{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T17:23:07Z","timestamp":1793726587826,"version":"4.6.1"},"reference-count":35,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,7,29]],"date-time":"2025-07-29T00:00:00Z","timestamp":1753747200000},"content-version":"vor","delay-in-days":0,"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":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Peripheral circulatory complication (PCC), a significant complication of type 2 diabetes mellitus (T2DM), poses a considerable mortality burden in the United States. This study aimed to analyse demographic and geographic disparities in PCC\u2010related mortality in T2DM patients from 1999 to 2020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Utilising the CDC WONDER database, we utilised death certificates to identify PCC\u2010related deaths using ICD\u201010 Code E11.5 and calculated age\u2010adjusted mortality rates (AAMRs) per 1,000,000 individuals. Joinpoint regression analysis was used to assess annual percent changes (APCs) in mortality rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>PCC caused 81,793 deaths. The AAMR increased from 1999 to 2004 (APC: 5.88, 95% CI: 2.44 to 12.70), followed by a decrease from 2004 to 2014 (APC: \u22123.70, 95% CI: \u22125.83 to \u22122.45), and an increase again until 2020 (APC: 8.34, 95% CI: 6.05 to 11.50). Males consistently exhibited higher mortality rates (AAMR: 11.08, 95% CI: 11.00 to 11.6) than females (AAMR: 8.34, 95% CI: 8.26 to 8.43). Racial\/ethnic disparities were evident, with American Indian or Alaskan natives showing the highest AAMR (19.76) compared to Asian or Pacific Islanders (6.11). Geographic disparities were observed, with the Midwest region (AAMR: 12.86) and West Virginia (AAMR: 18.52) exhibiting significantly higher mortality rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Mortality trends associated with PCC in T2DM patients have shown complex trajectories, with notable disparities across demographic and geographic lines. Further research is needed to comprehensively understand the dynamics of PCC and its implications for public health.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/edm2.70083","type":"journal-article","created":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T04:08:53Z","timestamp":1753848533000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Disparities in Peripheral Circulatory Complication\u2010Related Mortality in Type 2 Diabetes Mellitus Patients: A\n                    <scp>CDC<\/scp>\n                    Analysis (1999\u20132020)"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-7188-1312","authenticated-orcid":false,"given":"Iqra","family":"Shahid","sequence":"first","affiliation":[{"name":"King Edward Medical University  Lahore 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