Disparities in Peripheral Circulatory Complications Related Mortality in Type 2 Diabetes Mellitus Patients: A CDC Analysis (1999-2020)

Document Type

Conference Proceeding

Publication Date

10-2025

Publication Title

Journal of the Endocrine Society

Abstract

Introduction: Peripheral circulatory complications (PCC), frequently arising as a complication associated with type 2 diabetes mellitus (T2DM), are associated with significant mortality in the United States (US). Methods: We analyzed PCC-associated mortality in T2DM patients using CDC WONDER data (1999-2020) and ICD-10 Code E11.5. Age-Adjusted Mortality Rate (AAMR) per 1,000,000 individuals was quantified. Joinpoint regression (v5.1.0, NCI) assessed parallelism, annual percent changes (APC), and average APCs (AAPCs) with 95% CI, considering p < 0.05 as significant. Results: Between 1999 and 2020, a total of 81,793 deaths were attributed to PCC in T2DM patients with an overall increase in mortality rate (AAPC: 1.87, 95% CI: 1.32 to 2.54). The AAMR increased from 1999 to 2004 (APC: 5.88: 95% CI: 2.44 to 12.7), followed by a decrease from 2004 to 2014 (APC: -3.7, -5.83 to -2.45), and finally an increase again till 2020 (APC:8.34, 6.05-11.5). The mortality increased with age, with highest crude rate mortality (CMR) observed in the 85+ year age group (CMR: 3945.93) and lowest in 45-54 years’ age group (CMR: 63.40). Moreover, AAPCs were higher in males (2.30%, 1.74-3.11) compared to females (0.9%, 0.25-1.74) throughout the study period and the two genders showed an unparallel trend (p=0.05). Males observed a gradual increase in mortality from 1999 to 2005 (APC: 4.68, 1.22-8.27), followed by a decrease till 2014(APC: -3.29, -5.16 to -1.38) and then an increase till 2020 (APC: 8.79, 6.11-11.53). Geographically, the Midwest region had the highest AAMR (12.86), followed by West (12.26), South (10.93), and Northeast (8.02). In the Midwest, the most significant AAMR increase was observed from 2014 to 2020 (APC:8.25, 5.27-11.3). Among the US states, AAMR was highest for West Virginia (18.52) and lowest for Nevada (3.16). Similarly, in racial groups American Indian or Alaskan natives showed the highest AAMR (19.76), followed by Blacks (17.95), White (10.5), and finally Asian (6.11). The increase in mortality was also highest in American Indians (AAPC: 2.09, -3.23 to 7.71). An unparallel trend was observed between different census regions and racial groups (p< 0.05). Conclusion: The trend due to PCC mortality in patients with T2DM increased from 1999 to 2020. Males, Midwest region, West Virginia state, and American Indian or Alaskan natives had highest AAMRs. This highlights the urgent need for targeted interventions to control mortality and disparities across different epidemiological groups.

Volume

9

Issue

Suppl 1

First Page

A594

Comments

ENDO 2025 Endocrine Society Annual Meeting, July 12-15, 2025, San Francisco, CA

Last Page

A594

DOI

10.1210/jendso/bvaf149.1119

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