If not precisely treated ankle fractures in patients with diabetes could lead to very serious or even dire consequences. Below we discuss ways to reduce these risks and how to improve patient outcomes. Diabetic patients with a fractured ankle can present clinicians with problems in both operative as well as operative care. Complications which may arise, such as vasculopathy and neuropathy can be compounded by other recovery issues which happen more frequently in those with diabetes. For diabetic patients with a fractured ankle this guide has full information on ankle fractures and how to recover visit this link The Health Experts to help increased chance of successful and shorter recovery time.
For many patients, these chronic problems will not present until they have a fractured ankle or broken ankle. Diabetic ankle fractures can lead to complications such as:
- Higher infection risks.
- Delayed union, nonunion, malunion.
- Charcot arthropathy.
Additionally, wounds which do not heal as well. Such complications can compound a routine injury such as a broken ankle and lead to ankle fracture complications from diabetes, resulting in loss of a limb in extreme cases. In cases where there the patient has diabetes and broken bones in their foot or ankle, it is critical staff are aware of how to treat the patient
Some relevant statistics from the US CDC show that in the USA,
- 25.8 million people has type 1 diabetes.
- A greater percentage of these are over 65.
- Between 1988 and 2000, of 160,000 people treated for a fractured ankle, 5.71% also had type 2 diabetes.
Findings From Studies Of Diabetic Patients With Ankle Fractures
There are many studies which look at diabetes and healing broken bones, such as ankle fracture complications with diabetes. These have shown that patients both diabetes and a broken ankle have higher chances of complications such as those listed above. One such study showed that risks were 2.74 times higher in patients with a broken ankle and diabetes than those presenting without diabetes.
31% of diabetic patients with ankle fractures suffered complications, in comparison to 17% of non-diabetic patients. Another study also looked at the results of fourteen diabetic open ankle fractures. Eight of these developed complications and five lead to amputations. Of the fourteen, just three did not suffer any complications.
Information For Treating Ankle Fractures In Diabetic Patients
An important part of treatment of ankle fractures in patients with diabetes is monitoring and tight glycemic control. It has been shown maintaining control of levels of glucose can help broken ankle wounds to heal. This has also been shown in studies of rat models. A comparative study of rats with and without insulin treatments show improved healing in the treated group. A reduction of hemoglobin A1c levels by 1% lead to a fall in the rate of complications of 25% – 30%. This underscores how important it is to properly control glucose levels to reduce the chance of complications of ankle fracture in patients with diabetes. If you are unsure if you have broken your ankle visit this NHS page on how do i know i have broken a bone?.
It is also necessary to address ischemia which can impede the healing of wounds and fractures. Peripheral arterial disease can be detected by using the ankle-brachial index. Other evaluation methods include measuring transcutaneous oxygen tension. These values help to predict rates of healing in diabetic ankle fractures. Lower values indicate the need for an xray of the blood vessels. Abnormal findings need to be evaluated by vascular specialist.
There are different ideas for how to treat patients with diabetic ankle fractures and there are few studies which specifically look at this. One study showed that surgical treatment resulted in complications for around 47% of patients. This contrasted to no complications in those treated in a more conservative way. Thus it was recommended that surgery is avoided where possible. Another study reviews the outcome of 28 (neuropathic) diabetic ankle fractures who all had more conservative treatment. This included immobilisation and rest. All patients healed with no complications.
Conversely, another study showed that patients with insulin-dependent diabetes and ankle fractures who were treated non-surgically all suffered one or more complications. One of the six patients even required an amputation. This study recommended early surgical treatment. Displaced fractures do require surgical intervention. But, surgical staff must take steps to reduce the risk of ankle fracture surgery in diabetic patients.
Treatment protocols should be adhered to in order to reduce the risk of complications of ankle fracture in patients with diabetes.
- The broken ankle and the surrounding soft tissue should be assessed to help determine the right treatment.
- If required, you should perform a closed reduction of the ankle fracture if there is gross disfigurement. This helps to avoid ischemic complications and problems with the wound.
- The stability of the fracture or break should also be assessed. A splint or other methods can be used to encourage stability in the joint.
- If necessary, external fixators could be used to facilitate surgical interventions in fractures which are unstable.
