African-Americans With Diabetes Face Higher Risk of Preventable Amputations


African-Americans are at higher risk for two diseases-diabetes and peripheral arterial disease (PAD)-that together threaten to cause them more preventable amputations than other populations. Statistically, African-Americans are twice as likely than non-Hispanic whites to have PAD, and one in four older African-Americans have diabetes. Because it may damage blood vessels, diabetes can make PAD worse.

Even though African-Americans have a higher risk for diabetes and PAD, that does not fully explain the high rate of amputations, researchers say.

"Studies show that African-Americans, especially men, may not go to the doctor as often," said Katherine Gallagher, MD, a vascular surgeon and director of the multidisciplinary PAD program at the University of Michigan. "That's been established, but the reasons for this are still being looked at."

Further, once in the physician's office, patients may not mention their occasional leg pain during a short, busy visit. If they have diabetes, their 15-minute physician visit is full of other issues.

"Patients don't even bother to mention that, 'Oh, sometimes my legs hurt,'" she said. "They might get a leg cramp when they go up the stairs, but then the cramp goes away. It's not typical for a doctor to ask about PAD or check the pulse in the feet."

Also part of the causal chain for African-Americans is high blood pressure. High blood pressure is a risk factor for PAD and it is much more prevalent in the African-American community. According to a report from the American Heart Association in 2013, 43 percent of black men and 47 percent of black women in the United States had high blood pressure, versus 33 and 31 percent for white, non-Hispanic men and women.

Editor's note: This story was adapted from materials provided by the Society for Vascular Surgery.