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Objectives We aim to assess prevalence of diabetes related peripheral arterial disease and associated outcomes in hospitalized patients in the United States. Methods Trends in hospitalizations in diabetic patients with PAD were determined using the 2003–2017 National Inpatient Sample database. Hospital outcomes including diabetic ulcer incidence, amputations, and revascularizations were analyzed. Results The analysis included 10,303,673 hospitalizations in diabetic patients with PAD (DMPAD) during the study period. Prevalence of PAD among patients with diabetes increased over time (p&amp;lt;0.001). The prevalence of foot ulcers in diabetics have also increased over time (p&amp;lt;0.001). The incidence of amputations in patients with diabetes showed a decreasing trend with increasing prevalence of revascularizations from 2003 to 2009. Since 2010 however, rising rates of amputations, both minor and major are seen, especially in younger populations (age 18–49). Hospital costs for amputations have increased ($6.6 billion in 2003 vs $ 14.8 billion in 2017) as well as the costs for revascularization (6.1 billion in 2003 vs $13 billion in 2017) during the study period (p&amp;lt;0.001). Conclusions In this analysis of patients with DMPAD, an alarming rate of disease prevalence and in-hospital limb outcomes, including costs, are realized in the current era. Funding Acknowledgement Type of funding sources: None.

Increasing prevalence of diabetic peripheral angiopathy and complications in hospitalized patients in the United States