Left untreated, people suffering from diabetes can start to experience health complications in major organs, including the heart, blood vessels, nerves, eyes, and kidneys. Treatment for these complications continues to place a heavy burden on the U.S. health care system. A study conducted by the Centers for Disease Control and Prevention has revealed a dramatic decrease in the rates of five major diabetes-related complications among Americans in the past 20 years, predominantly among those over the age of 75.

“These findings show that we have come a long way in preventing complications and improving quality of life for people with diabetes,” senior epidemiologist in CDC’s Division of Diabetes Translation, Dr. Edward Gregg, said in a statement. “While the declines in complications are good news, they are still high and will stay with us unless we can make substantial progress in preventing type 2 diabetes.”

Gregg and his colleagues from the CDC evaluated existing data from the National Health Interview Survey, National Hospital Discharge Survey, U.S. Renal Data System, and Vital Statistics. Researchers set apart incidences of diabetes-related complications in the United States between 1990 and 2010. Treatment for diabetes and its complications total $176 billion in medical costs every year in the U.S. In spite of this decline in diabetes-related complications, the number of people in the U.S. who reported having diabetes in this time frame increased from 6.7 million to 20.7 million. There are currently 26 million Americans who have been diagnosed with diabetes, in addition to the 79 million who have prediabetes.

Overall, the rates of lower-limb amputations, end-stage kidney failure, heart attack, stroke, and deaths caused by high blood pressure saw a substantial decline over the past two decades. Among all five diabetes-related complications assessed throughout the study, heart attack and stroke saw the steepest reduction. The rates of cardiovascular complications and deaths caused by hyperglycemia decreased by over 60 percent. Lower-extremity amputations including lower and upper legs, ankles, feet, and toes declined by 50 percent. Finally, rates of end-stage kidney failure reported by Americans have fell by 30 percent in the past 20 years. Researchers from the CDC attributed the decline in health complications caused by diabetes to increases in health care services, risk factor control, and diabetes awareness.

According to the American Diabetes Association, risk factors for diabetes include a family history, race or ethnic background, age, overweight/obesity, lack of physical activity, and high blood pressures. For both the prevention and treatment of diabetes, health care professionals recommend a combination of lifestyle modifications and a regimen of doctor-approved medications. Lifestyle changes include weight loss, healthy eating, and becoming physically active to help control high blood pressure and cholesterol levels. An estimated 230,000 people in the U.S. die each year as the result of their diabetes diagnosis.

Source: Li Y, Wang J, Gregg E. Changes in Diabetes-Related Complications in the United States, 1990–2010. New England Journal of Medicine. 2014.