Evidence map›Paper›PMID 40844026›Full record

ArticleEndocrinology, diabetes & metabolism2025

Mortality Trends and Disparities in Cerebrovascular Disease Among Diabetic Population in the United States From 1999 to 2020: A CDC WONDER Analysis.

Allahdad Khan, Waseef Ullah, Moeen Ikram, Rameez Qasim, Umama Alam, Maheen Sheraz, Ayesha Khan, Kainat Kanwal, Peter Collins, Raheel Ahmed

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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 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Allahdad KhanDepartment of Medicine, Nishtar Medical University, Multan, Pakistan.ORCID https://orcid.org/0009-0006-2003-922X
Waseef UllahDepartment of Medicine, Lady Reading Hospital, Peshawar, Pakistan.
Moeen IkramFrontier Medical and Dental College, Abbottabad, Pakistan.ORCID https://orcid.org/0009-0009-9365-4700
Rameez QasimAllama Iqbal Medical College, Lahore, Pakistan.ORCID https://orcid.org/0009-0003-1784-5894
Umama AlamKhyber Medical College, Peshawar, Pakistan.ORCID https://orcid.org/0009-0001-0456-022X
Maheen SherazContinental Medical College, Lahore, Pakistan.ORCID https://orcid.org/0009-0000-4387-8436
Ayesha KhanDepartment of Medicine, Nishtar Medical University, Multan, Pakistan.ORCID https://orcid.org/0009-0005-4406-107X
Kainat KanwalCharleston Area Medical Center, Vandalia Health, Charleston, West Virginia, USA.
Peter CollinsNational Heart and Lung Institute, Imperial College London, London, UK.
Raheel AhmedNational Heart and Lung Institute, Imperial College London, London, UK.ORCID https://orcid.org/0000-0003-2814-7314

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDiabetes mellitus (DM) significantly increases the risk of cerebrovascular disease (CeVD), a major cause of mortality and long-term disability. Despite improvements in healthcare, disparities in CeVD-related mortality among diabetic populations in the United States persist.

methodsWe conducted a retrospective analysis using the CDC WONDER database from 1999 to 2020 to assess mortality trends related to CeVD among adults aged ≥ 45 years with DM. Deaths were identified using ICD-10 codes I60-I69 (CeVD) and E10-E14 (DM). Age-adjusted mortality rates (AAMRs) were calculated, and trends were analysed using Joinpoint regression, stratified by age, race/ethnicity, geography, urbanisation, and place of death.

resultsA total of 689,846 CeVD-related deaths occurred in diabetic individuals. AAMR decreased from 36.9 in 1999 to 29.3 in 2020, with an average annual percentage change (AAPC) of -1.41%. However, a sharp rise was observed from 2018 to 2020 (APC 14.87%), indicating a concerning reversal in progress. The highest crude mortality rates were in the 75-84 age group, and the lowest in the 45-54 group. Black and Hispanic populations, rural residents, and those in the Southern United States had the highest mortality rates. The Northeast and Asian populations had the lowest, reflecting persistent disparities in access to care and preventive services.

conclusionWhile CeVD mortality in diabetics declined over two decades, the recent reversal highlights emerging challenges, possibly due to healthcare disruptions and socioeconomic disparities. These findings underscore the need for targeted public health interventions to address inequities and improve outcomes in high-risk populations.

Indexed as

Cerebrovascular DisordersDiabetes MellitusHealthcare DisparitiesHealth Status DisparitiesAgedAged, 80 and overCenters for Disease Control and Prevention, U.S.FemaleHumansMaleMiddle AgedMortalityRetrospective StudiesUnited StatesCDC WONDERcerebrovascular diseasediabetesmortality

Identifiers

PMID40844026
PMCPMC12371552

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.