A Retrospective Study of Disparities in Mortality Due to Diabetes Mellitus Over a 22-Year Period in the United States

Background: Diabetes mellitus (DM) is a chronic endocrine disorder characterized by impaired insulin production or resistance to its action, resulting in elevated blood glucose levels. Urban-rural mortality rate of DM signifies the understanding of health disparities by analyzing differences in health and well-being of populations living in urban and rural areas. Methodology: A retrospective comparative study was conducted by collecting data from the CDC WONDER (Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research) database on August 24, 2022. ICD-10 (International Classification of Diseases, 10th Revision) codes E10-E14 were used, and the data were categorized into rural and urban deaths based on the 2013 urbanization classification. The variables used to study these differences were age, gender, and race. Results: The mortality due to DM was higher in rural areas compared to urban areas for all age groups, genders, and races. Significantly higher crude mortality rates per 100,000 population were observed in rural areas among individuals aged 75-84 years (177.17) and +85 years (347.37), compared with other age groups. In rural areas, males (33.91) had a significantly higher mortality rate than females (33.10). Mortality rates were also significantly higher in rural areas among Black or African American individuals (43.75) and American Indian or Alaska Native individuals (40.85), compared with other racial groups. Conclusions: This study reveals the significant disparities in urban versus rural mortality among patients with DM over 22 years. A substantial increase was seen in all races of individuals in the United States. There was a significant rise in mortality trends for both rural and urban populations in the year 2020, and a huge difference was seen in the mortality rate of American Indians in both urban and rural areas.