Diabetes poses a serious threat to foot and ankle health, especially in Bexar County, where amputation rates are significantly higher than the state average.
In 2020, the hospitalization rate for lower limb amputations in Bexar County was 71.4 per 100,000 residents, compared to 51.9 statewide. This stark disparity underscores the urgent need for specialized care and early intervention to prevent severe complications.
For people living with diabetes, proper foot and ankle care isn’t just about comfort -- it can be a matter of life and limb.
“Diabetes can impact the lower extremity health by causing nerve damage and poor circulation that can lead to serious conditions such as non-healing wounds, infections, deformities and eventually an amputation,” said Thomas Zgonis, DPM, FACFAS, a podiatric surgeon at the Methodist Diabetic Foot and Ankle Institute (DFAI).
Why diabetic foot care matters
Even minor foot issues can escalate quickly in patients with diabetes.
“Minor foot and ankle problems such as blisters, non-healing wounds, callouses or toe deformities in the presence of diabetic neuropathy (loss of sensation) or peripheral vascular disease (narrowing or blockage of blood vessels) can cause serious problems with limb threatening events,” Dr. Zgonis said.
Common diabetic foot complications include neuropathy, poor circulation, chronic wounds, infections and deformities like Charcot neuroarthropathy -- a condition that severely weakens foot bones.
“Changes in skin or toenail coloration, callouses, ingrown toenails, swelling of the feet or legs, numbness and/or tingling are all signs and symptoms of diabetes and are important to monitor in the diabetic population,” Zgonis added.
Prevention begins with proactive care
Many diabetes-related amputations can be prevented with early and consistent foot care. At DFAI, the focus is to empower patients to act early and provide comprehensive support when complications arise.
Zgonis listed some of the most important measures that can easily be taken to prevent a diabetes-related amputation:
- Daily foot checks and foot care of the skin and toenails
- Wear proper socks and footwear
- Maintain normal blood sugar levels and body weight
- Frequent exercise and eating healthier
- Give up smoking
- Patient and family education
- Frequent podiatric and medical visits
When amputation is necessary
Sometimes, despite best efforts, amputation becomes the safest treatment. In these cases, the Methodist DFAI team supports patients throughout the process.
“Minor (toe or partial foot) or major (below-the-knee or above-the-knee) amputations process includes an extensive preoperative assessment and multidisciplinary team consultations to assess the patient’s overall medical optimization, perioperative management and postoperative rehabilitation and wound care,” Zgonis said.
Recovery is a collaborative effort that involves surgeons, nurses, wound care specialists, social workers, family support, mental health professionals, physical and occupational therapists and prosthetists.
“We are committed to excellence in patient care and the prevention of amputations in patients with diabetes. We achieve this by creating multidisciplinary teams with an emphasis on managing diabetes-related complications, building Centers of Excellence across Methodist Healthcare, and ensuring access to every patient in need,” Zgonis said.
The opening of the new 5,292-square-foot DFAI facility in Northeast San Antonio is a key step toward this mission, which will bring expert care even closer to those who need it most.
A team approach to healing
The DFAI is more than a clinic -- it’s a coordinated network of experts focused on preventing and treating diabetic foot complications with compassion and precision.
“DFAI provides a team of experts in diabetic lower extremity amputation prevention and reconstruction when needed,” Zgonis said. “A multidisciplinary approach to patient-centered care is employed with preventive measures while major diabetic foot and ankle reconstructions are available to provide a functional lower extremity that’s free of infection or future complications.”
The new DFAI location -- at 12413 Judson Rd., Suite 210, across from Methodist Hospital | Northeast -- will serve as a vital point for residents of Live Oak and the greater Northeast area.
Whether through regular screenings, advanced wound care, surgical reconstruction or post-amputation support, DFAI aims to help improve outcomes through early intervention and specialized care.
To schedule an appointment or learn more about the Methodist Diabetic Foot and Ankle Institute, click or tap here.