By the Medical Vein Clinic Clinical Team | Featuring Dr. John Hogg, MD, DABR, DABVLM, Founder, and Dr. Thomas Gianis, MD, FACS, FSVS, Board-Certified Vascular Surgeon | Published November 14, 2025
Why San Antonio Leads the World in Diabetic Foot Amputations
San Antonio has the highest rate of diabetic foot amputations in the world. Bexar County’s diabetic amputation rate is three times the national average, resulting in approximately 1,500 amputations per year. In the United States, a limb is amputated due to diabetes every three minutes and thirty seconds. In Bexar County, 18% of the population has diabetes — more than double the national average of 7%. Most of these amputations are preventable. Early vascular screening, circulation evaluation, and minimally invasive treatment can stop the progression from diabetes to wound to amputation. Medical Vein Clinic in San Antonio specializes in exactly this — diagnosing and treating circulation problems before they become life-threatening.
November is National Diabetes Awareness Month, and we want to educate people about the crisis this illness is causing in San Antonio and South Texas. We hold a title that is alarming and growing worse: the “diabetic foot capital of the world.”. Tragically, we lead all the countries in the world in foot amputations due to complications of diabetes. But here’s some good news: most of these devastating outcomes are preventable with early intervention and proper treatment.
A Crisis Hiding in Plain Sight
In the U.S., more than 38 million people have diabetes, and nearly 98 million adults are pre-diabetic. In Bexar County, 18% of the population is diabetic, compared to the national average of 7%. In San Antonio, that means 220,000 plus people are affected. Statistics and numbers related to amputations as a result of diabetic-related illnesses are staggering:
- Bexar County’s diabetic amputation rate is three times the national average. That means approximately 1,500 of our neighbors lose limbs every year to diabetes complications.
- Every three minutes and 30 seconds in the U.S., a limb is amputated due to diabetes.
- People with diabetes are also more likely to develop atherosclerosis, which is the leading cause of peripheral artery disease (PAD)–a serious circulation issue that can lead to chronic pain, ulcers, and amputation if not treated early.
This is why Medical Vein Clinic is dedicated to helping patients detect circulation problems before they become life-threatening. Through advanced, non-surgical diagnostic testing and minimally invasive treatments, we help restore healthy blood flow, which prevents wounds, infections, and unnecessary amputations.
How Diabetes Damages Circulation
Diabetes affects much more than blood sugar; it impacts your entire vascular system. Over time, high blood sugar levels damage the lining of your blood vessels, making them less flexible and more prone to narrowing or blockages.
- Circulation damage: High blood sugar injures the blood vessel walls, reduces oxygen flow to the legs, and slows healing. That’s why small wounds can become big problems.
- Peripheral Artery Disease (PAD): Diabetics are two to four times more likely to develop PAD, which leads to a higher risk of ulcers, amputation, heart attack, and stroke.
- Nerve damage (Neuropathy): Diabetes also injures the nerves that signal pain. That means patients may not feel wounds or ulcers developing on their feet, so infections worsen without warning.
- Poor healing and infection: With poor circulation and reduced sensation, a minor blister or cut can turn into a chronic wound or severe infection, leading to tissue death (gangrene) and, in severe cases, amputation.
When circulation declines, it’s not just about the legs– it affects your mobility, independence, and long-term health.
Warning Signs for Diabetics
If you have diabetes and you’re experiencing any of these symptoms, please see a doctor:
- Leg pain when you walk
- Numbness or tingling in your feet or legs
- Sores that won’t heal or skin discoloration
- Any cuts, blisters, redness, or swelling
- Your skin color or temperature feels different
- Visible veins or swelling in your legs
These could be early warning signs of PAD (peripheral artery disease) or venous insufficiency. The good news is that both PAD and VI are treatable when detected early.
Effectiveness of Vascular Screening
Studies show that vascular screening programs can greatly reduce major amputations and lead to faster wound healing. The screening tools are straightforward: ABI testing, foot exams, and vascular assessment are routine and affordable. But the problem is screening isn’t happening. Despite the effectiveness, there’s a massive gap in implementation: In a study of more than 52,000 patients with diabetes and PAD who were at high risk for amputation, less than 5% received all three screening tools.
Dr. John Hogg, Founder and CEO of Medical Vein Clinic, reminds patients that circulation is the foundation of good health.
“Diabetes doesn’t just impact blood sugar; it silently damages the vessels that carry oxygen and nutrients throughout your body,” he explains. “When circulation slows, the legs often show the first signs: pain, numbness, discoloration, or wounds that won’t heal. Recognizing those signs early can prevent serious complications.”
Dr. Thomas Gianis, our board-certified Vascular Surgeon, has clear advice.
“All diabetic patients should get yearly arterial screenings along with vein evaluations. Diabetes affects your entire circulatory system, not just one part of it.”
