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Case ref:201906496
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Date:December 2020
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Body:Tayside NHS Board
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Sector:Health
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Outcome:Upheld, recommendations
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Subject:Clinical treatment / diagnosis
Summary
C complained on behalf of their family member (A) about a delay in diagnosis of A’s type 2 Diabetes Mellitus (an adult onset diabetes, occurs when the body cannot produce sufficient insulin to absorb blood sugar - T2DM).
A was initially diagnosed with type 1 Diabetes Mellitus (T1DM) by their GP and began taking insulin. Over the following years, A was reviewed in the board’s diabetes clinic at varying intervals. After a number of years, and after further tests were performed, A’s diagnosis was changed to T2DM, and their treatment was altered.
In response to our enquiries, the board said they considered that A’s care was appropriate and that there was no delay in diagnosis. We took independent advice from a consultant diabetologist (doctor specialising in the diagnosis and treatment of diabetes). We found that there was an unreasonable delay in diagnosing A with T2DM. We found that it would have been reasonable to consider a potential diagnosis of T2DM at the time of the initial T1DM diagnosis, or soon after. We also found that the treatment used for T2DM could have been provided to A much earlier and we noted that there were a number of opportunities over the following years to reconsider the basis for the diabetes and thus additional treatment options. We upheld C’s complaint and made recommendations.
Recommendations
What we asked the organisation to do in this case:
- Apologise to A for the unreasonable delay in reaching a correct diagnosis for their diabetes. The apology should meet the standards set out in the SPSO guidelines on apology available at www.spso.org.uk/information-leaflets.
What we said should change to put things right in future:
- Clinicians should remain mindful of diabetes patients with atypical presentations when considering a diagnosis. Patients should receive the appropriate treatment for their condition.
We have asked the organisation to provide us with evidence that they have implemented the recommendations we have made on this case by the deadline we set.