Targeted Diabetes Interventions Needed Amid Rising Mortality—Trends and Disparities in the United States (2000–2020)

Introduction and Objective: Diabetes mellitus (DM) is a leading cause of mortality in the U.S. Understanding mortality trends is critical for public health planning. We aimed to investigate longitudinal trends, and demographic and geographic disparities in DM mortality. Methods: This study analyzed CDC WONDER data from 1,586,563 deaths among individuals aged ≥35 years between 2000 and 2020, with DM (E10-E14) listed as the underlying cause of death. Age-adjusted mortality rates (AAMRs) per 100,000 were calculated. Temporal trends were evaluated to determine annual percent change (APC). Results: From 2005-2009, AAMRs declined from 48.2 to 40.6 (APC -4.1%, p<0.05). Rates plateaued (2009-2018), then rose sharply from 41.1 in 2018 to 47.7 in 2020 (APC +5.4%, p<0.01). Cumulative AAMRs were higher in males (52.1) than females (36.9). African Americans experienced the highest AAMR (79.8), followed by American Indians (70.0), and White adults (39.9). Noncore rural regions had higher AAMRs than large central metropolitan areas (51.0 vs. 43.2). Southern states had the highest AAMR (46.6), while the Northeast had the lowest AAMR (38.0). Conclusion: DM mortality trends show a concerning recent increase, with higher AAMRs observed among males, African Americans, and rural residents. These findings underscore the urgent need for targeted interventions to reduce healthcare inequities and address the disproportionate burden on vulnerable populations. Disclosure: P. Ashar: None. K. Tamirisa: None. A. Kulkarni: None.