The largest decline was seen in heart attack episodes, which dropped by about 60% during the past two decades; the smallest decline was in kidney failure, which dropped about 30%. The rate of strokes and of lower extremity amputations—in the upper and lower legs, ankles, feet and toes—declined by about half, the study showed.
The rate of stroke and heart attack are now comparable, given the substantial decline in rates of myocardial infarction. Declines in diabetes-related complications were especially great among people aged 75 and older.
Still the good news was tempered by other troubling findings. The number of adults diagnosed with diabetes more than tripled, increasing from 6.5 million in 1990 to 20.7 million in 2010. The report notes that the overall population of U.S. adults increased by about 27% during that time.
Also, in the case of end-stage renal disease, reductions in rates were smaller, and rates actually increased among older adults. The reasons why rates were so different for end-stage renal disease are not clear, though the Centers for Disease Control and Prevention said they may be related to the declines in heart disease.
“With declining mortality from cardiovascular disease, older patients with diabetes may have more years of life during which chronic kidney disease can progress to a point where dialysis or transplantation is needed,” the wrote.
The CDC used data from the National Health Interview Survey, the National Hospital Discharge Survey, the U.S. Renal Data System and the U.S. National Vital Statistics System to generate the findings. The agency accounted for changes in the size of the U.S. population to examine trends in the relative risk of complications.