Mortality Trends in Patients Aged 25 and Older With Comorbid COPD and Diabetes Mellitus in the United States: A CDC WONDER Database Study From 2000 to 2023.
Diabetes mellitus (DM) and chronic obstructive pulmonary disease (COPD) are among the leading chronic diseases that significantly impact global morbidity and mortality. Growing evidence indicates a bidirectional interplay between metabolic and pulmonary dysfunction. This study aims to identify the demographic and regional trends of DM and COPD-related mortality in the United States from 2000 to 2023.
DM- and COPD-related deaths in the United States from 2000 to 2023 were obtained from the CDC WONDER database using ICD-10 code E10-14 for DM and J40-44 as the underlying cause of death. Results are presented as age-adjusted mortality rates (AAMR) per 100,000 population, with Joinpoint regression used for trend analysis and to calculate annual percentage change (APC).
A total of 796,757 DM- and COPD-related deaths were recorded. From 2000 to 2008, the AAMR for DM and COPD increased from 11.19 to 14.32, remaining relatively stable until 2018. This was followed by a significant rise to 19.03 in 2021 (APC: 10.57), before declining to 16.28 in 2023 (APC: -9.08). Men demonstrated a higher AAMR (19.28) than women (12.02); however, both experienced decline post-2021, with rates falling to 20.54 in men (APC: -9.08) and 13.02 in women (APC: -8.33). AAMR increased among all racial groups except Asians and Hispanics. From 2000 to 2021, American Indians had the highest AAMR (30.48). After 2021, AAMR declined across all groups. Rural areas reported higher AAMR (19.02), compared to urban areas (12.85). AAMR in rural areas increased markedly from 2018 to 2020 (13.67). State-level comparisons revealed substantial variation in AAMR. Oklahoma had the highest rate at 28.79, followed by West Virginia (28.53), Kentucky (26.74), Vermont (23.95), and Mississippi (20.83). In contrast, Hawaii (6.69), Utah (7.33), and Massachusetts (7.99) reported the lowest rates, all below 10. Regionally, the Midwest had the highest average AAMR (16.30).
COPD-related diabetes mortality rose from 2000 to 2020, highest among men, Non-Hispanic American Indians, and rural populations, and then declined post-2021. Findings indicate increased vulnerability during acute events, highlighting the need for targeted interventions.
DM- and COPD-related deaths in the United States from 2000 to 2023 were obtained from the CDC WONDER database using ICD-10 code E10-14 for DM and J40-44 as the underlying cause of death. Results are presented as age-adjusted mortality rates (AAMR) per 100,000 population, with Joinpoint regression used for trend analysis and to calculate annual percentage change (APC).
A total of 796,757 DM- and COPD-related deaths were recorded. From 2000 to 2008, the AAMR for DM and COPD increased from 11.19 to 14.32, remaining relatively stable until 2018. This was followed by a significant rise to 19.03 in 2021 (APC: 10.57), before declining to 16.28 in 2023 (APC: -9.08). Men demonstrated a higher AAMR (19.28) than women (12.02); however, both experienced decline post-2021, with rates falling to 20.54 in men (APC: -9.08) and 13.02 in women (APC: -8.33). AAMR increased among all racial groups except Asians and Hispanics. From 2000 to 2021, American Indians had the highest AAMR (30.48). After 2021, AAMR declined across all groups. Rural areas reported higher AAMR (19.02), compared to urban areas (12.85). AAMR in rural areas increased markedly from 2018 to 2020 (13.67). State-level comparisons revealed substantial variation in AAMR. Oklahoma had the highest rate at 28.79, followed by West Virginia (28.53), Kentucky (26.74), Vermont (23.95), and Mississippi (20.83). In contrast, Hawaii (6.69), Utah (7.33), and Massachusetts (7.99) reported the lowest rates, all below 10. Regionally, the Midwest had the highest average AAMR (16.30).
COPD-related diabetes mortality rose from 2000 to 2020, highest among men, Non-Hispanic American Indians, and rural populations, and then declined post-2021. Findings indicate increased vulnerability during acute events, highlighting the need for targeted interventions.
Authors
Ahmed Ahmed, Fatima Fatima, Shafiq Shafiq, Mansoor Mansoor, Aqsa Aqsa, Naveed Naveed, Ali Ali, Sandhyavenu Sandhyavenu, Qureshi Qureshi, Neppala Neppala
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