Ok my statistics is rusty and never that good, so can't give an informed opinion on the validity of this paper. But it is based on a large population study of adult Danes (all white Caucasians). The authors are suggesting that increased risk of cardiovascular disease, stroke, peripheral arterial disease, peripheral neuropathy and particularly retinopathy, all occur as blood glucose levels increase above low normal levels ( > 4.0 mmol, 72 mg) , so such increased risk is present even at so-called normal and pre-diabetic BG levels. They attempt to show that this risk is incrementally CAUSED by higher BG levels, not just coincidental to these BG levels.
Therefore they are suggesting that it makes sense to do intensive risk screening for retinopathy, CVD, MI, stroke, neuropathy, etc even in so -called pre-diabetic patients. My takeaway is that keeping BGs and HBAC1s as low as possible is critical for susceptibility to these serious health conditions - the various health care boundaries are just"arbitrary" guidelines. But very hard to do in practice in the context of most Western & Asian carb intensive diets.
Big limitation of this study is that it only considers white North Europeans - relevance for other ethnic groups is completely unknown. Still some food for thought?