Temporal Trends and Disparities in Type 2 Diabetes Mellitus and Congestive Heart Failure Mortality in the United States From 1999–2020: A CDC WONDER Analysis

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ABSTRACT Background and Aims Type 2 Diabetes Mellitus (T2DM) is a growing health burden globally, and its concurrence with Congestive Heart Failure (CHF) significantly increases morbidity and mortality. However, long‐term mortality trends remain underexplored. This study aims to assess temporal trends in mortality from comorbid T2DM and CHF in the United States (U.S.) from 1999 to 2020, with emphasis on demographic and geographical disparities. Methods We analysed U.S. mortality data from 1999 to 2020 for adults aged ≥ 25 years with coexisting T2DM and CHF using the CDC WONDER Multiple Cause of Death database. Cases were identified using the ICD‐10 codes E11 and I50.0 for T2DM and CHF, respectively. Temporal trends in crude mortality rates (CMRs) and age‐adjusted mortality rates (AAMRs) per 100,000 population were stratified by demographic and geographic characteristics and were used to estimate the annual percent change (APC) and average annual percent change (AAPC) using Jointpoint regression. Results Between 1999 and 2020, 292,452 deaths related to T2DM, and CHF were recorded among U.S. adults, with most deaths occurring in medical facilities. The overall AAMR increased from 4.33 in 1999 to 8.98 in 2020, with a significant rise after 2014. (APC: 7.31) AAMRs varied substantially by age, sex, race, and urbanization level. AAMRs were 27.96 among adults aged ≥ 65 years versus 0.93 among those aged 25–64 years and 7.47 among males versus 5.24 among females. Across racial groups, AAMRs were highest among American Indian/Alaska Native populations at 11.53, followed by Hispanic/Latino populations at 6.76, Black/African American populations at 6.53, non‐Hispanic White populations at 6.06, and Asian/Pacific Islander populations at 4.07. AAMRs were also higher in non‐metropolitan regions at 8.58 compared with 5.62 in metropolitan regions. Geographically, the highest mortality rate was observed in West Virginia at 11.27, with the Western region also exhibiting the highest regional mortality. Conclusions T2DM and CHF‐related mortality have increased substantially over the past two decades, with marked increases after 2014. Increased susceptibility among certain demographic and geographical groups highlight the need for integrated strategies to combine personalized care, treatment adherence, and population‐level risk factor management to reduce mortality.