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NEW YORK — Federal researchers reported the first sweeping national picture of progress in combating some of the most devastating complications of the Type 2 diabetes epidemic on Wednesday, finding that rates of heart attacks, strokes, kidney failure, and amputations declined sharply over the past two decades.

The biggest declines were in the rates of heart attacks and deaths from high blood sugar, which each dropped by more than 60 percent from 1990 to 2010, the period studied.

While researchers had patchy indications that outcomes were improving, the study, published in The New England Journal of Medicine, documents startling gains.


“This is the first really credible, reliable data that demonstrates that all of the efforts at reducing risk have paid off,” said Dr. David M. Nathan, the director of the Diabetes Center at Massachusetts General Hospital, who was not involved in the study. “Given that diabetes is the chronic epidemic of this millennium, this is a very important finding.”

The number of diabetics more than tripled during the study period and is now nearly 26 million, burdening the health care system. Another 79 million Americans have pre-diabetes, meaning they are at high risk of getting the disease.

Researchers from the Centers for Disease Control and Prevention, who wrote the study, estimate diabetes and its complications account for $176 billion in annual medical costs.

Researchers said the declines were the fruit of years of efforts to improve the health of patients with Type 2 diabetes. Doctors are much better at controlling risk factors that can lead to complications — for example, using medicine to control glucose, lipids, and blood pressure — health experts said.

A widespread push to educate patients has improved how they look after themselves. And a major effort to track the progress of patients and help steer the ones getting off track has started to have an effect.


“These results are very impressive,” said Dr. K.M. Venkat Narayan, a professor of medicine and epidemiology at Emory University who was not involved in the study.

Beyond declines in the rates of heart attacks and deaths from high blood sugar, rates of strokes and amputations — legs, ankles, feet, and toes — fell by about half. Rates for end-stage kidney failure fell about 30 percent. The study did not measure blindness, another critical diabetes complication.