Trends and Disparities in Neurological Complications Associated Mortality Among Individuals With Type 2 Diabetes Mellitus in the United States from 1999 to 2020: A CDC Wonder Analysis

Document Type

Conference Proceeding

Publication Date

10-2025

Publication Title

Journal of the Endocrine Society

Abstract

Background: Neurological complications (NC) are a significant yet often overlooked cause of mortality in individuals with Type 2 Diabetes Mellitus (T2DM). Chronic hyperglycemia and vascular dysfunction contribute to cerebrovascular disease, neuropathy, and cognitive decline, exacerbating morbidity and mortality. Identifying mortality trends in these complications is essential for recognizing high-risk populations and guiding targeted interventions. Methods: We analyzed NC-related mortality in T2DM patients using CDC WONDER data (1999-2020) and ICD-10 codes E03, I10-I15. Age-Adjusted Mortality Rate (AAMR) per 1,000,000 and annual percent changes (APC) with 95% CI were calculated. Joinpoint Regression identified trends and disparities across age, gender, region, and race. A parallelism test was applied where significant (p< 0.05). Results: A total of 11,606 deaths were reported due to NC in patients with T2DM between 1999 and 2020. Overall trend shows an increase in mortality with a gradual increase from 1999 to 2014 (APC: 3.99; 95%CI: 7.07-7.78) followed by sharp increase from 2014 till 2020 (APC: 14.76;95%CI: 11.07-18.57). Mortality increased with age, with highest crude mortality rate (CMR) observed in 85+ years age group and lowest in 35-54 years age group. Males had higher AAMR throughout the study period as compared to females. Mortality was higher in the Midwest as compared to the Northeast. In Northeast, AAMR minimally increased from 1999 to 2012 (APC: 1.61; 95%CI: 0.69-3.97: p = 0.16) followed by sharp increase till 2020 (APC: 14.21; 95%CI:10.79-17.74; p < 0.001). Whereas in Midwest, AAMR increased from 1999 to 2002 (APC: 17.63; 95%CI: 7.01-48.83; p = 0.16), followed by negligible increase till 2013 (APC: 0.44;95%CI: 2.45-3.43; p = 0.749) which was later followed by sharp increase till 2020 (APC: 15.64; 95%CI: 11.40-19.83; p < 0.001). Among the states, the highest AAMR was exhibited by Wyoming (3.93) and lowest by New York (0.428). Similarly, in among racial groups, the highest number of deaths were reported in whites, followed by Black or African American, Asian or pacific islander, and American Indian or Alaskan natives. Conclusion: Overall, the mortality trend due to NC in patients with T2DM increased from 1999 to 2020. Males, Northeast region, Wyoming, and Whites had highest AAMRs. This all highlights the urgent need for targeted interventions to control mortality and disparities across different epidemiological groups.

Volume

9

Issue

Suppl 1

First Page

A857

Comments

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

Last Page

A858

DOI

10.1210/jendso/bvaf149.1625

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