Various authors of studies have shown that lower rates of complications with regards to diabetes and healing broken bones with staged protocols in a patient with what is called a ‘high energy’ pilon fracture. These patients are comparable to diabetic patients. Both groups have a higher risk of complications and require soft tissues to be stabalised prior to open treatments.
As a patient who has diabetes is at a higher risk of suffering complications, it can be harder to avoid these complications. Treatment strategies for broken or fractured ankles could include;
- Using external fixators to stabalise the injury and accommodate soft tissue injuries.
- Use multiple debridements.
- Use of antibiotics and antibiotic implants.
- Closing the wound with skin grafts or flaps.
- Definitive treatment through arthrodesis.
What conclusions can we draw about the complications of ankle fracture in patients with diabetes? There are higher risks for this category of patient and conditions such as vasculopathy, neuropathy and delayed healing can transform a routine injury into one which threatens the limb as a whole. Correct management of diabetic symptoms, such as glucose levels is crucial to avoid said complications. Whilst there are many surgical and non-surgical options for treatment, management of the soft tissues and maintaining stability in the injury are essential. If complications do arise, a strategy using surgery and other treatments will be needed to prevent you losing a limb.
Misdiagnosis is just one type of medical negligence that can take place. Medical negligence or as it is more broadly being considered as clinical negligence is professional negligence that has been committed by a healthcare worker that can range from any type of doctor to a person who cares for a person professionally and has allowed the service or treatment that they have provided to fall below what is expected. In order for a claim of clinical negligence to be brought before a court such harm must have been caused to the patient as a direct result of the negligence incident.
What is Medical Misdiagnosis?
There are three main types of misdiagnosis both have a serious effect on the health of a person and can have a domino effect on their future health. These three main types include;
- Delayed Diagnosis – this can happen when a person attends their GP or hospital with certain symptoms but the doctor cannot find an illness that aligns with the symptoms they are suffering and therefore cannot find anything wrong with them. However further on in time they are actually diagnosed with an illness or condition that should have been picked up on during the visits and as a consequence their health as deteriorated.
- Incorrect Diagnosis – this may take place when a patient presents varies symptoms and the physician incorrectly diagnosis it for a totally different condition than it is. Or this may happen if diagnostic tests and other investigative tests are read wrongly and therefore the condition is mistaken for another illness or sickness.
- Total Misdiagnosis – it is not always clear when a patient is showing certain symptoms what exactly is wrong with them and symptoms may often mask other illnesses but to totally be misdiagnosed means the doctor cannot find out what is causing the symptoms even though the person appears ill.
What are the Causes of Medical Misdiagnosis?
Medical misdiagnosis can happen for varies different reasons and a lack of medical knowledge may be one of them. If you feel that you have been misdiagnosed in any way and as a result this has had a damaging effect on your health then you can look to make a claim for compensation by contacting UK medical negligence no win no fee solicitors to find out if you have valid claim for misdiagnosis medical negligence. Some doctors, very few may not be able to spot patterns of symptoms that relate to a certain illness or may not be able to recognise the illness that has been presented to them by a patient and therefore cannot give a diagnosis. It is possible for doctors to read diagnostic testing wrong and information that is present may not be evaluated correctly by whoever is reading the results. Reading and examining data can play a big part in a person being correctly diagnosed as the information and results that may have been gathered may have passed through varies hands and updated by variety of people and if just one person gets something incorrect this can have a knock on affect to the rest of the data gathered. Also if you want to get free advice it’s important to use a no win no fee solicitor, that way you will not be charged any money for advice and starting the starting the claim.
Delayed diagnosis can be caused through the right diagnostics tests not being issued which may be a result of the physician being unsure of what the illness it may be, then it might be a case of not knowing which diagnostics tests to use. Without using diagnostics test such as X-rays, MRI’S and CT scans it may be almost impossible to be clear on what a person is suffering from. Such tests are designed to see what the eye cant for obvious reasons as we cannot see inside the body using such tests may be the key to giving a precise diagnosis when unsure
How can Diabetes be Medically Misdiagnosed?
