Prushni Bantu, Dhillon Harnoor, Patel Dhwani, Lu Xinyu, Pulluru Maheswari, Edwards Jeremy
Internal Medicine, Sri Venkateswara Medical College, Tirupati, IND.
Internal Medicine, Bharati Vidyapeeth (Deemed to Be University) Medical College, Pune, Pune, IND.
Cureus. 2025 Aug 18;17(8):e90376. doi: 10.7759/cureus.90376. eCollection 2025 Aug.
Diabetes mellitus (DM) is a major cause of mortality, and its association with heart failure (HF) remains underexplored. Understanding this relationship is essential to identifying high-risk populations and developing targeted public health interventions.
This study aims to analyze mortality trends and demographic disparities in DM with HF as a contributing cause.
A retrospective observational study was conducted using the Centers for Disease Control and Prevention (CDC) Multiple Causes of Death (MCD) database to assess mortality trends in individuals aged 25 years and older in the United States from 1999 to 2020. The study included deaths where DM (International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10): E10-14) was listed as the underlying cause and HF (ICD-10: I50) as a contributing cause. Data were analyzed by age, gender, race, geographic region, and place of death. Age-adjusted mortality rates (AAMR) and annual percent change (APC) were calculated.
A total of 273611 deaths were recorded. The AAMR for DM with HF showed a small increase from 1999 to 2005 (APC: +0.31), followed by a sharp, significant decline from 2005 to 2010 (APC: -5.24), and started to rise steadily from 2010 to 2020 (APC: +1.88). The highest mortality was observed in females (n = 139882, 51.10%), White individuals (n = 225333, 82.40%), and in metropolitan areas (n = 209482, 76.50%). Temporal trends showed an increasing AAMR in males (+2.66 APC post-2010) and increasing AAMR amongst Asian or Pacific Islander individuals (+1.66 APC post-2010), who had the lowest overall mortality rates, indicating evolving disparities.
Overall, DM and HF-related mortality trends have shifted with disparities in gender, race, and location. Targeted interventions addressing comorbid management, preventive strategies, and social determinants of health are critical to mitigating excess mortality in high-risk populations concerning uptrends.
糖尿病（DM）是主要的死亡原因之一，其与心力衰竭（HF）之间的关联仍未得到充分研究。了解这种关系对于识别高危人群和制定有针对性的公共卫生干预措施至关重要。
本研究旨在分析以心力衰竭为促成因素的糖尿病患者的死亡率趋势和人口统计学差异。
使用疾病控制与预防中心（CDC）的多死因（MCD）数据库进行了一项回顾性观察研究，以评估1999年至2020年美国25岁及以上人群的死亡率趋势。该研究纳入了将糖尿病（《国际疾病和相关健康问题统计分类》第十次修订版（ICD - 10）：E10 - 14）列为根本死因且心力衰竭（ICD - 10：I50）为促成因素的死亡病例。数据按年龄、性别、种族、地理区域和死亡地点进行分析。计算了年龄调整死亡率（AAMR）和年度百分比变化（APC）。
共记录了273611例死亡病例。伴有心力衰竭的糖尿病患者的年龄调整死亡率在1999年至2005年略有上升（APC：+0.31），随后在2005年至2010年急剧显著下降（APC： - 5.24），并在2010年至2020年开始稳步上升（APC：+1.88）。女性（n = 139882，51.10%）、白人个体（n = 225333，82.40%）以及大都市地区（n = 209482，76.50%）的死亡率最高。时间趋势显示男性的年龄调整死亡率上升（2010年后APC为 + 2.66），而在总体死亡率最低的亚洲或太平洋岛民个体中年龄调整死亡率也在上升（2010年后APC为 + 1.66），这表明差异在不断演变。
总体而言，糖尿病和心力衰竭相关的死亡率趋势随性别、种族和地点的差异而发生了变化。针对合并症管理、预防策略以及健康的社会决定因素的有针对性干预措施对于降低高危人群中与上升趋势相关的超额死亡率至关重要。
