Racial, ethnic and socioeconomic inequities in amputation risk for patients with PAD and diabetes

Diabetes mellitus (DM) affects > 30 million people in the US while PAD is also a highly prevalent disease that affects more than 8-12 million people in the United States.1 A substantial 20%-30% of patients with PAD have DM.2 The prevalence of PAD between patients with and without diabetes is significantly different: 20.9% prevalence of an ABI less than 0.9 in those with glucose intolerance, relative to 7% in those with normal glucose tolerance.6 The prevalence of DM is especially high in those patients who have chronic limb threatening ischemia (CLTI), with more than 50% of patients also having DM.8

Annually 150,000 Americans undergo non-traumatic lower extremity amputations.9 Peripheral artery disease and DM are the leading causes of limb loss, especially in racial and ethnic minorities and those with socioeconomic disadvantage.10-12 In this narrative review, we aim to summarize the latest evidence on the influence of race, ethnic and socioeconomic status (SES), and access to care on the risk of amputation in patients with PAD and diabetes.

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