ArticleCirculation. Cardiovascular quality and outcomes2023
Trends of Concomitant Diabetes and Peripheral Artery Disease and Lower Extremity Amputation in US Medicare Patients, 2007 to 2019.
Article in Circulation. Cardiovascular quality and outcomes, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 13 citations in OpenAlex.
- The impact of hydrogen sulfide on gut microbiota of diabetic mice with lower limb arterial ischemia.BMC microbiology · 2026Article
- The Central Role of Lipid Metabolism Disorders in Diabetes Mellitus: Mechanisms, Clinical Manifestations, and Emerging Therapeutic Strategies.Diabetes, metabolic syndrome and obesity : targets and therapy · 2026Review
- Prognostic value of lipoprotein(a) for cardiovascular events after lower limb revascularization in diabetic patients with chronic limb-threatening ischemia.Cardiovascular diabetology · 2025Observational
- Facility-Level Variation in Major Leg Amputation Among Patients With Newly Diagnosed Diabetic Foot Ulcer.JAMA network open · 2025Article
- Association between tissue loss type and amputation risk among Medicare patients with concomitant diabetes and peripheral arterial disease.Journal of vascular surgery · 2024Article
- Benefits of Taurisolo in Diabetic Patients with Peripheral Artery Disease.Journal of cardiovascular development and disease · 2024Article
- The Association Between Triglyceride-Glucose Index and Its Combination with Obesity Indicators and Lower Extremity Peripheral Artery Disease in Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study.Diabetes, metabolic syndrome and obesity : targets and therapy · 2024Article
- Examining health care access disparities in Hispanic populations with peripheral artery disease and diabetes.Vascular medicine (London, England) · 2023Article
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Authors and funding
12 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundPrevious studies demonstrate geographic and racial/ethnic variation in diagnosis and complications of diabetes and peripheral artery disease (PAD). However, recent trends for patients diagnosed with both PAD and diabetes are lacking. We assessed the period prevalence of concurrent diabetes and PAD across the United States from 2007 to 2019 and regional and racial/ethnic variation in amputations among Medicare patients.
methodsUsing Medicare claims from 2007 to 2019, we identified patients with both diabetes and PAD. We calculated period prevalence of concomitant diabetes and PAD and incident cases of diabetes and PAD for every year. Patients were followed to identify amputations, and results were stratified by race/ethnicity and hospital referral region.
results9 410 785 patients with diabetes and PAD were identified (mean age, 72.8 [SD, 10.94] years; 58.6% women, 74.7% White, 13.2% Black, 7.3% Hispanic, 2.8% Asian/API, and 0.6% Native American). Period prevalence of diabetes and PAD was 23 per 1000 beneficiaries. We observed a 33% relative decrease in annual new diagnoses throughout the study. All racial/ethnic groups experienced a similar decline in new diagnoses. Black and Hispanic patients had on average a 50% greater rate of disease compared with White patients. One- and 5-year amputation rates remained stable at ≈1.5% and 3%, respectively. Native American, Black, and Hispanic patients were at greater risk of amputation compared with White patients at 1- and 5-year time points (5-year rate ratio range, 1.22-3.17). Across US regions, we observed differential amputation rates, with an inverse relationship between the prevalence of concomitant diabetes and PAD and overall amputation rates.
conclusionsSignificant regional and racial/ethnic variation exists in the incidence of concomitant diabetes and PAD among Medicare patients. Black patients in areas with the lowest rates of PAD and diabetes are at disproportionally higher risk for amputation. Furthermore, areas with higher prevalence of PAD and diabetes have the lowest rates of amputation.
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