{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T21:34:29Z","timestamp":1793828069620,"version":"4.6.1"},"reference-count":44,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,7,13]],"date-time":"2025-07-13T00:00:00Z","timestamp":1752364800000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Endocrino Diabet &amp;amp; Metabol"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The pathological changes in the lining of blood vessels associated with diabetes are a well\u2010established risk factor for stroke, with some studies suggesting a two times increase in risk compared to non\u2010diabetics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Death certificates from the CDC WONDER (Centers for Disease Control and Prevention Wide\u2010Ranging OnLine Data for Epidemiologic Research) database were examined from 1999 to 2019 for ischemic stroke\u2010related mortality in patients with type 2 diabetes mellitus (T2DM). Annual percent change (APC) and age\u2010adjusted mortality rates (AAMRs) per 100,000 persons were calculated and stratified by year, sex, and race\/ethnicity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From 1999 to 2019 there were 18,135 deaths from ischemic stroke in patients with T2DM. The AAMR remained relatively constant from 0.31 in 1999 to 0.32 in 2004, gradually declining to 0.14 in 2014 (APC: \u22126.74), followed by a rapid increase to 0.44 in 2017 (APC: 53.11). Men showed consistently higher AAMR than women in 1999 (AAMR men: 0.34 vs. women: 0.29) and 2019 (AAMR men: 0.55 vs. women: 0.42). When comparing race, African Americans (AA) presented with a consistently higher AAMR in 1999 (AAMR AA: 0.4 vs. white: 0.29) and in 2019 (AAMR AA: 0.62 vs. white:0.44). Notably, a significant escalation in AAMR occurred from 2014 to 2019, affecting both populations; this trend reached its pinnacle in 2019 (2016 AAMR AA: 0.4 vs. white: 0.26) (2019 AAMR AA: 0.62 vs. white: 0.44).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The findings highlight fluctuating trends in AAMRs with distinct shifts observed after 2014. Noteworthy gender and racial disparities in AAMRs were also evident. The study emphasises the need for ongoing vigilance and focused interventions to address the evolving dynamics of ischaemic stroke\u2010related mortality in the T2DM population.<\/jats:p><\/jats:sec>","DOI":"10.1002\/edm2.70065","type":"journal-article","created":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T05:58:39Z","timestamp":1752472719000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Ischemic Stroke Mortality in Type 2 Diabetes in the U.S.: National Trends and Demographic Disparities From 1999 to 2019"],"prefix":"10.1002","volume":"8","author":[{"given":"Muhammad Moiz","family":"Nasir","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Dow University of Health Sciences  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syed Husain","family":"Farhan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Dow University of Health Sciences  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hasan","family":"Mushahid","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Dow University of Health Sciences  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syeda Ayesha","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Dow University of Health Sciences  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3829-7298","authenticated-orcid":false,"given":"Muhammad Hamza","family":"Shuja","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Dow University of Health Sciences  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam Bilal","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Dow University of Health Sciences  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syed Hassaan","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Dow University of Health Sciences  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syed Ahmed","family":"Farhan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine McLaren Greater Lansing Hospital  Michigan Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Azeem","family":"Hassan","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jawad","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Northwest Health\u2014Porter  Valparaiso Indiana USA"},{"name":"Dow University of Health Sciences  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6237-0221","authenticated-orcid":false,"given":"Mohammad","family":"Hamza","sequence":"additional","affiliation":[{"name":"Guthrie Medical Group  Cortland New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2627-685X","authenticated-orcid":false,"given":"Javed","family":"Iqbal","sequence":"additional","affiliation":[{"name":"Nursing Department Communicable Diseases Centre Hamad Medical Corporation  Doha Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,13]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001167"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.5853\/jos.2022.02306"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjms.2016.01.011"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(16)30506\u20102"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdi.12932"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11892\u2010013\u20100421\u20109"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.113.001318"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.22385"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.111.625277"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e318270401d"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6635e1"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0319867"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.numecd.2025.104063"},{"key":"e_1_2_10_15_1","first-page":"1","article-title":"2013 NCHS Urban\u2010Rural Classification Scheme for Counties","volume":"166","author":"Ingram D. 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