San Antonio is the diabetic foot amputation capital of the world. We're changing that

SAN ANTONIO – San Antonio has earned a troubling distinction as the diabetic foot amputation capital of the world.

This alarming title has one local doctor concerned about the health crisis unfolding in the city.

Vascular surgeon Dr. Thomas Gianis and one of his patients, Herman Bueno, spoke with KSAT’s Erica Hernandez about the challenges that diabetes poses and the urgent need for better prevention and care.

Life changes after diagnosis
“Seven years ago, I was diagnosed with diabetes,” Bueno said.

After his diagnosis, Bueno made significant lifestyle changes. “No sugar, you know, no more sweet teas, it’s unsweetened now,” he explained.

Despite these efforts, Bueno still faced a major setback when he had to have his leg amputated three years ago due to complications from diabetes.

Gianis said amputations like Bueno’s have become an unfortunate routine in San Antonio.

“It became, unfortunately, like a routine thing that was being done and it’s still being done daily across the city by my colleagues and I,” Giannis said.


When asked if this qualifies as a health crisis for San Antonio, Dr. Gianis was clear: “Absolutely.”

According to Medical Vein Clinic data, about 18% of Bexar County’s population has diabetes—more than double the national average of 7%. That means more than 220,000 people in San Antonio are affected.

Each year, about 1,500 people in the area lose limbs due to diabetes complications, primarily peripheral artery disease.

“Blockages to the arteries of the legs, which can obviously cause a myriad of problems with people’s legs, with wounds, non-healing wounds, and amputations,” Giannis explained.

Causes and solutions
Giannis said there isn’t one single cause for the high amputation rate. It can range from genetics to lack of access to healthcare.

He emphasized the importance of educating people at a younger age about healthier lifestyles, regular doctor visits and yearly vascular screenings for diabetic patients.

If you are diabetic, there are some warning signs. If you have the following symptoms, you should 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
Hope and resilience
Despite his amputation, Bueno remains optimistic.


“Diabetes is not a death sentence. Embrace it like anything else,” he said.

“If this can help at least one person, I think we’ve accomplished something,” Bueno added