We tend to think of medicine as a story of progress in managing disease. But one condition bucking the trend is Type 2 Diabetes. Some research suggests that the number of adults with this condition could almost double by 2020.Charities such as Diabetes UK are concerned that changes to healthcare service could lead to worse care. With different aspects of diabetes care being commissioned by different healthcare providers, gaps in provision may appear.Good management of diabetes requires a range of different services – blood-sugar monitoring, foot clinics and eye-care. In one of my cases a diabetic man was seen at a Diabetic Foot Clinic run by one Primary Care Trust. When he developed a small wound on his foot, the Clinic told him that he was not in fact in their catchment area and now needed to be treated by a different team in a centre run by a different Primary Care Trust. It took 4 weeks for the referral to take place and there was a muddle over the referral letter which was either not sent or lost on arrival. By then his condition had deteriorated rapidly. By the time he was seen by the new team, treatment was too late and he had to undergo a below-knee amputation.This is not the only story of failures in administration having a devastating impact on patients. But it shows the importance of making sure services are 'joined up'. I note that Alan Milburn – from whom the government was hoping for support for its reforms – has warned of the risk of reforms increasing bureaucracy and reducing patient care. With a rapidly increasing incidence of diabetes, a condition which needs a range of different services, there is the potential for more devastating errors to occur.Paul Sankey is a solicitor specialising in clinical negligence. If you or a member of your family have a clinical negligence enquiry please call our expert clinical negligence solicitors on 0800 916 9049, fill in our short online claim form or email firstname.lastname@example.org and one of our specialist clinical negligence team will be in touch.