Diabetes is an umbrella term given to a variety of metabolic disorders that find it difficulty in processing and storing sugar. It is one of the leading illnesses that can cause fatality if not diagnosed correctly and early on so that medication can be used to help manage the illness and possibly eliminate it completely. There are different types of diabetes and with them comes a variety of different symptoms. Diabetic symptoms can be very few and far between and some can be much exaggerated depending on the type of diabetes i.e. type 1 or type 2 and depending on the person. Therefore based on symptoms alone it is not always simple to diagnose diabetes as it effects people differently.
In general diagnosing diabetes is not difficult especially when diagnosing type 1 diabetes which usually start off at a young age and can come on quite heavy. However type 2 diabetes and gestational diabetes the type that affects pregnant women may not always show clear signs of the illness and therefore may be either mistaken for another sickness or may be totally missed altogether. More information about diabetes can be obtained from National Diabetes Information Clearing House.
What are the Consequences of Diabetes being Delayed in Diagnosis?
Diabetes is a very serious condition and if left undiagnosed or even in the case of delayed diagnosis can have serious effects on the life of the sufferer. Diabetics can have a high volume of hypoglycaemic in their blood and if such a volume is not control or diagnosed can cause some serious long term complication such as blindness, kidney failure, birth defects, heart disease, stroke, disability and even more illnesses. It is vital that any symptoms that are related to diabetes are checked out immediately by a doctor as early diagnosis can prevent a life time of suffering.
Muslims residing in Britain that have been diagnosed with diabetes are hesitant to see their general practitioners during Ramadan, because they will be informed that they cannot engage in fasting. However, despite the risks that are associated with fasting, there are many Muslims residing in the UK, which will put their lives at risks to engage in the activities surrounding the event.
During the holy month, Muslims throughout the United Kingdom will engage in fasting, and not inform their doctors of the dietary choices that are making at the time. Studies published in the Keele journal entitled Health Expectations, has uncovered that Muslims that have diabetes will choose not to tell their GPs of their dietary choices, until the holy month has completed. Doctor Patel, a leading author informed DW that there are a lot of people that are afraid of speaking with their doctors or nurses about how to manage their diabetic conditions.
This is especially true, during the month of Ramadan. Muslims know that they will be told by their general practitioner that they are not allowed to engage in the fasting activities that surround Ramadan. Muslims also figured that if they spoke with their nurses or doctors, they would not understand how significant the holiday is to the Muslim people. Even though most Muslims do fast during the holy time, the Quran does outline a few exceptions to the practice.
According to the Quran, Muslims are informed that they need to refrain from food, during the daylight hours that fall within the Ramadan holiday. This year the holiday begins on the twenty eighth or twenty ninth of June and lasts for thirty days. However, even though the Quran clearly outlines that all Muslims should fast during this time, there are some instances where Muslims can be exempt from having to engage in this religious activity.
Dr Patel, explains that according to the Quran, Muslims can be exempt from fasting if they are sick, menstruating, or travelling. Even though diabetes is categorized as an illness, there are a lot of Muslims that believe that their diabetic condition does not qualify as one. Thinking from this frame of mind, the Muslims suffering from diabetes choose to fast, even though they should not.
Muslims suffering from diabetes that choose to fast, can be hurting themselves immensely. Fasting can adversely affect the way that diabetics control their condition, along with cause dehydration. Over the long term, fasting can increase a diabetic’s chance of mortality. Authors are calling for more information regarding the Ramadan holiday, and insightful pieces of literature to be able to disperse to the Muslim population during this time.
Community leaders have recognised that diabetic Muslims that choose to fast during Ramadan, need to recognise the risks associated with their actions. Leaders are working to address the issues that arise when Ramadan comes around. At times, making the people address the problems associated with their actions seems to be an uphill struggle.
Mr. Diwan who practices at a mosque in Manchester, admits that when visiting patients during Ramadan, that the patients give him every excuse regarding the reasons why they chose to fast. He states that many Muslims that have diabetes have been fasting for twenty or thirty years, telling these individuals that they are unable to fast due to their medical problems, makes them feel guilty that they are not abiding by what the Quran states.
Statistics state that nearly 325,000 Muslims residing in the UK suffer from diabetes. The figures have steadily increased overtime. Reaching patients, while their conditions can be controlled has become burdensome. Patients refuse to seek the proper assistance that they require to control their condition during the holy Holiday of Ramadan.
