S2757 Temporal Trends in Mortality Associated With Coexisting Liver Cirrhosis and Diabetes Mellitus Among Adults in the US (1999-2023): A CDC WONDER-Based Study

Introduction: Liver cirrhosis (LC) and diabetes mellitus (DM) significantly contribute to adult morbidity and mortality in the United States (U.S.). Inspite of the ongoing investigation and increasing burden of the disease, disparities in mortality persist across demographic and geographic groups. To evaluate temporal and regional mortality trends related to LC and DM among U.S. adults, emphasizing demographic disparities and geographic variation. Methods: We examined CDC-WONDER data on deaths related to LC and DM among adults aged ≥25 from 1999 to 2023. Age-adjusted mortality rates (AAMRs) per 100,000 were calculated. Joinpoint regression was used to determine annual percent change (APC) and average annual percent change (AAPC) across categories. Results: From 1999-2023, a total of 115,388 LC and DM-related deaths were recorded among adults aged ≥25, with most deaths occurring in medical facilities (50,244). AAMR increased from 1.58 in 1999 to 2.88 in 2023, with an AAPC of 2.49 (95% CI: 1.62–3.36, P < 0.000001). Men consistently accounted for a higher share of mortality (63,347 deaths; AAPC = 2.75) than women (52,041 deaths; AAPC = 2.5). Among the Non-Hispanic population, NH Whites had the highest (80,603) deaths with AAMR from 1.39 in 1999 to 2.83 in 2023 and AAPC = 2.99 (95% CI: 2.07 to 3.91, P < 0.000001). The South recorded the highest number of deaths (48,932) with a significant increase in AAMR from 1.53 in 1999 to 3.49 in 2023. Non-metropolitan areas had higher AAMR values than metropolitan areas (2.14 vs 1.8), although metropolitan areas had increasing number of deaths (72,533 vs 7,845).The states that fell in the top 90th percentile were Oklahoma (3.49), Texas (3.39), Kentucky (3.05), West Virginia (2.95) and New Mexico (2.81). Conclusion: Mortality related to Coexisting Liver Cirrhosis and DM has risen significantly, with pronounced disparities by year, sex, age and region. Focused public health efforts are needed to address these differences and promote equitable care and outcomes.