New diabetes cases are down in the U.S. for the first time in decades, according to a new CDC report. 
 
 There were 1.4 million new cases of diabetes in 2014, a drop from 1.7 million in 2008. 
 
 It's the first time in a quarter century there's been a significant decline, the CDC reported. Over that period, the number of adults between 18 and 79 with newly diagnosed diabetes cases more than tripled -- jumping from 493,000 to more than 1.4 million new cases a year. About 21.9 million Americans now live with the disease. 
 
 A study last year estimated that nearly 10 percent of U.S. adults have type 2 diabetes, and other research finds more than a third of adults have prediabetes, a high blood sugar condition that may lead to diabetes. 
 
 But this latest CDC data shows a small but promising reversal. 
 
 "This is the first time I think we can really comfortably say we've seen a decrease in incidence in the rate of new cases. For a while we were calling it a plateau," Edward Gregg, chief of epidemiology and statistics in the division of diabetes translation at the CDC, told CBS News. 
 
 Whether prevention efforts are finally bearing fruit, or if the disease has peaked, is unclear. 
 
 "When you see changes like this in a major public health problem it's always difficult to dissect what caused it. We think it's the gradual diffusion of science and education that's occurred over this last decade," Gregg said. 
 
 Health officials have been trying for years to encourage exercise and better dietary habits to help reduce the risk of diabetes. 
 
 "We learned in the last decade you could prevent diabetes. The lifestyle changes and education are not easy and it takes a while, but I think that's what we're seeing," Gregg said. 
 
 There's still a lot to be done, though, he added. 
 
 "Our incidence rate is 60 percent higher than it was back in the early nineties. If we use that as a benchmark of where we could be and should be, we have a long way to go," Gregg said. He is presenting the new data at a diabetes conference in Vancouver on Wednesday. ||||| More than half of Asian Americans with diabetes are undiagnosed 
 
 New statistics also show rising prevalence of diabetes among all groups 
 
 More than half of Asian Americans and nearly half of Hispanic Americans with diabetes are undiagnosed, according to researchers from the National Institutes of Health and the Centers for Disease Control and Prevention. Their results were published Sept. 8 in JAMA, the Journal of the American Medical Association . 
 
 Additionally, prevalence of diabetes for all American adults went up, from nearly 10 percent to over 12 percent between 1988 and 2012. Diabetes prevalence – how common the condition is – also went up in every age, sex, level of education, income and racial/ethnic subgroup. One bright spot: The proportion of people with diabetes that was undiagnosed decreased 23 percent between 1988-1994 and 2011-2012. The statistics account for age differences across the surveys. 
 
 Using newly available 2011-2012 data from the CDC’s National Health and Nutrition Examination Survey (NHANES), researchers were able to quantify diabetes prevalence for Asian Americans for the first time and found that they have the highest proportion of diabetes that was undiagnosed among all ethnic and racial subgroups studied, at 51 percent. Diabetes was also common in Asian Americans, at 21 percent. Hispanic Americans had the highest prevalence of diabetes at nearly 23 percent, with 49 percent of that undiagnosed. 
 
 One difference between Asian Americans and the other groups studied, however, is that Asian Americans often develop type 2 diabetes at a lower body mass index (BMI). The NHANES data showed the average BMI for all Asian Americans surveyed was under 25. For the U.S. population overall, the average BMI was just below 29. A BMI of 25 to under 30 is considered overweight, and a BMI of 30 or greater is considered obese. The American Diabetes Association recommends Asian Americans get tested for diabetes at a BMI of 23 or higher, a lower BMI threshold than the general population. 
 
 “The large proportion of people with undiagnosed diabetes points to both a greater need to test for type 2 diabetes and a need for more education on when to test for type 2 diabetes, especially since populations such as Asian Americans may develop type 2 at a lower body mass than other groups,” said the study’s senior author, Catherine Cowie, Ph.D., director of diabetes epidemiology programs at the NIH’s National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). 
 
 Researchers used NHANES results from 26,415 adults between 1988 and 2012. For the 2011-2012 survey, NHANES surveyed a disproportionate number of Asian Americans. 
 
 “By NHANES surveying a much larger group of Asian Americans to provide more precise statistics, we’re able to identify with hard data a problem that had not been well-studied in the past,” said first author Andy Menke, Ph.D., an NIDDK contractor. “However, the Asian population is diverse, and we do not yet have data on differences within that population. Getting more specific data on Asian and other subgroups may help better pinpoint education and diagnosis efforts.” 
 
 About 1 in 5 non-Hispanic black adults had diabetes, higher than the overall population. However, they had a lower proportion of diabetes that was undiagnosed than the Asian or Hispanic subgroups, with about 37 percent being undiagnosed. Non-Hispanic whites had the lowest prevalence of diabetes at 11 percent, and they had the lowest proportion of undiagnosed, at just over 32 percent. 
 
 In type 1 diabetes, the body does not make insulin. In type 2 diabetes — the most common type, which has increased along with the obesity epidemic — the body does not make or use insulin well. Both types of diabetes have potential complications including heart, kidney, nerve and eye diseases. 
 