More than one third of individuals residing in England are on the verge of developing type-2 diabetes. A recent report released by the British Medical Journal states that there has been a rapid increase in the amount of people suffering from diabetes, since 2003. Authors are predicting a rapid increase in type-2 diabetic conditions within the upcoming years.
This prediction comes from the medical journal, as a result of the life choices that people residing in the UK are making. The consequences of diabetes are decreased life expectancy and increased disabilities. The Diabetes foundation states that the NHS has already spent one tenth of their budget, on helping individuals who have diabetes, get the assistance that they require.
People in the beginning stages of the condition, do not experience any symptoms. However, the level of sugar in their blood varies. When an individual’s sugar levels become exceptionally high, this means that they are on the brinks of developing diabetes. Roughly five to ten percent of people that are in the pre-diabetic state will go on to develop type-2 diabetes, within a year of the initial diagnosis.
The study analyzed health surveys that were given in England during 2003 till 2011. When the survey initially launched, back in 2003, 11.6 percent of adults that were surveyed were in the beginning stage of diabetes. However, when the survey was conducted in 2011, nearly 35.3 percent of adults that were surveyed were suffering with pre-diabetes.
Three years ago, Ms. Helen Barker, from East Yorkshire, was told by her general practitioner that she was following in the footsteps of her brother and father. Ms. Barkers brother and father were both diagnosed with type-2 diabetes, and Helen was quickly on the way to receiving the diagnosis as well. Ms. Barker was told that her glucose levels were not where they needed to be.
Doctors informed the thirty nine year old that she would have to change her current lifestyle, and also watch the things that she ate. Helen was also informed that she needed to exercise more often as well. Helen followed the instructions of her doctors and lost five stones as a result. In a private interview, Helen admitted that following the doctor’s advice, when she was initially told, helped her to avoid getting diabetes.
She stated that her father, whom suffers from the condition, is forced to deal with a plethora of health issues. He is unable to operate a motor vehicle, due to the damage that having diabetes has done to his eyes, and he is being prepped to begin going through kidney dialysis. She believes that if her father would have known sooner that he could have done the same thing that she did to avoid being conflicted with the condition, that things for him would be different today.
Professor Baker, who is one of the authors in control of performing the survey, that noticed the increase in diabetes within England, states that the levels continue to increase steadily within Europe. However, it is not just England that is seeing an increase in cases, many countries, all over the world are also noticing an increase as well. There are a lot of people that have type-2 diabetes that have taught themselves how to properly manage the condition. But, some people are forced to endure other complications when they become afflicted.
The complications that could arise with type-2 diabetes are severe. Individuals who are unlucky to obtain the condition can experience: blood vessel damage, blindness, nerve damage, damage to the kidneys, increased risk of impotence, as well as decreased sexual performance. There are some great programs that the health services are attempting to put into play, to assist people who may be at risk of conflicting the condition. Anyone over forty should be properly tested on a yearly basis, to ensure that they are not on the verge of developing type-2 diabetes, or are already plagued by the condition.
Researchers have uncovered that the downside that goes along with taking medication to control type-2 diabetes symptoms may outweigh the benefits, when it comes to some patients. A study performed by researchers published within the JAMA journal of internal medicine, found that elderly people who are taking medication to control their type-2 diabetes condition, do not have as much to gain, as younger people engaging in the task. The research team also grouped together several doctors, which would help them in solidifying their claims.
The research team believes that doctors need to be more open, when prescribing medications to their patients. Doctors need to ensure that their patients have not only been informed of the benefits that go along with consuming a specific medication, but that they are also well aware of the risks that can arise as well. The charity for diabetes care within the UK, believes that doctors need to determine how to strike a balance, when it comes to prescribing medications to their patients.
Understanding what the condition is, can help people understand the reasoning’s why certain medications may not be working correctly for them. Type-2 diabetes is a condition when an individual has an inability to properly control their blood sugar levels. The condition is directly linked to the lifestyle choices that an individual makes. Choices such as their diet, as well as increased cases of obesity, have helped to make this condition fairly common, amongst adults all across the globe.
