Eighty percent of people with diabetes live in low and middle-income countries, where health systems are not equipped to respond to this growing epidemic and few people can access the care they need.

Within this context diabetes and its complications present a tremendous and growing threat to health and human development and is one of the world’s most pressing public health problems.

To address this crisis, new and proven approaches are required in the management of diabetes complications within these challenging environments defined by low resources, limited investment and minimal health infrastructure.

Within diabetic retinopathy care we’ve seen an increase in innovative solutions in these contexts ranging from the implementation of artificial intelligence aided screening, instant messaging mentoring for clinicians and task sharing and task shifting to ensure system wide care is optimized.

According to the WHO World Report on Vision 146 million people have diabetic retinopathy, with 45 million having vision threatening diabetic retinopathy. By 2040 it is anticipated that 70 million people will have vision threatening diabetic retinopathy .

How can we as a community respond to these pressing challenges in diabetic retinopathy care?

In this discussion, members are asked:

1. What are some of the innovative solutions that you have implemented or seen implemented to manage diabetic retinopathy in low resource settings?
2. What was the decision making process used by the implementers to identify this as the most appropriate solution?
3. How can integrated models of DR care reduce costs, utilise available resources and increase impact?
4. What are some of the determinants of success or failure when seeking to implement innovative solutions for managing DR in low resource settings?

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