ArticleEndocrinology, diabetes & metabolism2025
Trends and Disparities in Mortality due to Diabetes Mellitus and Sepsis in the US Adults: 1999-2023.
Article in Endocrinology, diabetes & metabolism, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Targeted activation of PPARG or AKT1 alleviates liver injury in mice with type 2 diabetes and sepsis by modulating inflammatory and metabolic pathways.Annals of medicine · 2026Article
- A 25 year nationwide analysis of mortality trends from cerebrovascular diseases in patients with lung cancer (1999-2023).Annals of medicine and surgery (2012) · 2026Article
- Feeding the invaders: how metabolic imbalance shapes infection and biofilm development.FEMS microbiology reviews · 2026Review
- A Host-Clinical Integrated Prediction Model for Early Sepsis Risk in Diabetic Patients with Acute Infections: Development and Internal Validation.Journal of inflammation research · 2026Article
- Trends and Disparities in Mortality due to Diabetes Mellitus and Sepsis in the US Adults: 1999-2023.Endocrinology, diabetes & metabolism · 2025Article
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Abstract
backgroundDiabetes mellitus (DM) increases susceptibility to infection and worsens outcomes in sepsis, a leading cause of preventable death. However, population-level trends in sepsis-related mortality among diabetic individuals in the United States (US) remain poorly characterised, especially in the context of the COVID-19 pandemic. This study evaluates national patterns, temporal shifts, and demographic disparities in sepsis-related mortality in diabetic patients from 1999 to 2023.
methodsWe conducted a retrospective analysis using the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) Multiple Cause of Death database. Sepsis-related deaths with co-listed DM were extracted for US adults between 1999 and 2023. Age-adjusted mortality rates (AAMRs) were calculated and Joinpoint regression was used to estimate annual percentage changes (APCs) and identify significant trends.
resultsA total of 483,207 sepsis-related deaths occurred in individuals with DM during the study period. AAMRs declined significantly from 1999 to 2018 (APC: -1.22; p < 0.001), reversed sharply from 2018 to 2021 (APC: +18.14; p = 0.01), and declined again through 2023 (APC: -12.25; p < 0.001). Mortality was highest among older adults (AAMR: 32.63), males (9.72 vs. 7.80 in females), and non-Hispanic Black and American Indian/Alaska Native populations (AAMRs: 17.94 and 17.92, respectively). Hispanic populations showed the steepest pandemic-era increase (APC: +22.49) and subsequent decline (APC: -20.43). Rural areas consistently had higher AAMRs than urban areas (8.77 vs. 8.27), with sharper increases during the pandemic. State-level disparities widened dramatically from 2021 to 2023, and regionally, the South and Midwest exhibited the highest and most persistent mortality burdens.
conclusionSepsis-related mortality in diabetic individuals in the US has undergone dynamic shifts over the past 25 years, punctuated by COVID-19 era surges and shaped by deep-rooted demographic, geographic, and structural inequities. These findings warrant integrated diabetes-infection care models, early sepsis recognition, and equity-driven interventions to reduce mortality.
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