Favorable Trends in Mortality among Patients with Concomitant Peripheral Arterial Disease and Diabetes Mellitus over Past Two Decades

Background: This study examines the temporal trends in diabetes and peripheral artery disease (PAD)-related mortality in the United States, considering sociodemographic and regional factors, using data from death certificates in a national public database. Methods: Data were extracted from the Centers for Disease Control and Prevention Wide Ranging Online Data for Epidemiologic Research database from 1999 to 2020. Age-adjusted mortality rates (AAMRs) per 100,000 individuals and annual percent changes (APCs) with 95% confidence intervals (CI) were calculated. Results: Between 1999 and 2020, there were 2,252,252 PAD-related and 5,413,811 diabetes- related deaths, with 469,699 deaths involving both conditions. The overall AAMR for PAD and diabetes-related mortality (aged >= 25 years) decreased from 7.97 in 1999 to 6.37 in 2020, with a notable decline from 2001 to 2010 (APC:-6.16, 95% CI:-7.07,-5.23). The AAMR for PAD-related mortality fell from 40.25 to 30.56, while the AAMR for diabetes-related deaths rose from 76.71 to 93.63. Males and non-Hispanic (NH) Black individuals had higher AAMRs than females and other racial groups. The highest crude mortality rate was in the 80e84 age group. Nonmetropolitan areas consistently reported higher AAMRs than metropolitan areas, and states like Ohio, Vermont, District of Columbia, and West Virginia had significantly higher rates. Conclusions: Over 2 decades, PAD- and diabetes-related mortality trends show a positive overall reduction in AAMR. However, disparities persist, with higher rates among males, NH Black individuals, and residents of nonmetropolitan areas. Significant state-level variations highlight the need for targeted interventions and tailored health-care strategies.