Trends in mortality and comorbidity of type 2 diabetes mellitus among u.S. adultswith multiple myeloma: A CDC wonder-based analysis, 1999–2023

Abstract Background : Type 2 diabetes and Multiple myeloma are becoming a growing cause of worry among aging populations. Type 2 diabetes and Multiple myeloma share many risk factors like age, obesity, and chronic inflammation. It is also found that diabetes may influence the worsening of multiple myeloma. Hence it becomes crucial to understand the epidemiological intersections between the two conditions in order to optimise treatment and lower death rates. This study assesses the trends in mortality in patients with Type 2 diabetes and Multiple myeloma in the United States from 1999-2023. Methods : We analyzed death certificates of adults aged>45 years' from the CDC-WONDER database with Type 2 diabetes (ICD-10 codes: E10-14) and Multiple myeloma (ICD-10 codes: C90) from 1999-2023. Age-adjusted mortality rates (AAMR) per 100,000 population were stratified by gender, race, census region, year and age. Join-Point analysis was performed to estimate annual percent change (APC) and average annual percent change (AAPC) in mortality trends, along with 95% confidence intervals (CIs). Results: Between 1999 and 2023, Type 2 diabetes and Multiple myeloma caused 22,467 deaths in patients aged>45 years. The overall AAMR increased from 0.647 in 1999 to 0.886 in 2023. Demographically, AAMR among the men increased significantly from 0.827 to 1.205 (AAPC: 1.22; 95% CI: -1.02 to 3.52). Although experiencing a lower mortality as compared to males, females also experienced a surge in mortality from 0.563 to 0.633(AAPC: 0.90; 95% CI: -0.11 to 1.93). In terms of race, mortality increased among the Non-Hispanic (NH) Black or African Americans from 1.942 to 2.158 (AAPC:0.60 ; 95% CI: -0.06 to 1.26), moreover the AAMR in the Hispanics increased from 0.986 to 1.099 (AAPC: 0.84; 95% CI:-0.05 to 1.73) while those among the white community increased from 0.493 to 0.679 (AAPC: 0.87; 95% CI -1.13 to 2.91). Geographically, regions in the South showed the highest overall AAMR (0.760) followed by the West (0.748), followed by the Midwest(0.731), and the Northeast (0.617). Between the urban and rural areas, rural areas had a higher AAMR as compared to the urban areas with an overall AAMR of 0.809. When stratified according to states, AAMRs varied highly from the highest in Columbia to the lowest in California. Conclusion: The overall mortality rates for Type 2 diabetes and Multiple myeloma increased between the years 1999-2023. The greatest change was seen in males, regions in the Northeast, racially in NH Blacks and the rural areas.