SAT-564 Trends in Mortality Due to Diabetes Mellitus and Stroke in the United States (1999-2020): A National Epidemiological Study

Abstract Disclosure: F. Ahmed: None. A. Fayyaz: None. Y. Rasheed: None. H. Ahmad: None. H. Abid: None. T. Mirza: None. M. Abid: None. H. Zahid: None. R. Haider: None. A. Ullah: None. N. Gohar: None. O.M. Kamel: None. S. Eltawansy: None. M. Bakr: None. M. Hashim: None. A. Sohail: None. Introduction: Diabetes Mellitus (DM) is a key risk factor for stroke, significantly contributing to mortality in U.S. This study analyzes long-term trends in DM- and stroke-related mortality (1999-2020) using CDC WONDER data. We assess demographic, geographic, and clinical disparities through age-adjusted mortality rates (AAMRs), joinpoint regression models, and annual percentage change (APC) analysis. Methods: A retrospective analysis of 696,849 DM- and stroke-related deaths among adults aged ≥25 years was conducted. AAMRs per 100,000 population (95% confidence intervals [CIs]) were calculated, and joinpoint regression models estimated annual and average annual percentage changes (AAPC), with significance set at p < 0.05. Results: From 1999 to 2020, AAMR fell from 20.08 (95% CI: 19.87-20.29) in 1999 to 16.04 (95% CI: 15.89-16.19) in 2020, reaching its lowest in 2014 at 11.89 (95% CI: 11.75-12.03) with most of the deaths occurring in medical inpatient facilities (36.7%). The overall mean AAMR was 14.65 (95% CI: 14.61-14.68) with an AAPC of -1.39%, 95% CI: -1.81 to -1.13, p < 0.000001. Mortality in females and males exhibited decreasing trends with AAPCs (Females: -1.70%, 95% CI -2.06 to -1.37, p < 0.000001; Males: -0.94%, 95% CI -1.39 to -0.64, p < 0.000001). The highest AAMR was in the South (15.71, 95% CI: 15.65-15.77), followed by the West (15.57, 95% CI: 15.49-15.64), Midwest (15.16, 95% CI: 15.09-15.23), and Northeast (11.17, 95% CI: 11.1-11.24). The Northeast showed the steepest mortality decline (AAPC: -2.05%, 95% CI: -2.53 to -1.78, p < 0.000001), followed by the Midwest (-1.60%, 95% CI: -2.03 to -1.35, p < 0.0000001), West (-1.43%, 95% CI: -2.03 to -1.07, p < 0.0000001), and South (-0.86%, 95% CI: -1.19 to -0.51, p < 0.0000001). The highest AAMRs were in African Americans (28.89, 95% CI: 28.73-29.06), followed by American Indians (20.99, 95% CI: 20.39-21.6), Pacific Islanders (14.73, 95% CI: 14.55-14.92), and Whites (12.69, 95% CI: 12.65-12.72). The largest decline was in Pacific Islanders (AAPC: -2.13%, 95% CI: -2.69 to -1.51, p < 0.0000001). Urban mortality declined from 19.48 in 1999 to 15.35 in 2020, with the lowest in 2009 (12.5, 95% CI: 12.33-12.67). Rural AAMR declined from 22.74 in 1999 to 19.65 in 2020, touching its lowest in 2014 (12.26, 95% CI: 13.89-14.64). AAPC was -1.49% in urban (95% CI: -1.93 to -1.20, p < 0.000001) and -0.92% in rural populations (95% CI: -1.29 to -0.68, p < 0.000001). States in the 90th percentile for AAMR included Ohio, New York and California, while Alaska, Wyoming, and Utah were in the 10th percentile. Conclusion: DM- and stroke-related mortality has declined over two decades, yet disparities persist across gender, race, geography, and urbanization. Males, Black/African Americans, rural populations, and Southern states face the highest burden. Public health efforts must focus on targeted risk reduction and enhanced disease management. Presentation: Saturday, July 12, 2025