Regional and demographic variations in diabetes mellitus and myocardial infarction mortality among US adults: a retrospective observational analysis from 1999-2023

Abstract Background Individuals with diabetes mellitus (DM) are at an increased risk of having myocardial infarction (MI). However, long-term DM and MI-related mortality data are limited. We aim to identify the trends in the mortality rates from DM and MI among US adults stratified by demographic and geographical parameters. Methods The CDC-WONDER database was used to extract death certificate data for adults aged ≥ 25 years. Crude mortality rates (CMR) and age-adjusted mortality rates (AAMRs) per 100,000 persons were calculated, and temporal trends were identified by calculating annual percent change (APC) using JoinPoint regression analysis. Results From 1999 to 2023, a total of 712,921 DM and MI-related deaths were reported among adults in the United States. The AAMR significantly declined from 18.99 in 1999 to 10.20 in 2018 Following this, the AAMR rose to 12.27 in 2021, with an APC of 7.2 (95% CI: 4.7 to 8.9). This was followed by a decline in AAMR to the pre-pandemic levels (AAMR: 9.6 in 2023). The AAMR for males was considerably higher compared to women throughout the study period (16.5 vs. 10.2). Non-Hispanic Black or African American people had the highest AAMR (19.5), followed by Hispanic or Latino people (15.3), NH white people (12.5), and NH other populations (11.2). Southern region and rural areas experienced higher mortality rates compared to urban areas. Conclusion We observed decreasing trends in DM and myocardial infarction-related deaths throughout the study period, however, a surge was noted during the COVID-19 pandemic. Mortality is higher among men, NH black populations, and rural areas.Overall and sex stratified AAMR Race stratified AAMR