The longterm side effects of having the condition include: kidney damage, heart disease, damage to the nerves, as well as blindness, if the condition is not managed properly, following the diagnosis. One common drug that is used to help lower blood sugar levels in adults is known as metformin. This drug also helps to prevent the side effects that accompany the condition, as well.
Weighing the pros and the cons of any decision that you make is important, especially when you’re an adult, and when it comes to properly managing your health. A report, which was conducted by researchers at the University of Michigan, along with researchers from UCL, discovered that an average forty five year old person, who is able to drop their blood sugar levels by a mere one percent, will instantly gain an additional ten months onto their lives, in comparison to a seventy five year old individual who only gains three additional weeks, to their average lifespan.
This needs to be balanced against the downsides that accompany having to consume medication for an individual’s entire life. People, who are diagnosed earlier, will have to be on a regime of medications and have to undergo multiple injections in order to ensure that their blood sugar levels are measuring where they need to be. The drugs used to help control the condition, have a list of side effects of their own, which include sickness, indigestion, and the chances of blood sugar levels, dropping too low, which is known as a condition called hypoglycemia.
There is a balance that needs to be obtained when it comes to giving patients certain medications, which are required to give an individual a longer lifespan. If the medications that are being prescribed to help control the condition, cause negative side effects that can impact an individual’s way of life in a negative manner, giving the individual medications to control the condition, so they can live longer, may be the wrong thing to do. The study concentrates on looking at each patient’s individual needs, when dealing with type-2 diabetes, instead of adopting a blanket style approach, where one solution is supposed to work for everyone.
After the discovery that an extremely high number of people are suffering from pre-diabetic conditions, Abi Jackson launched an investigation that looks at the reasoning’s why it is not too late for action to be taken. Major new research has caused the subject of Type-2 diabetes to become a headliner again.
The medical journal in Britain published an article that revealed that nearly fourteen million people are on the verge of having pre-diabetes. These figures are three times higher than the amount of people that were on the verge of developing the condition back in 2006. The numbers showcase that the amount of people who suffer from the condition within the UK is on the rise.
Even though there are a lot of people that have been diagnosed with the pre-diabetic condition, there are a lot of experts that believe that there are even more people that are not aware that they suffer from the condition at all. Warnings are being released of associated surges in the amounts of people developing type-2 diabetes.
Unfortunately, this increase is not anything new. In an investigation that was performed in 2010, it was revealed that there were over one million Britons that were suffering from type-2 diabetes that had not previously been diagnosed. It is expected that the overall cases of diabetes will increase from the three million standpoint that it is at now, to three or possibly more than five million by the year 2030. The vast majority of diagnoses will be people suffering with type-2 conditions.
The reason why type-2 conditions are higher than type-1 conditions is due to the fact that type-2 conditions are linked to the lifestyle choices that individuals make. Type-1 does not have any lifestyle links. Type-1 diabetes is believed to be caused by a fault within the immune system, that leads to the cells in the body that are responsible for producing insulin, being destroyed. Type-1 diabetes usually appears before individuals reach the age of forty, taking place, traditionally prior to childhood, in most cases.
When it comes to type-2 conditions, the cells that are responsible for producing insulin, are still present within the body. However, these cells are not able to produce an adequate amount of insulin, or the insulin that the body does produce is not allowing the body to work sufficiently. This wreaks havoc within the blood glucose levels of the body. Both types of diabetes can lead to major complications, if the condition is not adequately managed. These complications include: nerve damage, kidney damage, amputation, and blindness.
What exactly is pre-diabetes? This condition is actually not a condition at all. When someone is told that they are suffering from pre-diabetic conditions, this means that their blood sugar, also known as blood glucose levels have drastically increased. However, the condition is not enough to have officially become full blown type-2 diabetic conditions. The positive thing is there is a lot that can be done about it, when it is in the pre-diabetic stage.
In eighty percent of cases, it is possible to delay, or prevent type-2 diabetes altogether. Something that people tend to misinterpret is that whenever the word pre-diabetes is used, they instantly believe that it is going to be inevitable that they will develop the condition. This is not always the case. It is possible to be in the pre-diabetic stage, and not develop full blown type-2 diabetes. People that have been told that they are in the pre-diabetic stage should take this condition as a wakeup call, to change their current lifestyle choices, before the inevitable does happen.