MON-548 Trends and Disparities in Respiratory Failure Associated Mortality Among Individuals with Diabetes in the United States from 1999 to 2020: A CDC Wonder Analysis.

Disclosure: F. Ahmed: None. I. Shahid: None. F. Fatima: None. M. Fatima: None. H. Abid: None. N.U. saleem: None. A. Raza: None. M. Ali: None. H. Ahmad: None. M. Abid: None. A. Zafar Masood: None. M. Kakakhel: None. H. Zahid: None. N. Gohar: None. M. Bakr: None. K. Aman: None. T. Mirza: None. O.M. Kamel: None. A. Ullah: None. R. Haider: None. M. Ahmed: None. S. Eltawansy: None. A. Sohail: None. A. Bhat: None. Background: Diabetes worsens respiratory failure outcomes through hyperglycemia, oxidative stress, and immune dysfunction. Despite critical care advances, disparities persist in diabetes-related respiratory failure mortality. Using the CDC WONDER database spanning over two decades, we analyze national trends and disparities to highlight evolving patterns and healthcare inequities. Methods: This study is based on an in-depth search of the CDC WONDER database (1999-2020) involving ICD-10 Codes: E10-E14 and J96 using Age-Adjusted Mortality Rate (AAMR) per 1,000,000 individuals. Joinpoint regression (Version 5.1.0, National Cancer Institute) was used to assess parallelism, annual percent changes (APC), and average APCs (AAPCs) with a 95% confidence interval. The parallelism test shows trends between two groups are not parallel if p < 0.05. Results: A total of 413,378 deaths were reported from 1999 to 2020. There was a consistent increase in AAMR from 1999 to 2018 (APC: 2.29: 95% CI; 1.99-2.58; p < 0.001), followed by a drastic increase till 2020 (APC: 38.5: 95% CI; 29.6-47.95; p < 0.001). Males had consistently high AAMR throughout the study period with a gradual increase from 1999 to 2018 (APC: 2.51; 95% CI: 2.23-2.79; p < 0.001), followed by a dramatic increase till 2020 (APC: 42.6; 95% CI: 34.5-51.2; p < 0.001). In females, AAMR followed a similar trend with a gradual increase till 2018 (APC: 1.92; 95% CI: 1.59-2.25; p < 0.001), followed by a sharp increase till 2020 (APC: 33.6; 95% CI: 23.6-44.3; p < 0.001). The West region had the highest AAMR (66.89), followed by South (57.03), Midwest (50.53), and Northeast (48.05). In Northeast AAMR, there was a gradual increase from 1999 to 2018 (APC: 0.88; 95% CI: 0.55-1.20; p < 0.001), followed by a sharp increase till 2020 (APC: 43.6; 95% CI: 32.4-55.8; p < 0.001). In the Midwest region, AAMR gradually increased till 2018 (APC: 2.72; 95% CI: 2.30-3.14; p < 0.001), followed by a sudden increase till 2020 (APC: 40.7; 95% CI: 28.4-54.20; p < 0.001). The AAMR was highest for Mississippi (103.9) and lowest for Alaska (25.03). The Black or African American showed the highest AAMR (86.36), followed by white and Asian (62.28) and Pacific Islander (52.92). The highest mortality burden was recorded in individuals aged 85+ among all other age groups. Conclusion: Overall, the mortality trend due to respiratory failure in diabetics increased from 1999 to 2020, but the tremendous increase from 2018 to 2020 is alarming. Males, west, Mississippi Natives, Blacks, or African Americans had higher AAMRs. This all highlights the urgent need for targeted interventions to control mortality and disparities across different epidemiological groups. Presentation: Monday, July 14, 2025