According to a commentary, this study is the first to document the economic effect of productivity loss and thus is the first comprehensive study to account for the cost of diabetes worldwide, by world region, and by each of 184 individual countries. It notes the data used to generate the indirect cost estimates are comprehensive and based on generally well-validated parameters. In addition, the researchers made efforts to overcome some of the important limitations of previous studies of direct medical costs by incorporating different estimates of costs for diagnosed and undiagnosed diabetes, and by using more precise, directly measured cost ratios between people with diabetes and those without.