UT Health San Antonio physiatrist helps write first American Diabetes Association guidelines to include disability management

A clinician and researcher with The University of Texas Health Science Center at San Antonio helped “write the book” when it comes to standards of care for diabetes.

Monica Verduzco-Gutierrez, MD, professor and chair in the Department of Physical Medicine and Rehabilitation, contributed a section of the latest American Diabetes Association Standards of Care guide.

Under her guidance, a portion was added to the ADA guide to include a recommendation for assessment and referral to a healthcare provider specializing in disability management, if needed.

Published in January under the direction of the ADA, the “Comprehensive Medical Evaluation and Assessment of Comorbidities: Standards of Care in Diabetes — 2024” outlines what should be included in diabetes care, treatment guidelines, goals and evaluation tools.

Verduzco-Gutierrez was part of this year’s American Diabetes Association Professional Practice Committee, a group of about 40 medical professionals of various specialties. The committee reviews and updates the guidelines used by healthcare professionals across the country in the treatment of diabetes.

She said this was the first time the diabetes guide considered disabilities in its recommendations.

Under the disability section of the guide, it recommends that a patient with diabetes be assessed for disability at each medical visit. If a disability is impacting their ability to function or properly manage their diabetes, they should be referred to a professional specializing in that disability.

According to the ADA guide, a disability is a “physical or mental impairment that substantially limits one or more major life activities of an individual.” It further states diabetes can cause a 50-80% increased risk of disability compared to those without diabetes. Lower-body functionality is the most common diabetes-related disability.

“The recommendation is to screen patients who have diabetes for disabilities because a lot of them do end up getting neuropathy and losing legs, having strokes, getting amputations. Helping write the guidelines for all clinicians to follow when it comes to taking care of diabetic patients, that’s huge,” Verduzco-Guiterrez said.

She said this work was especially meaningful in a city like San Antonio, which has a large population of people living with diabetes and diabetes-related complications.

“We have a lot of patients who use a prosthetic. There are so many patients that do get amputations and we need to help with their disability and mobility issues,” she said.

In the guide, it is recommended that clinicians also consider social determinants of health, race/ethnicity and socioeconomic status. Rates of diabetes-related major amputations are found to be higher among members of racial or ethnic minority groups and those who live in rural or underprivileged areas.

Verduzco-Guiterrez was one of two physical medicine and rehabilitation professionals on the ADA guide committee.


The 2024 ADA guide can be found in the January 2024 Diabetes Care Journal:



The University of Texas Health Science Center at San Antonio (UT Health San Antonio) is one of the country’s leading health science universities and is designated as a Hispanic-Serving Institution by the U.S. Department of Education. With missions of teaching, research, patient care and community engagement, its schools of medicine, nursing, dentistry, health professions, graduate biomedical sciences and public health have graduated more than 42,550 alumni who are leading change, advancing their fields and renewing hope for patients and their families throughout South Texas and the world. To learn about the many ways “We make lives better®,” visit UTHealthSA.org. Stay connected with The University of Texas Health Science at San Antonio on Facebook, Twitter, LinkedIn, Instagram and YouTube.

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