Trends and Demographic Disparities Among Adults With Sudden Cardiac Death and Diabetes Mellitus in the United States: A Nationwide Analysis

Background Sudden cardiac death (SCD) represents a major cause of cardiovascular mortality, with diabetes mellitus (DM) significantly increasing susceptibility. However, long‐term national trends and demographic disparities in SCD among decedents with co‐documented SCD and DM remain insufficiently characterized. Methods We conducted a retrospective analysis using the CDC WONDER database from 1999 to 2020. Adults with SCD and DM listed on death certificates were included. Age‐adjusted mortality rates (AAMRs) per 100 000 population were calculated and stratified by sex, age group, race/ethnicity, census region, state, and urbanization status. Temporal trends were assessed using annual percent changes (APCs), with p < 0.05 considered statistically significant. Results A total of 51 756 deaths among decedents with co‐documented SCD and DM were identified. Overall AAMR increased from 1.29 in 1999 to 1.46 in 2020 (APC +0.46%, p = 0.012). Men had significantly higher mortality than women. Older adults (≥ 75 years) exhibited the highest mortality burden, though relative increases were notable in younger groups. Black individuals had the highest mortality, with a sharp rise in 2020. Rural populations experienced higher mortality than urban counterparts, with significant upward trends. Southern states demonstrated the highest regional burden. Conclusion The population‐level burden of co‐documented SCD and DM in the United States has increased modestly over the past two decades, with significant demographic and geographic disparities. Targeted public health interventions and equitable cardiovascular risk management are urgently needed to reduce these disparities.