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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
Trends and disparities in mortality from comorbid non-insulin-dependent diabetes mellitus and stroke (1999-2022): A retrospective analysis
Sardar Muhammad Imran Khan, Hamza Asif, Muhammad Hassan Raza, Muhammad Waqas, Syed Zahid Ali, Muneeb Khawar, Muneeb Saifullah, Abbas Muhammad Mehdi
Sardar Muhammad Imran Khan, Department of Cardiology, National University of Medical Sciences, Rawalpindi 04616, Punjab, Pakistan
Hamza Asif, Muhammad Hassan Raza, Department of Medicine, Nishtar Medical University, Multan 66000, Punjab, Pakistan
Muhammad Waqas, Department of Cardiology, Wah Medical College, Islamabad 04433, Pakistan
Syed Zahid Ali, Department of Neurology, University of Louisville School of Medicine, Louisville, KY 40208, United States
Muneeb Khawar, Muneeb Saifullah, Department of Medicine, King Edward Medical University, Lahore 05450, Punjab, Pakistan
Abbas Muhammad Mehdi, Department of Medicine, International School of Medicine, International University of Kyrgyzstan, Bishkek 720065, Kyrgyzstan
Author contributions: Khan SMI, Asif H, Raza MH, Waqas M, Ali SZ, Khawar M, Saifullah M, Mehdi AM led conceptualization, methodology, and formal analysis, and wrote and reviewed the manuscript; all authors contributed to the software, validation, and investigation, and thoroughly reviewed and endorsed the final manuscript.
Institutional review board statement: We respectfully inform you that this study did not involve the recruitment or enrollment of human subjects. It is based entirely on secondary analysis of publicly available, de-identified mortality data. Therefore, the requirement to upload an Institutional Review Board Approval Form or Document is not applicable.
Informed consent statement: We respectfully inform you that this study did not involve the recruitment or enrollment of human subjects. It is based entirely on secondary analysis of publicly available, de-identified mortality data. Therefore, the requirement to upload an Informed Consent Form is not applicable.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Not applicable.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Abbas Muhammad Mehdi, MD, Department of Medicine, International School of Medicine, International University of Kyrgyzstan, 6 Seven April Street, Bishkek 720065, Kyrgyzstan.
malikmehdi0508@gmail.com
Received: May 29, 2025
Revised: July 12, 2025
Accepted: September 10, 2025
Published online: September 19, 2025
Processing time: 111 Days and 13.5 Hours
BACKGROUND
Comorbid non-insulin-dependent diabetes mellitus (NIDDM) and stroke significantly contribute to mortality among older adults. This study examines age-adjusted mortality rates (AAMRs) and disparities by demographics, region, and age groups to identify trends and guide public health efforts.
AIM
To analyze trends in AAMRs due to comorbid NIDDM and stroke among older adults. The study aims to identify demographic, geographic, and age-related disparities to inform targeted public health strategies.
METHODS
Mortality data from the Centers for Disease Control records were analyzed. AAMRs per 100000 and annual percentage changes (APCs) with 95%CI were calculated using Joinpoint Regression
RESULTS
Between 1999 and 2022, 209001 deaths among adults aged 55+ were attributed to comorbid NIDDM and stroke, with women accounting for 111481 and men 97520 deaths. Urban-rural disparities revealed distinct patterns, with a sharper rise in metropolitan areas post-2014 (APC: 8.6) as compared to non-metropolitan areas. Racial disparities were pronounced, particularly among the Asian/Pacific Islander population, with a steep increase post-2018 (APC: 17.6). Age-stratified analysis showed a marked rise in mortality for ages 55-64 and 85+ from 2015 onwards (APC: 14.3 and 13.5, respectively). Regional trends highlighted the West as having the highest AAMR (14.4), while the Northeast exhibited the lowest (7.0). State-level analysis showed West Virginia with the highest AAMR (18.7) and Nevada the lowest (3.8).
CONCLUSION
Rising mortality from comorbid NIDDM and stroke underscores increasing disparities across gender, race, age, and regions. Urgent, tailored interventions are required to mitigate these inequities.
Core Tip: The growing mortality burden from coexisting type 2 diabetes and stroke highlights widening disparities across demographic and regional lines. Targeted, context-specific interventions are urgently needed to address these inequities.
