Abstract Body (Do not enter title and authors here): Background:
Diabetes mellitus (DM) is a major public health concern in the United States, with peripheral circulatory complications significantly contributing to morbidity and mortality. This study examines the temporal patterns and demographic disparities in mortality related to diabetes mellitus with peripheral circulatory complications in the U.S. from 1999 to 2020.
Research question
What are the temporal trends and demographic disparities in mortality from diabetes mellitus with peripheral circulatory complications in the U.S. from 1999 to 2020?
Methods:
We performed a retrospective cohort study using death certificate data from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiological Research (CDC WONDER) database from 1999 to 2020. We calculated age-adjusted mortality rates (AAMRs), annual percent change (APC), and average annual percentage change (AAPC) per 1,000,000 persons. The data were stratified based on year, gender, ethnicity, and geographic area.
Results:
Between 1999 and 2020, peripheral circulatory complications in Diabetes Mellitus accounted for 99259 deaths among adults (≥25 years) in the United States. The overall AAMR for peripheral circulatory complications in Diabetes Mellitus-related deaths increased from 25.20 in 1999 to 25.4657 in 2004 (APC: 0.16; 95% CI: -2.61 to 7.03), after which it declined sharply to 14.91 in 2014 (APC: -5.12*; 95% CI: -8.18 to -4.03), and then increased again, sharply this time, to 25.28 in 2020 (APC: 7.51*; 95% CI: 5.18 to 10.60). Majority of the deaths occurred in medical facilities inpatient (33.8%). Men exhibited higher AAMRs compared to women (men: 27.5; women: 16.0). Highest Crude Mortality Rate (CMR) was seen in adults aged ≥ 85 years. Non-Hispanic (NH) American Indians showed the highest AAMRs (42.13), followed by NH Black (35.02), Hispanic (27.79), NH White (18.96), and NH Asian (10.41). Geographically, AAMRs ranged from 5.72 in Nevada to 34.97 in West Virginia, with Midwestern region having the highest mortality (AAMR: 24.43). Non-metropolitan areas exhibited higher AAMRs than Metropolitan areas (non-metropolitan: 25.86; Metropolitan: 19.73).
Conclusion:
After a period of decline (2004–2014), mortality from peripheral circulatory complications in adults with Diabetes Mellitus has risen since 2014, with notable disparities across racial and geographic groups. These trends highlight the need for targeted interventions and equitable healthcare access.