Researchers from the Centers for Disease Control and Prevention (CDC) released a study earlier this week in which they found that the rates of complications in diabetes patients in the U.S. have significantly decreased during the last two decades.

The study, published in the New England Journal of Medicine by the CDC's Division of Diabetes, found considerable drops in all five diabetes-related complications between 1990 and 2010, including acute myocardial infarction, death from hyperglycemic crisis, stroke, amputation, and end-stage renal disease.

Edward W. Gregg, a senior epidemiologist at the CDC and lead author of the study, attributed the decline of complication rates to a few factors including patients taking better care of themselves, doctors and physicians helping patients adopt healthier lifestyles, and improvements in education and awareness initiatives.

"There's still long ways to go and diabetes carries with it a lot of problems, but it's very encouraging," Gregg said.

Although the particular study did not look into life expectancy rates among diabetics, Gregg said the CDC has been looking over those types of data recently and found that life expectancy has also improved considerably in the last 30 years.

"People with diabetes now have a longer life expectancy than they did 10, 20, 30 years ago, and that's encouraging too," Gregg said. "We think that's probably related to a lot of the same factors that are going on basically."

Treatment and medicine have certainly played a role in the reductions, Gregg added, but education and awareness campaigns need to continue encouraging patients to manage and monitor their health.

"There's always better treatment that can be developed and that's underway all the time," he said. "We're hoping that those things will continue to happen, and we'll see more and more progress with this."

The complications that researchers found have decreased the most were acute myocardial infarctions with a drop of 67.8 percent and hyperglycemic deaths at a decline of 64.4 percent, according to the study.

Strokes and amputation rates decreased by 52.7 percent and 51.4 percent respectively, while the smallest decline was in end-stage renal disease, which dropped by 28.3 percent. The number of acute myocardial infarctions did rise from about 140,000 cases to 191,000 between 1990 and 2000, but dropped back to under 136,000 cases by 2010. In 2005, amputation cases were at its lowest since 1990. End-stage renal disease cases steadily rose from almost 18,000 cases in 1990 to 50,000 in 2005. By 2010 it dropped to more than 32,000 cases.

Gregg said that outside of the U.S., other countries have seen decreases in the complications in its diabetes patients too.

"We've kind of been watching the literature of other countries and we see that these improvements tend to be happening in other countries as well," he explained.

Gregg said, however, that while these have been positive steps for diabetics, they still face higher chances of developing kidney disease, amputations and heart attacks. Additionally, diabetes rates have continued to increase in the last two decades. According to the study, the rate of diabetes has more than tripled in adults between 1990 and 2010. The number of adults diagnosed with diabetes jumped from 6.5 million to 20.7 million while the overall adult population in the U.S. increased approximately 27 percent from 177.7 million to 226.1 million.

Gregg said the CDC has been working with community programs around the nation that provide health counseling and health tips on how to change the lifestyles of those diagnosed with pre-diabetes.

"They get help in improving their diet, increasing physical activity levels, achieving a healthy weight and all those things that have been shown over and over again now to really reduce chances that someone will go on to develop diabetes," he said. "We're really hoping that those sorts of high quality programs will be promoted all around the country."

According to the diabetes division of the National Institutes of Health, in 2009 the rate of Hispanics 20 years and older diagnosed with diabetes was 11.8 percent, only to follow the 12.6 percent of African Americans that had diabetes. Among the Hispanic community, 7.6 percent were Cuban Americans, another 7.6 percent for Central and South Americans, 13.3 percent for Mexican Americans and 13.8 percent for Puerto Ricans. Hispanic adults are 1.7 times more likely than white adults to have been diagnosed with diabetes, according to the Office of Minority Health, a branch of the U.S. Department of Health and Human Services. According to the same data, 13.2 percent of Hispanics over the age of 18 in 2010 had been diagnosed with diabetes.

"With improvements in public health like this, it's generally easier to improve things when things are very bad ironically," Gregg said. "It's sort of a paradox. It gets tougher the more you lower things, but there's still very long ways to go here and we're very encouraged that we continue to make decreases."

Giuseppina Imperatore, epidemiologist and lead researcher for the CDC's division of diabetes translation, said poor diet, physical inactivity, genetics and obesity rates play major roles in becoming diabetic.

Imperatore said that from 1997 to 2011, the rate of Hispanics diagnosed with diabetes rose by 46 percent. Meanwhile, the rate for Cuban Americans rose by 66 percent. She also pointed out that higher rates of obesity are found in the Hispanic and African American communities.

Elizabeth Seaquist, president of Medicine and Science at the American Diabetes Association, agreed that obesity is certainly a factor in getting diabetes. However, she has found that genetics could play a bigger role, and changes to a person's environment could make the person more susceptible to their predisposed genetics.

"What we're seeing with the obesity epidemic is that people are getting diagnosed at a younger and younger age because obesity itself decreases the ability of your body to use your insulin normally," Seaquist said. "So it brings out the disease in someone who's already been genetically predisposed."

Despite the correlation between diabetes and obesity, Seaquist said that there's many more people who are obese and do not have diabetes than there are obese people with diabetes. She referred to recent studies that observed the weight of first generation children whose parents emigrated to the U.S. from Latin countries and compared them to the weight of children that grew up in the respective Latin country.

"The findings generally show that people who came to the U.S. usually are heavier than the people who stayed in the country of origin," Seaquist said. "The assumption is that the lifestyle changes that they adopted when they came to the U.S allowed their genetic predisposition for diabetes to appear earlier."

She said the major change comes from eating habits in the U.S. where food is much more abundant and people tend to over eat.

"The wonderful thing is we have availability of food. That is a good thing," Seaquist said. "The bad thing is we have an always available abundance of food and people eat food more than they need in many cases."

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