Abstract TP118: Temporal Trends and Disparities in Non-Specified Stroke Mortality Among Adults with Diabetes Mellitus in the United States: A CDC WONDER Analysis from 1999 to 2020

Background: Stroke is a leading cause of death and disability, with diabetes mellitus (DM) increasing the risk. However, trends in stroke mortality not classified as ischemic or hemorrhagic among individuals with DM are poorly understood. Methods: We analyzed CDC WONDER data (1999–2020) for adults aged ≥25 years with non-specified stroke (ICD-10: I64) and DM (E10–E14). Age-adjusted mortality rates (AAMRs) per 100,000 were calculated using the 2000 U.S. standard population. Joinpoint regression assessed trends via Annual Percent Change (APC) and Average Annual Percent Change (AAPC), stratified by demographics and geography. Results: Between 1999 and 2020, there were 407570 deaths due to stroke (not-specified as hemorrhage or infarction) with diabetes mellitus, highest in medical facilities (41.89%). AAMR declined from 12.97 to 7.36, with a drop from 1999–2018 (APC: –4.4), followed by a rise from 2018–2020 (APC: 11.5) and a total AAMR of 8.58. Males (9.31), and NH Black individuals (17.61) had the highest total AAMRs; females (8.00), and NH Whites (7.42) the lowest. The South (9.35), Mississippi (16.2), and Noncore rural areas (9.36) had the highest AAMRs; the Northeast (6.69), Nevada (4.26), and Large Fringe Metro areas (10.75) the lowest. Conclusion: After years of decline, non-specified stroke mortality among adults with DM is rising again, with a disproportionate impact on NH Black males in Noncore Southern regions.