MON-549 Trends and Disparities in Chronic Obstructive Pulmonary Disease (COPD) Associated Mortality Among Individuals with Diabetes in the United States from 1999 to 2020 - A CDC Wonder Analysis

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Abstract Disclosure: F. Ahmed: None. M. Kakakhel: None. H. Zahid: None. K. Aman: None. A. Sohail: None. T. Mirza: None. H. Abid: None. H. Ahmad: None. A. Ullah: None. N. Gohar: None. M. Abid: None. R. Haider: None. M. Ahmed: None. M. Fatima: None. F. Fatima: None. I. Shahid: None. A. Raza: None. M. Ali: None. A. Zafar Masood: None. S. Eltawansy: None. A. Bhat: None. O.M. Kamel: None. M. Bakr: None. Background: COPD, a group of obstructive lung diseases, characterized by inflammation and airway obstruction, is a leading cause of mortality worldwide. Diabetes, prevalent in almost 10-15% of US population, can exacerbate this impact due to glycosylation of proteins, oxidative stress, inflammation and increased susceptibility to infections. Increasing prevalence of both diabetes and COPD marks the importance of understanding their combined impact on mortality across various epidemiological groups. Methods: This study is based on in-depth search of the CDC WONDER database (1999-2020) involving ICD-10 Codes: E10-E14 and J44 using Age-Adjusted Mortality Rate (AAMR) per 1,000,000 individuals. Join point regression (Version 5.1.0 National Cancer Institute) was used to assess Parallelism, Annual Percent Changes (APC) and Average APCs (AAPCs) with 95% Confidence Interval. Parallelism test shows trends between two groups are not parallel if p<0.05. Results: A total of 629672 deaths were reported from 1999 to 2020. AAMR increased from 1999 to 2008 (APC:3.62 %), then a slight increase till 2018 (APC: 0.33%) followed by a large rise from 2018 to 2020 (APC: 12.30%). The AAMR of males (148.37) was higher than females (68.05) both demonstrating an increase but AAPC of females 2.89(95%CI 2.27-3.50, p<0.001) was more than males 2.54(95%CI 2.07 - 3.01, p<0.001) with significant parallelism(p=0.0004). Midwest had highest AAMR (96.12) followed by South (91.29), West (78.89) and Northeast (67.35). Northeast had lowest increase with AAPC of 1.67(95%CI 1.o5 - 2.30, p<0.001). South had highest increase with AAPC of 3.58(95%CI 2.92 - 4.24, p<0.001). The AAMR was highest for Alaska Natives (101.23) and lowest for Asians (33.64). Non-Hispanic Blacks showed highest increase with AAPC of 3.15(95%CI 2.17 - 4.15, p <0.001). Parallelism test was significant for Asian vs NH Blacks(p=0.0004), NH Blacks vs White(p=0.003) and Asian vs Alaska Natives(p=0.0002). AAMR was highest for West Virginia (176.04) and lowest for Hawaii (37.88). Crude rate was highest for 85+ years, 968.83 per 1,000,000. Non-metropolitan areas had higher AAMR (116.89) than metropolitan areas (78.28). Nonmetropolitan areas showed more increase with AAPC of 3.84(95%CI 3.16 - 4.51, p<0.0001) than metro ones with AAPC of 2.59(95%CI 2.08 - 3.11, p<0.0001) with significant parallelism test (p=0.0002). Conclusion: Overall the mortality trend due to COPD in diabetics increased from 1999 to 2020 but the tremendous rise from 2018 to 2020 is alarming. Males, Midwest, Alaska Natives and non-metropolitan areas had higher AAMRs. Our findings highlight the urgent need for targeted interventions to control mortality and disparities across different epidemiological groups. Presentation: Monday, July 14, 2025

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