Hassan Syed Tawassul, Faheem Muhammad Shaheer Bin, Sufi Yasmeen, Nadeem Anushah, Siddiqui Wajeeha, Sameen Dur E, Ahmed Amna Kaleem, Nasir Faiza, Samadi Sumaya
Karachi Medical and Dental College, Karachi, Pakistan.
Karachi Institute of Medical Sciences, KIMS, Karachi, Pakistan.
Brain Behav. 2025 Aug;15(8):e70723. doi: 10.1002/brb3.70723.
Diabetes mellitus (DM) has a strong bidirectional relationship with mental disorders, collectively increasing the risk of mortality. We aim to analyze the mortality trends related to DM and associated mental disorders while exploring demographic and regional disparities in the United States from 1999 to 2023.
Death records were obtained from the Centers for Disease Control and Prevention-Wide-ranging ONline Data for Epidemiologic Research (CDC WONDER) database from 1999 to 2023. Crude and age-adjusted mortality rates (AAMRs), measured per 100,000 people, were calculated and standardized to the 2000 US standard population. Annual percent changes (APCs) in AAMRs and crude mortality rates (CMRs) were computed through the Joinpoint regression program and data stratification was done based on sex, race, age, and geographical regions.
A total of 1,332,198 death records indicated the presence of both DM and mental disorders. AAMR increased fourfold from 1999 (9.5) to 2023 (40.4) per 100,000 population. Notable increase shifts were noted in AAMR across different periods between 1999 and 2021 (APC: 1999-2005: 14.98; 2005-2018: 2.92; 2018-2021: 8.98), after which it declined sharply until 2023 (APC: -6.42). Males (36.8) had elevated AAMRs in comparison to females (22.4). Non-Hispanic (NH) American Indians contributed to most of the AAMR (39.8). CMR was 11-fold higher in older adults as compared to those aged between 35 and 64 years. Regionally, AAMRs in nonmetropolitan areas (35.9) and Midwest regions (34.7) were the highest.
Further research and targeted interventions are needed for in-depth evaluation of these rising mortality trends to find the root cause and lower the burden of DM and associated mental disorders.
糖尿病（DM）与精神障碍存在强烈的双向关系，共同增加了死亡风险。我们旨在分析与糖尿病及相关精神障碍相关的死亡趋势，同时探讨1999年至2023年美国的人口和地区差异。
从疾病控制与预防中心的广泛流行病学在线数据（CDC WONDER）数据库中获取1999年至2023年的死亡记录。计算每10万人的粗死亡率和年龄调整死亡率（AAMR），并根据2000年美国标准人口进行标准化。通过Joinpoint回归程序计算AAMR和粗死亡率（CMR）的年度百分比变化（APC），并根据性别、种族、年龄和地理区域进行数据分层。
共有1332198条死亡记录显示同时存在糖尿病和精神障碍。每10万人口的AAMR从1999年的9.5上升到2023年的40.4，增长了四倍。1999年至2021年不同时期的AAMR出现了显著的上升变化（APC：1999 - 2005年：14.98；2005 - 2018年：2.92；2018 - 2021年：8.98），之后到2023年急剧下降（APC：-6.42）。男性的AAMR（36.8）高于女性（22.4）。非西班牙裔（NH）美国印第安人占AAMR的大部分（39.8）。老年人的CMR比35至64岁的人高11倍。在地区上，非都市地区（35.9）和中西部地区（-6.42）的AAMR最高。
需要进一步研究和有针对性的干预措施，以深入评估这些不断上升的死亡趋势，找出根本原因并降低糖尿病及相关精神障碍的负担。
