JMIR Publications

ABSTRACT

Background:

Pneumonia is the most common respiratory tract infection among diabetic patients across all age groups and sexes.

Objective:

The present study aims to explore the demographic trends in mortality among patients suffering from both diabetes mellitus (DM) and pneumonia.

Methods:

The Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database was used to collect deidentified death certificate data for DM- and pneumonia-related deaths in adults aged 25 years and older from 1999 to 2022. Age-adjusted mortality rates (AAMRs) per 1,000,000 people were calculated. The Joinpoint Regression Program was used to assess annual percentage changes in mortality trends, with statistical significance set at P < .05. This study adhered to the STROBE guidelines for reporting.

Results:

Between 1999 and 2022, 425,777 deaths from DM and pneumonia occurred. The overall AAMR declined significantly from 98.73 in 1999 to 49.17 in 2016 (APC: -4.68), then surged sharply to 97.66 by 2022 (APC: 23.55). Men consistently experienced higher mortality than women throughout the study period, with male AAMR rising from 62.61 in 2016 to 127.05 in 2022 (APC: 24.88), while female AAMR increased from 41.05 in 2017 to 75.25 in 2022 (APC: 27.60). Race-based analysis demonstrated that American Indian or Alaska Native populations had the highest mortality rates among racial groups. Non-Hispanic Whites showed a significant decline from 89.76 in 1999 to 44.19 in 2017 (APC: -4.58), followed by an increase to 83.11 by 2022 (APC: 25.25). Adults aged ≥ 65 years had the highest mortality burden, decreasing steadily to 206.9 in 2017 (APC: -5.15) before rising to 371.3 in 2022 (APC: 20.01). Nonmetropolitan areas exhibited consistently higher mortality than metropolitan areas, with particularly steep post-2018 increases (APC: 64.42). Type-specific mortality revealed Type 1 DM AAMRs fell from 9.2 in 1999 to 1.4 in 2015 (APC: -11.94) before rising again. Type 2 DM AAMRs surged drastically post-2017, peaking at 62.2 in 2020 (APC: 58.74) before partially declining to 41.6 by 2022.

Conclusions:

DM is associated with increased mortality risk following pneumonia among men, older individuals, and American Indian populations. Improvements in a number of healthcare interventions and policies are needed to restrain the increasing trend in at-risk populations.