Temporal trends in diabetes mellitus type 2 and sepsis-related mortality among U.S. adults: a 22-year analysis.

Background: Diabetes mellitus (DM) type 2, the most prevalent form of diabetes, is affecting a population of 460 million worldwide. Individuals with diabetes are at a higher risk of developing sepsis which can be lethal if not managed properly. This study aims to analyse the trends in mortality due to diabetes mellitus type 2 and sepsis in the United States between 1999 and 2020. Methods: Death certificate data from the CDC WONDER database was retrospectively analysed from 1999 to 2020 for mortality due to DM type 2 and sepsis in the adult population using ICD-10 codes. Age-adjusted mortality rates (AAMRs) obtained were stratified by year, sex, race/ethnicity, age, location of death, urbanization and census region. The Joinpoint regression programme was then used to calculate Annual Percentage Change (APC). Results: 109,094 DM type 2 and sepsis-related deaths were reported among adults of United States from 1999 to 2020 with an overall AAMR of 2.29 (95% CI: 2.28-2.31). The overall AAMR was higher in males (2.61; 95% CI: 2.58-2.63) than in females (2.05; 95% CI: 2.03-2.07). Geographically, the mortality rates were higher in the Western region (3.05; 95% CI: 3.02-3.09). Similarly, the AAMRs for non-metropolitan areas were consistently higher than those of metropolitan areas. Stratification by race/ethnicities showed that NH American Indians/Alaska Natives had the highest AAMR (5.09, 95% CI: 4.80-5.37) while the lowest was observed in NH Whites (1.88, 95% CI: 1.87-1.90). Most deaths occurred at medical facilities (77.45%). Conclusion: Males, older adults, NH American Indians, non-metropolitan areas and Western region were associated with higher DM type 2 and sepsis-related mortality, which is concerning. This study has brought light on the need for strategies and interventions to reduce the impact of sepsis on the population having DM type 2. Further research is necessary to identify effective strategies for prevention, early detection, and management of sepsis in this high-risk population. Supplementary Information: The online version contains supplementary material available at 10.1007/s40200-025-01781-8.