Since 2008, the number of Americans living with diabetes increased by nearly 2.2 million people. But a new report shows that some states and communities are faring much better than others. According to study authors, rising rates of obesity are largely to blame for this surge in the epidemic, Time.com reports.

For the study, researchers with the Gallup-Healthways State of American Well-Being series conducted almost 180,000 telephone interviews with adults about their health in 2015 throughout all 50 states. Scientists also targeted specific communities in these states to get a more definitive look at which regions of the country were best battling this widespread blood sugar disorder. Researchers interviewed an extra 246,620 people to gather data about the communities.

Findings showed that Utah, Rhode Island and Colorado were the three states with the lowest incidence of diabetes. Each of these states reported that less than 8 percent of the population suffered from the condition. More specifically, Boulder, Colorado; Bellingham, Washington; and Fort Collins, Colorado were the three healthiest cities on the nationwide diabetes ranking.

Conversely, researchers found that Alabama, West Virginia and Mississippi had the highest numbers of people living with diabetes in the United States. Each state’s survey showed that  nearly 16 percent of its residents were diagnosed with the disease. The U.S. cities with the highest prevalence of diabetes were Mobile, Alabama; Charleston, West Virginia; and Corpus Christi, Texas, which all noted that about 17 percent of their population suffered from the illness. 

Additionally, the report listed obesity rates for each state next to its diabetes rankings. Not surprisingly, states with the highest rates of diabetes also suffered from elevated rates of obesity. “While not all people with diabetes are obese, and not all who are obese develop diabetes, research shows that about 54 percent of middle aged Americans who are obese and have not yet developed diabetes will do so in their lifetime,”wrote study authors.

In conclusion, researchers recommended communities stress diabetes education, quality health care and monitor health outcomes, as well as interact with people and technology, to help lower diabetes rates. The report noted that hospitals and health systems that implemented these tools experienced better health outcomes and quality of life for their patients.

To view the full rankings, download a copy of the report here.

To learn more about the U.S. diabetes epidemic, click here.