At 12 years old, after getting extremely sick and almost slipping into a coma, Tomas Espinoza was diagnosed with Type 1 diabetes. As an adult, he put off taking care of his condition for years—until, at the age of 31, he needed all the toes on his left foot amputated.
“I wasn't really taking care of myself at that time. I liked to go out drinking and partying, and I wasn't taking my medicine,” said Tomas. “I could have lost my leg.”
Looking back, he realizes that his amputation could have been avoided by taking an active role in his diabetes care. Eating healthy food, getting regular exercise and managing blood sugar levels can help prevent or delay long-term, serious diabetes-related complications such as lower-limb amputation, heart disease, vision loss and kidney disease.
“Diabetics, especially, really need to take control of their health and well-being,” said Dr. Michael Sobolevsky, a podiatry doctor at the Texas Diabetes Institute, the facility run by University Health. “A lot of times, if they wait and linger, it’s too little, too late at that point.”
The Cost of Uncontrolled Diabetes
Unfortunately, Tomas’s story is not an uncommon one in San Antonio and surrounding Bexar County. Texas has one of the highest rates of diabetes-related amputations in the nation, at about 52 per 100,000 hospital admissions. Yet, compared to Texas overall, Bexar County consistently has even higher hospitalization rates for diabetic amputations.
“The consequences of ignoring your health as a diabetic can be drastic and cause lifelong disability,” said Dr. Sobolevsky, who calls San Antonio “the diabetic foot capital of the world.” “Below-the-knee amputation can shorten your life expectancy, not to mention negatively affect your quality of life.”
Nerve Damage and Artery Health
Dr. Anand Prasad, the lead interventional cardiologist at the University Health Limb Salvage Clinic at Texas Diabetes Institute, says prolonged high blood sugar can cause complications that raise the chance of a lower-limb amputation.
“When your blood sugar remains high for a long time, it doesn’t just damage nerves, it impacts the walls of your arteries, especially those supplying blood to the legs and feet,” said Dr. Prasad.
When blood supply is limited, this leads to peripheral arterial disease (PAD), making even a tiny cut to heal slowly or not at all. Peripheral nerve damage can lead to neuropathy (loss of feeling, tingling, numbness), making it easy for cuts, sores and ulcers on the feet to go unnoticed.
“This is why artery health is important—it promotes good blood circulation and prevents infections from spreading into the tissue and bones,” said Dr. Prasad.
For Dr. Sobolevsky’s patient, Tomas, what began as a cut on his foot progressed over time to a full-blown infection that had spread to the bone. After surgical amputation, his wound wasn’t healing correctly and needed to be stapled shut.
“The healing process took a while, and I had to use a knee scooter for almost seven months,” Tomas said. “I couldn’t really put any pressure on my foot.”
Prevent Diabetes-Related Complications
The effect diabetes has on the body happens slowly, but untreated diabetes can lead to long-term complications or even death. Aside from lower-limb amputations, high blood sugar can lead to a number of other health conditions over time, including:
- Heart disease
- Chronic kidney disease (CKD)
- Nerve damage
- Hearing loss
- Vision loss
The key to avoiding diabetes-related complications is managing your blood sugar by eating well, exercising, taking insulin or other medication, and lowering your stress levels. You should also see your primary care provider at least twice a year to find and treat any problems early.
“Humans are creatures of habit. We don’t like change. It’s still hard for me, trying to adjust to things right now,” Tomas said. “But my diabetes is finally under control.”
Diabetes Care at University Health
Diabetes can have long-term effects on your body, including damage to your arteries, nerves and feet. The good news is that with early detection and lifestyle changes, you can take control of your health.
If you are at risk of diabetes, schedule an appointment with one of our primary care providers and learn more about the world-class diabetes care we offer at the Texas Diabetes Institute.
Limb Salvage Care
If you currently have diabetes and notice signs of poor blood circulation like slow-healing wounds, or experiencing neuropathy, don’t wait and schedule an evaluation with our specialists at the University Health Limb Salvage Clinic at Texas Diabetes Institute.
We are among the few clinics in Texas dedicated solely to limb preservation. The podiatry and interventional cardiology team collaborate under one roof to help preserve your mobility and prevent amputation through advanced, non-surgical treatments.
For more information, call 210-358-8330.
