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