Trends and Disparities in Mortality Due to Non-Insulin Dependent Diabetes Mellitus and Acute Myocardial Infarction: A 23-Year Analysis from 1999 to 2022

Abstract Background Non-insulin dependent diabetes mellitus (NIDDM) and acute myocardial infarction (MI) are critical health challenges that increase mortality, particularly in older adults. This study analyzed trends in AAMRs and disparities in comorbid NIDDM and MI mortality (1999–2022) across demographics, regions, and age groups to identify inequities and guide interventions. Methods Mortality data from CDC death certificates were analyzed. AAMRs per 1000,000 and annual percentage changes (APCs) with 95% confidence intervals (CIs) were calculated using Joinpoint Regression. Results From 1999–2022, 183,221 deaths were attributed to comorbid NIDDM and MI, with men consistently having higher rates than women. American Indians/Alaska Natives showed the highest AAMRs, followed by Non-Hispanic Blacks, while Asian/Pacific Islanders had the lowest. The West (AAMR 118.8) and Midwest (115.0) had the highest rates, while the Northeast had the lowest (70.4). Age-specific trends showed the steepest increases among individuals aged 85+. Non-metropolitan areas saw sharper rises post-2015 (APC 7.4), while metropolitan areas showed a moderate increase (APC 6.1). West Virginia recorded the highest state burden (AAMR 173.6), while Nevada had the lowest (30.1). Conclusion Mortality from comorbid NIDDM and MI has surged, with widening disparities across gender, race, regions, and age groups. Targeted interventions are essential to reduce these inequities and prevent deaths.