Diabetes mellitus (DM) affects more than 30 million people in the United States, and peripheral artery disease (PAD) is also a highly prevalent disease that affects approximately 8–12 million people in the United States [1]. A substantial 20% to 30% of patients with PAD have DM [2]. The prevalence of PAD between patients with and without DM is significantly different: 20.9% prevalence of an ankle brachial index <0.9 in those with glucose intolerance, relative to 7% in those with normal glucose tolerance [3]. The prevalence of DM is especially high in those patients who have chronic limb-threatening ischemia (CLTI), with >50% also having DM [4].

Annually, 150,000 Americans undergo nontraumatic lower extremity amputations [5]. PAD and DM are the leading causes of limb loss, especially in racial and ethnic minority populations and those with socioeconomic disadvantages [6], [7], [8]. In this narrative review, we aimed to summarize the latest evidence on the influence of race, ethnicity, socioeconomic status (SES), and access to care on the risk of amputation in patients with PAD and DM.