2287-P: Trends and Disparities in Mortality Due to Coexisting Diabetes Mellitus and Chronic Obstructive Pulmonary Disease among Adults in the U.S. (1999–2023): Insights from the CDC Wonder Database



Introduction and Objective: The coexistence of diabetes and chronic obstructive pulmonary disease (DM and COPD) portends poorer outcomes. Yet, nationwide mortality trends and geographic disparities for this comorbidity are poorly characterized.Methods: We analyzed CDC WONDER Multiple Cause-of-Death data (1999-2023) for adults ≥35 with both DM and COPD. Age-adjusted mortality rates (AAMRs per 100,000) were calculated. Trends were evaluated using Joinpoint regression to compute annual percent change (APC) and average APC.Results: From 1999-2023, 815,444 deaths occurred. Overall AAMR rose 1.5-fold (AAPC 1.68%), with a sharp increase (1999-2008), stability (2008-2018), a surge to peak 24.08 (2018-2021), then decline. Males had higher AAMR than females (23.62 vs 14.62). Racial disparities were marked, with highest AAMR in Non-Hispanic American Indian/Alaska Native (26.93) and Black (20.14) groups. Mortality increased with age; rates in adults ≥65 were 12 times those in 35-64. Geographic inequality was striking, with state-level AAMRs (1999-2020) varying nearly 4-fold, highest in Appalachian/Southern states (e.g., West Virginia 35.69) and lowest in Hawaii (8.48) (Figure 1).Conclusion: Mortality from coexisting DM and COPD has risen significantly over 24 years, peaking recently then declining. Marked disparities by sex, race, age, and geography underscore critical unmet needs.

Disclosure

Z. Li: None. J. Li: None. R. Duan: None. Y. Yan: None. A. Zhao: None. S. Liu: None.

Funding

This work was supported by Collaborative Traditional Chinese and Modern Medicine for Chronic Disease Management Research Project (CXZH2024085); Shanxi Province Metabolic Disease (Type 1 Diabetes) Clinical Medical Research Center (20240410501001); Shanxi Province Science and Technology Achievements Transformation Guidance Special Fund (202304021301066); Shanxi Province Science and Technology Innovation Talent Team Special Plan (202204051002029); Shanxi Province Research Funding for Returned Overseas Scholars (2024-143); Shanxi Province Basic Research Program (202303021212330); Shanxi Province Key Laboratory of Endocrine and Metabolic Diseases (202404010920011).



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