For women in Singapore, mean FPG decreased by 0.21 mmol/L per decade during the study period, the only significant decrease recorded.
In an editorial comment accompanying the study, Dr. Martin Tobias of the Health and Disability Intelligence Department of New Zealand’s Ministry of Health, noted that the finding that 70% of the world’s diabetes increase was attributable to population growth and aging confirms "the old saying that demography explains two-thirds of everything." However, he added, the findings are "stark," both supporting the position that diabetes poses severe risks for families, nations, and the entire world, and reinforcing the need to strengthen worldwide diabetes surveillance.
Dr. Tobias defended the study’s complex statistical modeling methods to make up for lost country-years and missing data. "Readers may ask how trends can be estimated for 92 countries with no data at all, and for the first decade of the pandemic (the 1980s), for which information is sparse. We can be reassured since the Collaborating Group tested the validity of their model by deliberately removing data for some countries and years, and applied the model to this restricted dataset. The model adequately predicted values for the withheld data [that is, out-of-sample prediction], which confirms fitness for purpose," he wrote.
Two authors on the study, Christopher J. Paciorek, Ph.D., and John K. Lin, both of the Harvard School of Public Health in Boston, disclosed stock holdings with Pfizer and Johnson & Johnson, respectively. Study author Dr. Majid Ezzati acknowledged chairing a session at the World Cardiology Congress, which was supported by its organizer. Dr. Tobias declared that he had no conflicts of interest.