Protecting your circulation protects your life. Early detection and proper vascular care can prevent ulcers, infections, and even amputations. Schedule your vascular screening, share educational posts, and talk to loved ones about circulation health and diabetes.
Most insurance plans, including Medicare and Medicaid, cover vascular screening and PAD evaluation for diabetic patients. Medical Vein Clinic verifies your coverage before your appointment.
Watch: Dr. Thomas Gianis on Why Diabetic Patients Need Yearly Arterial Screenings
Every small step you take today helps prevent an amputation tomorrow. Comprehensive vascular screening and advanced wound care can prevent most diabetic amputations when we catch problems early. What we need is better awareness of the warning signs followed by prompt action.
What to Do Right Now: Your Diabetic Vascular Health Checklist
This National Diabetes Awareness Month, here’s your action plan:
- Schedule your complete vein and arterial evaluation. Early detection of PAD and venous insufficiency prevents the progression from circulation problem to wound to amputation. Call Medical Vein Clinic at 210-622-8000 to schedule.
- Get yearly arterial screenings along with vein checks. Diabetic patients should receive an ankle-brachial index test, foot exam, and vascular assessment every year — regardless of whether symptoms are present.
- Check your feet and legs every day. Look for cuts, blisters, redness, swelling, discoloration, or any change in skin temperature. Report anything unusual to your doctor immediately — do not wait.
San Antonio doesn’t have to be the “diabetic foot capital of the world.” Together, we can rewrite that story.
Ready to Take the First Step?
Contact Medical Vein Clinic for your complete vein evaluation and start protecting your health today. Call 210-622-8000 or book your vascular screening online at medicalveinclinic.com/book-an-appointment. We have two locations in San Antonio: Stone Oak at 18831 Meisner Drive and Northwest San Antonio at 5742 W. Loop 1604 N.
Healthy Legs Take You Further™.
Watch: Medical Vein Clinic — Vascular Care for Diabetic Patients in San Antonio
Frequently Asked Questions About Diabetes, Circulation, and Amputation Prevention in San Antonio”
Why does San Antonio have such high rates of diabetic amputations?
San Antonio and Bexar County have a diabetes rate of 18%, far above the national average of about 7%, affecting more than 220,000 people. The county’s diabetic amputation rate is three times the national average, meaning roughly 1,500 neighbors lose limbs to diabetes complications each year. Most of these outcomes are preventable with early circulation screening and treatment.
How does diabetes cause foot and leg amputations?
High blood sugar damages blood vessel walls over time, reducing oxygen flow to the legs and slowing healing, so small wounds can become serious. Diabetes also damages the nerves that signal pain, so patients may not feel ulcers developing on their feet, letting infections worsen unnoticed. Poor circulation plus reduced sensation can turn a minor blister into a chronic wound, gangrene, and eventually amputation.
What is peripheral artery disease and how does it relate to diabetes?
Peripheral artery disease (PAD) is a serious circulation problem where the arteries to your legs narrow or block, leading to pain, ulcers, and amputation risk if untreated. People with diabetes are two to four times more likely to develop PAD because high blood sugar accelerates the artery-narrowing process. That’s why diabetic patients need their circulation checked regularly.
What is an ABI test and do I need one?
The ankle-brachial index (ABI) is a quick, painless test that compares blood pressure in your ankle and arm to check for reduced blood flow in your legs. It’s one of the routine, affordable tools for catching PAD early, along with foot exams and vascular assessment. If you have diabetes, an ABI is worth asking about, since studies show fewer than 5% of high-risk diabetic patients receive all the recommended screenings.
Can diabetic leg wounds be healed without amputation?
Yes, in many cases. When circulation problems are caught early and blood flow is restored through minimally invasive treatment, wounds heal better and amputations can often be prevented. Comprehensive vascular screening and advanced wound care prevent most diabetic amputations when problems are caught early. The key is acting on warning signs promptly rather than waiting.
How often should diabetic patients get vascular screenings?
Dr. Gianis advises that all diabetic patients get yearly arterial screenings along with vein evaluations, because diabetes affects the entire circulatory system, not just one part. Daily foot and leg self-checks are also important. Yearly screening helps catch problems before they become limb-threatening.
Does Medical Vein Clinic treat diabetic circulation problems?
Yes. Medical Vein Clinic focuses on detecting and treating circulation problems before they become life-threatening, using non-surgical diagnostic testing and minimally invasive treatments to restore healthy blood flow. This helps prevent wounds, infections, and unnecessary amputations. Care is led by board-certified vascular surgeon Dr. Thomas Gianis. Call 210-622-8000 to schedule a screening.
Does insurance cover vascular screening for diabetic patients?
Yes. Most insurance plans, including Medicare and Medicaid, cover vascular screening and treatment for diabetic patients when it’s medically necessary. We verify your benefits before your visit so you understand your coverage. Call 210-622-8000 to confirm.
