Abstract TMP103: Trends in Ischemic Stroke-Related Mortality in Patients With Type 2 Diabetes in the United States, 1999-2020

Abstract

Background: The pathological changes in lining of blood vessels associated with diabetes is a well-established risk factor for stroke, some studies suggesting a two times increase in risk compared to non-diabetics. Methods: Death certificates from CDC WONDER (Centers for Disease Control and Prevention Wide-Ranging OnLine Data for Epidemiologic Research) database were examined from 1999 to 2020 for ischemic stroke related mortality in patients with type 2 diabetes mellitus (T2DM). Annual percent change (APC) and age-adjusted mortality rates (AAMRs) per 100,000 persons were calculated and stratified by year, sex, and race/ethnicity. Results: From 1999 to 2020 there were 20,941 deaths from ischemic stroke in patients with T2DM. The AAMR remained relatively constant from 0.31 in 1999 to 0.32 in 2004 (APC: -0.78), showing a sharp decline to 0.15 in 2007 (APC: -20.79), a near constant rate of 0.14 in 2007 (APC: -1.05), followed by a rapid increase to 0.44 in 2017 (APC: 44.55), and 0.66 in 2020 (APC: 14.59). Men showed consistently higher AAMR than women in 1999 (AAMR men: 0.34 vs women: 0.29) and 2020 (AAMR men: 0.78 vs women: 0.58). When comparing race, African Americans (AA) presented with a consistently higher AAMR in 1999 (AAMR AA: 0.37 vs white: 0.31) and 2020 (AAMR AA: 0.97 vs white:0.63). Notably, a significant escalation in AAMR occurred from 2016 to 2020, affecting both populations; this trend reached its pinnacle in 2020 (2016 AAMR AA: 0.39 vs. white: 0.27) (2020 AAMR AA: 0.97 vs. white: 0.63). Conclusion: The findings highlight fluctuating trends in AAMRs with distinct shifts observed after 2007. Noteworthy gender and racial disparities in AAMRs were also evident. The study emphasizes the need for ongoing vigilance and focused interventions to address the evolving dynamics of ischemic stroke-related mortality in the T2DM population.