The rate of foot and leg amputations in diabetics over the age of 40 fell 65% between 1996 and 2008, according to a recent report.

Improvements in blood sugar control, foot care, diabetes management and an overall decline in cardiovascular disease all contribute to lower amputation rates, say researchers at the Centers for Disease Control and Prevention. Diabetes is still the leading cause of lower-limb amputations in the United States.

“The significant drop in rates of nontraumatic lower–limb amputations among U.S. adults with diagnosed diabetes is certainly encouraging, but more work is needed to reduce the disparities among certain populations,” said CDC researcher Nilka Rios Burrows, Ph.D. “We must continue to increase awareness of the devastating health complications of diabetes.”

The study was published online in Diabetes Care.