CDC-WONDER Database Analysis of COVID-19 and Diabetes Mellitus-Related Mortality

Objectives: COVID-19 has been associated with increased diabetes onset and worsened metabolic complications in individuals with pre-existing diabetes. While both conditions are known risk factors for severe health outcomes, their combined effect on mortality remains unknown. This study evaluates mortality rates attributed to both COVID-19 and diabetes mellitus (DM) in the United States (US), with a focus on sociodemographic disparities. Design: We conducted a retrospective analysis using the Centers for Disease Control and Prevention WONDER database from January 2020 to December 2021. Deaths related to COVID-19 (ICD-10 code U07.1) and DM (ICD-10 codes E10-E14) were identified as underlying or contributing causes of death. Age-adjusted mortality rates (AAMRs) per 100,000 population were calculated and stratified by age, sex, race/ethnicity, and US census region. Results: Between 2020 and 2021, 115,351 deaths were attributed to both COVID-19 and DM. AAMRs were higher among males (28.1, 95% CI: 27.9-28.4) than females (16.5, 95% CI: 16.4-16.7). By race/ethnicity, Native Hawaiian/Pacific Islander individuals had the highest AAMR (55.9, 95% CI: 50.4-61.4), followed by Hispanic (51.1, 95% CI: 50.4-51.7) and non-Hispanic Black (38.5, 95% CI: 38.0-39.1) populations. The South and West regions of the US reported the highest AAMRs. Mortality rates increased in 2021 compared to 2020 across all groups, with marked disparities persisting throughout the study period. Conclusion: The dual burden of COVID-19 and DM has led to elevated mortality rates in the US, disproportionately affecting minority populations. Addressing these disparities requires comprehensive public health strategies integrating medical, social, and policy-driven solutions. SDG Keyword: Reduced inequalities