service.

Our lawyers are recognised by the Legal 500 and Chambers directories as specialists in clinical negligence cases and our team includes lawyers with specialist clinical negligence accreditations from Action against Medical Accidents (AvMA) and the Law Society.

Further information

If you have any questions regarding this blog, please contact Sharon Burkill in our Medical Negligence and Personal Injury team.

About the author

Sharon Burkill  is a Legal Director in the Clinical Negligence and Personal Injury team and has experience in litigating a range of cases including diabetes related injuries.