Hartmann and colleagues acknowledge in their study that worse diabetes outcomes are more common in people with lower economic status”5 and that “a lack of access to routine health care is a leading cause of morbidity and mortality after disasters; stroke, acute myocardial infarctions and diabetes complications are all shown to increase after the immediate threat has dissipated”. This is consistent with reports from the International Diabetes Federation that an estimated 75% of people with diabetes live in low and middle-income countries where health care facilities and resources for managing diabetes are poor and public awareness is low. In this way, the likelihood of undiagnosed and challenging blood-sugar levels is much greater and increases the chance of Diabetes-related Eye Diseases developing and progressing to advanced vision threatening stages.