OBJECTIVES: Diabetes is problematic in all populations but has posed a particular challenge for Black Americans. Diabetes and associated diseases occur at an earlier age for this population. This study explored demographic factors contributing to the diagnosis of diabetes and peripheral artery disease (PAD), a precursor to ischemic limb and subsequent lower limb amputation.

METHODS: The National Institutes for Health All of Us Research workbench database was used. Persons ≥18 years, with a singular diagnosis of diabetes or PAD or both were included. Bivariate analyses examined associations between patient race/ethnicity, age, gender, and patient diagnoses. P-values £ 0.05 were statistically significant. Statistical analysis was completed using Social Science Statistics (socscistatistics.com).

RESULTS: 40,465 participants met the inclusion criteria: diabetes only (N=33,847), PAD only (N=4,249) and comorbid diagnosis of diabetes and PAD (N=2,369). Race/ethnicity included 26% Black, 44% White, 22% Hispanic, and 8% other races. The majority were female (55%) and in the age group 46-65 (51%). Significant associations were found between cohort assignment and gender, race/ethnicity, and age. A higher proportion of persons assigned to diabetes only (cohort 1) were female, Hispanic, and between the ages of 46-65 (all p-values £0.05); PAD only (cohort 2) were male, White, and age 66+ (all p-values £0.05); diabetes and PAD (cohort 3) were male, Black, and age 66+ (all p-values £0.05). Compared to White persons, Black persons were 1.98 times more likely to be diagnosed with diabetes and 1.14 times more likely to be diagnosed with diabetes and PAD, with a higher proportion of them in the age group 46-65.

CONCLUSIONS: The study reveals the interplay of gender, race/ethnicity, and age in the diagnosis of diabetes and PAD. The Black population has a greater likelihood of being diagnosed with both conditions. This group is at risk of lower-limb amputation and should receive care commensurate with that risk.