Managing diabetes to prevent complications: insights from Baylor Medicine experts

November is National Diabetes Month, a time to raise awareness about diabetes, its potential complications and how proactive management can improve quality of life. Nearly one in 10 people in the U.S. have diabetes and millions more have pre-diabetes. Diabetes not only impacts blood sugar levels but can lead to serious complications, especially related to vascular health.

Diabetes occurs when the body cannot effectively process glucose, leading to high blood sugar. Symptoms include increased thirst, frequent urination, fatigue and blurry vision. Left unmanaged, diabetes can cause serious damage to blood vessels, which leads to complications such as heart disease, kidney issues and nerve damage.

“High blood sugar affects almost every organ, especially the heart, kidneys, eyes and nerves,” said Dr. Nader Zamani, assistant professor of surgery in the Division of Vascular Surgery and Endovascular Therapy. “This damage can also severely impact blood vessels, so people with diabetes must be vigilant about controlling their blood sugar to prevent lower extremity complications, including amputation.”

Diabetes and vascular disease: a serious risk

Diabetes increases the risk of vascular disease due to the damage it causes to blood vessels over time. “People with diabetes have a higher chance of developing peripheral artery disease (PAD), a condition that narrows blood vessels and reduces blood flow to the limbs,” Zamani said. “Complications can range from persistent pain in the legs to slow wound healing. In severe cases of arterial disease, patients may require an amputation.”

Zamani works at the Michael E. DeBakey VA Medical Center and said he often sees patients with diabetes who didn’t realize the importance of vascular health until they were already experiencing complications.

Dietary tips for controlling blood sugar

Claire Edgemon, Baylor Medicine dietitian in the Weight Loss and Metabolic Center, recommends being mindful of food choices to keep blood sugar levels stable. “Foods high in refined sugars and simple carbohydrates – like candy, pastries, white bread and sugary drinks – cause rapid blood sugar spikes and should be minimized,” she said. Instead, she encourages reaching for whole foods that offer a steady release of energy. “Whole grains, lean proteins and fiber-rich foods such as vegetables and legumes help stabilize blood sugar levels and protect against vascular damage.”

Edgemon also suggests incorporating healthy fats like those found in avocados, nuts and olive oil, as they can help with satiety and reduce the need for high-sugar snacks. “Balance is key, so pair complex carbs with proteins or healthy fats to slow down glucose absorption.”

Expert advice from a foot and ankle surgeon

When it comes to managing diabetes, proper foot care also is crucial. Diabetes can lead to serious foot complications, including neuropathy, which causes numbness and a loss of sensation and peripheral arterial disease (PAD), which reduces blood flow to the feet.

“Foot ulcers, if left untreated, can progress to severe infections, potentially necessitating amputation,” said Dr. Tyler Coye, assistant professor of surgery in the Division of Vascular Surgery and Endovascular Therapy and a foot and ankle surgeon specializing in diabetic limb salvage.

Coye shares the following tips for selecting diabetic footwear to prevent complications:

• Consult a podiatrist: A podiatrist can offer personalized advice based on your condition, foot structure and lifestyle.
• Choose comfort: Choose shoes with ample cushioning and cushioned insoles to reduce pressure on your feet and prevent issues like calluses and blisters.
• Proper sizing: Ill-fitting shoes can lead to blisters and calluses that may escalate into ulcers. Ensure shoes are well-fitted with enough room to wiggle your toes without being too loose.
• Breathable materials: Shoes made from breathable materials like leather or mesh help prevent moisture buildup, reducing the risk of fungal infections.
• Use diabetic socks and custom orthotics: Diabetic socks wick away moisture and provide cushioning, while custom orthotic inserts can reduce pressure points and improve comfort.

Lifestyle choices for prevention and management

Proactive management can make a significant difference. Beyond diet, Edgemon stresses the importance of regular physical activity, which helps improve insulin sensitivity and aids in blood sugar control. “Even a brisk walk after meals can improve glucose levels,” she said.

Zamani adds that regular screenings for vascular health are essential for patients with diabetes, even those who have not had any symptoms. “Regular exams and adhering to the best possible medical care can identify issues early. This drops the risk of severe complications considerably.”

If patients do experience complications due to diabetes, the Save the Extremity Program (STEP) at Baylor Medicine is ready to help. STEP provides patients with advanced care to prevent limb loss due to complications from diabetes.

“The limb salvage program at Baylor consists of the toe and flow model,” said Dr. Jayer Chung, associate professor of surgery in the Division of Vascular Surgery and Endovascular Therapy. “We have a vascular surgeon who provides the flow of blood and a podiatrist who takes care of the toe. We also bring in other specialists as needed to maximize not just the preservation of the limb but its function as well.”

Houston resident Jay Netherly, a diabetes patient, faced a stubborn, non-healing wound on his foot that eventually led him to Baylor St. Luke’s Medical Center after months of frustration and failed treatments. Chung diagnosed him with chronic limb-threatening ischemia and performed a bypass and stent placement to restore blood flow to his foot, while additional therapy our podiatry colleagues helped to heal the wounds on his foot. Thanks to STEP’s collaborative approach and expert care, Netherly was able to heal and avoid a major amputation and preserve his ability to walk.

If you or a loved one is facing similar challenges, consider reaching out to Baylor Medicine for the specialized support you need: 713–798–5700.

By Tiffany Harston, senior communications associate in the Michael E. DeBakey Department of Surgery