ArticleFrontiers in endocrinology2026
Trends in acute myocardial infarction-related mortality among adults with type 1 vs. type 2 diabetes in the United States, 1999-2020.
Article in Frontiers in endocrinology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: Diabetes mellitus (DM) continues to be a major contributor to acute myocardial infarction (AMI)-related mortality. Both T1DM and T2DM are associated with AMI, however, data evaluating the socioeconomic impact and mortality burden of AMI in T1DM remain limited. Methods: We utilized publicly available, deidentified data from the Centers for Disease Control and Prevention (CDC) Wide-ranging Online Data for Epidemiologic Research (WONDER) database. Using the International Classification of Diseases 10th Revision (ICD-10), we identified diabetic patients with AMI. Age-adjusted mortality rates (AAMRs), standardized per 100,000 population, were stratified by year, sex, ethnicity, urbanization, geographic region, and state. Analyses were conducted using Joinpoint Regression Software version 5.0.2. Results: Between 1999 and 2020, a total of 203,068 AMI-related deaths occurred among individuals with DM. Of these, 169,973 had T2DM, while 33,095 had T1DM. The overall AAMR was substantially higher in T2DM (4.5) than in T1DM (0.9). Mortality was consistently higher among males (T2DM: 5.0; T1DM: 1.0). Among T2DM patients, the AAMR was highest in Hispanic (5.9), while in T1DM, it was greatest in non-Hispanic (0.9). Across both cohorts, rural areas demonstrated higher mortality (T2DM: 5.9; T1DM: 1.3). T2DM-related mortality peaked in the Western United States (AAMR: 5.3), whereas T1DM-related mortality was highest in the Midwest (AAMR: 1.1). West Virginia showed the highest T2DM mortality (AAMR: 7.9), followed by Iowa, California, Ohio, and Tennessee. For T1DM, Rhode Island reported the highest mortality (AAMR: 1.8), with Tennessee, West Virginia, Arkansas, and North Dakota also ranking in the 90th percentile. Conclusion: AMI imposes a substantial mortality burden among individuals with DM, especially those with type 2 diabetes mellitus. Marked disparities by sex, ethnicity, region, and urbanization emphasize the need for targeted preventive and healthcare strategies to reduce inequities.
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