Abstract

ABSTRACTWe reviewed diabetic gangrene in 104 American blacks and found that the clinical features were similar to those reported for the general diabetic population. We observed, however, that there was a significant association of hypertension with above-knee and bilateral amputations in our patients (P < .001 and .01, respectively), and that the mean blood pressure of the bilateral amputees (124.5 ± 3.8 mm Hg) (SEM) was significantly higher (P < .005) than that of the unilateral amputees (114.4 ± 1.7 mm Hg). These results suggest a strong association of hypertension with far-advanced occlusive vascular disease of the lower limbs. Moderately severe anemia (hematocrit 20% to 30%) was associated significantly with primary above-knee amputation and mortality (P < .02 and .05, respectively). Mortality resulted mostly from mixed causes (cardiopulmonary failure, uremia, sepsis, diabetic coma). The dead patients had significantly increased prevalence of cardiac disease (P < .02), higher frequency of above-knee amputation (P < .01), and a duration of diabetes (17.4 ± 2.8 years) significantly longer (P < .025) than that of the surviving patients (12.0 ± 1.0 years)