 “By learning more about who has diabetes – and who has the disease but does not know it – we can better target research and prevention efforts,” said NIDDK Director Griffin P. Rodgers, M.D. “We have treatments to help people with diabetes, but treatments can only help those who have been diagnosed. I hope our research can serve as a reminder for people at risk for diabetes to get screened for this potentially devastating disease.” 
 
 NIDDK provides free diabetes-related information and education resources at http://www.diabetes.niddk.nih.gov and through the National Diabetes Education Program, a partnership between NIH and the CDC, at http://www.ndep.nih.gov. 
 
 This study was conducted by the NIDDK, with contractors from Social and Scientific Systems, Inc., supported under NIDDK contract GS10F0381L and by the CDC. This study supports the Healthy People 2020 goal of increasing the diagnosis of diabetes among those with the disease. 
 
 The NIDDK, a component of the NIH, conducts and supports research on diabetes and other endocrine and metabolic diseases; digestive diseases, nutrition and obesity; and kidney, urologic and hematologic diseases. Spanning the full spectrum of medicine and afflicting people of all ages and ethnic groups, these diseases encompass some of the most common, severe and disabling conditions affecting Americans. For more information about the NIDDK and its programs, see http://www.niddk.nih.gov. 
 
 About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov. 
 
 NIH...Turning Discovery Into Health® ||||| With cases of diabetes growing each year, many adults are getting caught in a potentially dangerous situation: they are diagnosed with Type 2 diabetes when they actually have Type 1 diabetes, a substantially different condition. 
 
 Enlarge Image Close Bryan Derballa for The Wall Street Journal Alissa Kaplan Michaels, who has Type 1 diabetes, struggled for 3½ years before her disease was diagnosed correctly. 
 
 Both types of diabetes make it difficult for patients to control blood-sugar levels, which can lead to complications that include blindness, kidney failure and death. But Type 1 and Type 2 require different forms of treatment. 
 
 Alissa Kaplan Michaels, who has Type 1 diabetes, lived for 3½ years with the wrong diagnosis. The New York public-relations consultant says she complained to her doctor in 2008 of blurry vision and was told she had Type 2 diabetes after a blood test showed high sugar levels. She changed her diet and exercised more, but her blood-sugar levels kept rising. She started taking several oral diabetes medications. She stopped eating bread and pasta. She changed doctors—three times. And she still felt terrible. 
 
 Don't Confuse These Despite the similar sounding names, Type 1 and Type 2 diabetes are substantially different conditions. Type 1 is an autoimmune disorder that attacks the body's ability to make insulin. In Type 2, brought on by inactivity and obesity, the body can't make efficient use of insulin to control blood sugar. Type 1 Diabetes The condition begins mainly in childhood and adolescence, but increasingly in adults. 
 
 People with Type 1 are often thin or normal weight. 
 
 Patients are prone to ketoacidosis, a dangerous buildup of acids in the blood. 
 
 Regular insulin injections are required treatment. Source: National Institutes of Health Type 2 Diabetes Onset is primarily in people over 40 years old, but increasingly in younger patients. 
 
 People with Type 2 are often obese. 
 
 There is no ketoacidosis. 
 
 Treatment involves healthy diet and exercise, diabetes medications, and sometimes insulin injections. 
 
 Last fall, a covering doctor at her endocrinologist's practice started asking about her health history, childhood weight patterns, her recent struggles with her blood sugar and family history of Type 2 diabetes, of which there was none. That day, Ms. Kaplan Michaels got a new diagnosis. She didn't have Type 2 diabetes, she had Type 1. 
 
 Ms. Kaplan Michaels, 44 years old, immediately dropped the oral medications that had upset her stomach. Instead, she increased her daily insulin injections. She also resumed eating carbohydrates. Within weeks, her energy was back. "At first I was relieved and then I was very angry," she says. "Nobody should have to go to four doctors to get a diagnosis for something that isn't that difficult to diagnose." 
 
 Type 1 diabetes is an autoimmune disorder that attacks the body's ability to make insulin, which allows the body to properly process glucose. The disorder, once called juvenile diabetes, begins mainly in children and adolescents, but is increasingly occurring in adults. Type 1 diabetics need daily insulin injections to survive. If patients manage their blood-sugar levels well, they can live for decades without encountering the dangerous complications associated with the disease. 
 
 Type 2 diabetes, by contrast, is brought on by inactivity and obesity, mainly in adults, and is characterized by the body's inability to make efficient use of insulin. Type 2 diabetes, which is beginning to occur in teenagers, can be kept at bay in some cases with lifestyle changes and is widely treated with oral medications to improve insulin absorption. Type 2 diabetics also can require insulin injections. 
 
 "Most of my [adult Type 1 patients] have been misdiagnosed as having Type 2," says Robin Goland, co-director of the Naomi Berrie Diabetes Center at Columbia University Medical Center in New York. "Once the right diagnosis is made the patient feels much, much better, but they are distrustful of doctors and who could blame them?" 
 
