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 80-84 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.