Diabetes is often called a silent disease because many people are unaware they have it until serious complications develop, according to Texas Medical Association (TMA) physicians. Dr. Brandon Cantazaro, an internist and member of TMA’s Council on Health Promotion who practices in the Rio Grande Valley, highlighted that the region has one of the highest diabetes rates in the United States, with 26% of residents affected compared to just under 12% nationally.
This National Diabetes Awareness Month, TMA physicians are raising awareness about the risks associated with undiagnosed or poorly managed diabetes. Nationwide, more than 38 million people live with diabetes, including 2.9 million Texans. In Texas, over one in ten residents (12.7%) have been diagnosed with the disease, and approximately 90% of those cases are type 2 diabetes.
Dr. Jayesh “Jay” Shah, a wound care specialist from San Antonio and president of TMA, treats patients experiencing severe complications from diabetes. “Some of the most unfortunate end-stage complications of diabetes [include] end-stage kidney disease, having no circulation in the limbs, patients getting amputations, and patients having trouble with healing,” said Dr. Shah.
Nerve damage can prevent patients from noticing injuries such as cuts on their feet. “A lot of those patients don’t know they have a cut on their foot,” said Dr. Cantazaro. “There will be nerve damage to where they will not have sensation.” Poor blood circulation further hinders healing for these individuals.
The impact extends beyond physical health; families can face significant challenges when a primary earner becomes disabled due to diabetes-related complications. “A lot of these patients are young with a young family, and it really is very devastating for these families to have their breadwinner getting disabled because of diabetes,” Dr. Shah said.
Both physicians recommend that individuals who are overweight, have a family history of diabetes, or belong to higher-risk ethnic groups consult a doctor for testing and advice.
Gestational diabetes is another concern; it affects up to 9% of pregnancies each year in the U.S., but can be managed through medical screening and treatment plans during pregnancy.
While type 2 diabetes may lead to multiple health issues if unmanaged, adopting lifestyle changes and working closely with healthcare providers can help avoid many complications. “Having the discipline of making sure you are following a healthy diet, you are taking the medication as prescribed by your doctor, and you are exercising, you can control diabetes and even reverse some of the conditions,” said Dr. Shah.
Dr. Cantazaro encourages gradual changes: “You can start making small changes over time, little by little.” He recounted advising one patient who regularly consumed sugar-filled soft drinks to reduce intake gradually rather than stopping all at once.
He also described how another patient successfully managed her high blood-sugar levels by incorporating regular walks into her routine, controlling portion sizes at meals, and adhering to prescribed medications—resulting in significantly improved health outcomes after several months.
Managing diabetes alone can feel overwhelming for many people; however, Dr. Cantazaro emphasized that support systems and incremental lifestyle adjustments make it possible for individuals living with diabetes to maintain long-term health: “It is not your identity. With support and small lifestyle changes, you can live a long, healthy, and active life.”
