Progress in diabetes prevention or epidemiology—or both, or neither?

Abstract

After decades of negative reports, in The Lancet Diabetes & Endocrinology, Dianna Magliano and colleagues1 report encouraging signs that, among the 24 datasets they studied (of which 22 were from high-income countries or regions), comprising 5 billion person-years, the incidence of diagnosed diabetes might have declined in recent years in the majority of data sources. However, numerous questions remain. In particular, what might be driving these trends? Were these declines the result of interventions and policies designed to reduce the incidence of type 2 diabetes, or were they data artifacts? Which segments of these populations were represented in these data? And what of the global context of diabetes: given the increases in type 2 diabetes in low-income and middle-income countries, where do we go from here?