Diabetes Mellitus and Nontraumatic Lower Extremity Amputation in Black and White Americans

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Abstract
LOWER EXTREMITY amputation (LEA) is a costly and disabling complication of diabetes mellitus that results from the individual and combined pathophysiologic effects of peripheral arterial disease and peripheral neuropathy.1-5 Despite the high prevalence of type 2 diabetes mellitus in the United States and other industrialized nations, there are no long-term, broadly generalizable studies of incident LEAs in individuals with and without diabetes mellitus from the same population, nor are there population-based rates of LEA in black and white Americans, 2 groups with strikingly different rates of diabetes mellitus. We performed this study to characterize the long-term incidence of LEA in the United States in relation to race and diabetes mellitus. We hypothesized that black Americans would be at higher risk of LEA than white Americans, regardless of their diabetes mellitus status.