The American death rate from diabetes is more than triple what it was just a generation ago, according to a major new statistical analysis. It now ranks as the third-leading cause of death in the US, right after heart disease and cancer.

Background: The last time a comparable statistical analysis was conducted, in the 1980s and early 1990s, deaths from diabetes (almost entirely type 2 diabetes) were found to be a mere 4% of total deaths. While it’s been known that the incidence of diabetes has risen dramatically since then—along with obesity, a major contributor to type 2 diabetes—there’s been no reliable information about just how serious and fatal this rising diabetes tidal wave actually is.

Study: Boston University and University of Pennsylvania researchers analyzed two federal health surveys conducted between 1997 and 2010. One had 22,000 participants…the other, 282,000.

Results: Diabetes causes 12% of deaths in the US. If you add in people who have elevated blood sugar but aren’t yet diabetic—that is, people with prediabetes, who have a high likelihood of eventually developing diabetes—that percentage rises to 14%. (One reason: Prediabetes harms health long before it may lead to diabetes.)

Surprising finding: If you have diabetes, your chance of dying in the next year is a staggering 90% higher than if you don’t have diabetes.

Bottom line: Obesity and diabetes usually go hand in hand, so it is crucial to keep your blood sugar levels and your weight down. To learn more ways to prevent diabetes, see Bottom Line’s article, “Got Prediabetes? Millions Do…But You Can Reverse It!.”