Abstract P363: Regional And Racial Variation In The Prevalence Of Concomitant Diabetes And Peripheral Artery Disease

Introduction and Objectives: Prior research has demonstrated regional and racial variation in the prevalence of concomitant diabetes and peripheral artery disease (PAD). However, trends in prevalence of diabetes and PAD across races has not been well explored in recent patient cohorts. Methods: Using data from the Centers for Medicare and Medicaid Services from 2003-2016, we identified patients concurrently diagnosed with both diabetes and PAD (n=10,506,254). Overall prevalence of concomitant diabetes and PAD was determined. Regional variation at the state and hospital referral region (HRR) level was then identified using zip code data. Racial demographics within Medicare data were used to stratify prevalence by race. Results: The overall prevalence of diabetes and PAD across the entire cohort was 15.3 per 1,000 Medicare patients. When stratified by HRR, prevalence of patients with concomitant diabetes and PAD varied by nearly 7-fold with a low of 5.0 and a high of 33.2 per 1,000 Medicare patients. When stratified by race, the number of new patients concomitantly diagnosed with diabetes and PAD decreased across all races, with the greatest decline seen in the Hispanic population (absolute decrease 1.84%, relative reduction 63%). The number of new black patients decreased as well (absolute decrease 1.40%, relative reduction 52%), but blacks continue to comprise the highest proportion of newly diagnosed patients at 1.29% (Figure 1). Conclusion: Significant regional and racial variation exists in the prevalence of concomitant diabetes and PAD diagnoses among Medicare patients with black patients remaining disproportionately affected. Efforts to improve prevention and care management should target these endemic regions and populations.