Sepsis-related mortality among adults with T2DM remained substantial over two decades in the United States. In a retrospective analysis of national death certificate data published in the Journal of Diabetes & Metabolic Disorders, marked demographic and geographic disparities were observed from 1999 to 2020.

The analysis used adult mortality data from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research database. Deaths attributed to T2DM and sepsis were identified using International Classification of Diseases, Tenth Revision codes. Age-adjusted mortality rates were stratified by year, sex, race and ethnicity, age group, urbanization, census region, and location of death. Temporal trends were evaluated using Joinpoint regression to estimate annual percentage change.

A total of 109 094 deaths related to T2DM and sepsis were identified during the study period. The overall age-adjusted mortality rate was 2.29 (95% CI 2.28-2.31). Mortality was higher in males at 2.61 (95% CI 2.58–2.63) compared with females at 2.05 (95% CI 2.03-2.07). The Western census region had the highest mortality rate at 3.05 (95% CI 3.02-3.09), and non-metropolitan areas consistently showed higher rates than metropolitan areas.

By race and ethnicity, non-Hispanic American Indian and Alaska Native individuals had the highest age-adjusted mortality rate at 5.09 (95% CI 4.80-5.37), while non-Hispanic White individuals had the lowest at 1.88 (95% CI 1.87-1.90). Most deaths occurred in medical facilities, accounting for 77.45% of cases.

These findings highlight sustained disparities in sepsis-related mortality among adults with T2DM across demographic and geographic subgroups in the United States over a 21-year period.