Diabetes Mellitus and Depressive Disorder-Related Mortality in the United States (1999–2020): A Demographic Analysis of Long-Term Trends

Introduction: Diabetes mellitus remains a significant public health challenge in the United States, with depressive disorder frequently compounding its burden. Together, these comorbid conditions not only worsen clinical outcomes but may also drive long-term mortality. However, national-level data exploring mortality trends at their intersection remain limited. Objective: This study aims to analyze mortality trends and demographic disparities in diabetes mellitus with depressive disorder as a contributing cause using the Centers for Disease Control and Prevention (CDC) Multiple Causes of Death (MCD) database from 1999 to 2020. Materials and methods: A retrospective observational study was conducted using the CDC MCD database to assess mortality trends in individuals aged 25 years and older in the United States from 1999 to 2020. The study included deaths where diabetes mellitus (ICD-10: E10-E14) was listed as the underlying cause and depressive disorder (ICD-10: F32) as a contributing cause. Data were analyzed by age, gender, race, geographic region, and place of death. Age-adjusted mortality rates (AAMR) and annual percentage change (APC) were calculated. Results: A total of 13644 deaths were recorded. The AAMR for diabetes mellitus with depressive disorder showed an initial increase (6.04% APC from 1999 to 2002), but declined significantly (-3.49% APC from 2002 to 2010) and then had a significant incline (3.32% APC from 2010 to 2020). The highest mortality was observed in females (n = 7842, 57.5%), White individuals (n = 11885, 87.1%), and metropolitan areas (n = 10618, 77.8%). Temporal trends showed an increase in AAMR in males (+11.47% APC from 2018 to 2020) and White individuals (+4.04% APC from 2011 to 2020), with disparities noted across demographic and geographic factors. Conclusions: This study highlights significant mortality trends increasing in diabetes mellitus with depressive disorder, with disparities by gender, race, and location. Findings underscore the need for targeted prevention strategies and improved healthcare access.