It is estimated that over 3 million deaths each year are directly related to diabetes. Of greatest concern is that diabetes prevalence appears to be highest in the low- and middle-income countries. Managing diabetes, a complex task in ideal circumstances, can be made extremely difficult in emergency situations. Millions of people around the world live under constant threat from armed conflict or natural disasters, such as floods, hurricanes and earthquakes. The difficulties faced by poor and underserved people in accessing diabetes care are exacerbated in times of catastrophe. Debbie Jones reports on an International Diabetes Federation initiative which aims to ensure care for people with diabetes in emergency situations.