 Enlarge Image Close Bryan Derballa for The Wall Street Journal Ms. Kaplan Michaels, pictured with her son, Leo, was able to resume an active life after her Type 1 diabetes was correctly diagnosed and she began proper treatment. 
 
 Estimates of the number of people with Type 1 diabetes in the U.S. range from 1.3 million to 2.6 million people, accounting for 5% to 10% of the total diabetic population. Incidence of Type 1 has been rising in the U.S. and in parts of Europe by about 2.5% to 4% a year for reasons scientists can't explain, according to several large-scale studies published in peer-reviewed medical journals. Scientists say Type 1 diabetes is caused by a combination of genetic and environmental factors but they don't know what the trigger is. 
 
 An incorrect diagnosis usually occurs in the offices of primary-care doctors, many of whom haven't received adequate education in medical school about rising rates of Type 1 in adults and how to diagnose it. "It is not on their radar because they see so much diabetes and it is by far mostly Type 2," said Irl B. Hirsch, professor of medicine at the University of Washington Medical Center in Seattle. 
 
 After elevated blood sugars are detected, diagnosing which diabetes a person has usually is done by looking at the patient, assessing family history, weight and age, doctors say. "It's not a good way to make a diagnosis. You'd like to measure something that represents the disease process," says Jerry Palmer, director of endocrinology at VA Puget Sound Health Care System. To properly diagnose Type 1, doctors need to test for antibodies that indicate the presence of the autoimmune disorder. But few order such tests. 
 
 Cherie Serota, 48, was told by her primary-care doctor in early 2009 that she was on the brink of having Type 2 diabetes. Weighing just 120 pounds, Ms. Serota, of Brookville, N.Y., didn't fit the profile of a typical Type 2 patient. She revved up her exercise regime and watched her diet. One night after Chinese takeout sent her blood-sugar levels high, she called her doctor who told her this was normal and not to eat Chinese food anymore. Eventually she stopped eating carbohydrates. "That really did me in," says the mother of three. "I had no energy." 
 
 Six months later, feeling drained and now down to 113 pounds, the former fashion executive sought out an endocrinologist at New York University who told her she had Type 1. When she told her primary-care doctor, he was so surprised she made him call the specialist, she says. 
 
 "I understand why I was misdiagnosed; it is a very small amount of people who are diagnosed as an adult," Ms. Serota says. 
 
 In some adults with Type 1, the loss of insulin-producing cells, located in the pancreas, is much slower than for children, making the onset of the disease more gradual. Some researchers consider the slow onset a distinct form of Type 1 called latent autoimmune diabetes in adults, or Lada. Because the disease progresses more slowly, it can be more easily confused with Type 2, researchers say. 
 
 Benjamin Jones, a 63-year-old retired probation officer, likely had the slow-onset form of the disease. For six years, Mr. Jones treated what had been diagnosed as Type 2 diabetes. He changed his diet and took three oral medications daily. An avid exerciser, Mr. Jones says for several years he was able to keep his blood-sugar levels in check in part by Rollerblading, swimming, playing tennis and basketball, and cycling. Still, rarely did his blood-sugar level dip below 120, which is high for a non-diabetic person. 
 
 After a bad reaction to a flu shot earlier this year, Mr. Jones says his sugar levels surged to 500. He says he asked to be put on insulin, but his primary-care doctor refused, fearing that Mr. Jones could risk hypoglycemia, a condition in which blood sugars go too low. That was when Mr. Jones sought out a specialist at the Joslin Diabetes Center in Boston. He was immediately put on insulin, given an antibody test and told he had Type 1. 
 
 "When your sugar is high you don't feel right. You feel on edge," Mr. Jones says. "I feel like a new person, like I should feel." 
 
 Write to Kate Linebaugh at kate.linebaugh@wsj.com
– Some big news in America's public health arena: The number of new cases of diabetes is clearly falling for the first time in 25 years, reports the New York Times. Stats released Tuesday by the CDC show a nearly 20% drop from 2008 to 2014 in what the newspaper calls "the first sustained decline" since diabetes began booming in the 1990s. Specifically, the US saw 1.4 million new cases in 2014, down from 1.7 million in 2008. There's still plenty of major trouble spots: The decline is pronounced among white people and less so for AfricanAmericans and Hispanics, and a notable gap remains in regard to education levels. "It's not yet time for a parade," says the head of the diabetes program at Massachusetts General Hospital. But, he adds, "It has finally entered into the consciousness of our population that the sedentary lifestyle is a real problem, that increased body weight is a real problem." CBS notes that 10% of adults in the US are believed to have type 2 diabetes and that more than a third have prediabetes—a condition that can lead to the full disease—which makes any sign that the numbers have peaked welcome. A CDC researcher calls the results "a little surprising" given the decades-long increases. But "it seems pretty clear now that incidence rates have actually started to drop." (Meanwhile, a novel new treatment could one day make daily insulin injections a thing of the past.)