In the third in this series of ‘comparative healthcare’ medical practitioners explore the approach to diabetes in Bangaldesh and Australia respectively. The social and medical consequences of this chronic condition are highlighted through the approach to patients at various stages of the disease from two national perspectives. An astonishing 7% of the 153 million people are reported to have diabetes in Bangladesh. Many remain undiagnosed. Delays in diagnosis or management of diabetes have life limiting consequences for those who can ill afford private health care in the poorer nation.  Screening and early intervention appear to be denied to many in the developing country. The context is very different with Australians very fortunate to have a coordinated primary health care sector. The outlook for Bangladeshis with uncontrolled diabetes or with treatable sequela would be unacceptable in Australia. At every stage in the disease trajectory the doctors emphasise the importance of life style modification, a particular challenge in affluent Australia with its growing incidence of life style related pre morbid conditions in an increasingly sedentary population. A corner stone of the support of people with diabetes is the role of nurses and allied health professionals. With a funded commitment to multidisciplinary care in the community people with diabetes in Australia have access to support closer to home whereas those in Bangladesh remain heavily dependent on specialist, hospital based services. One can only speculate how Bangladesh will cope as its population ages and there are an ever increasing proportion of people who require urgent and expensive medical interventions. At the very least there is a strong case for greater investment in primary care especially to limit the economic consequences of diabetes and other chronic conditions. Finally as in other articles in this series we would like to emphasise that, the views expressed are those of the authors and do not necessarily reflect health policy or practice in their respective countries. Nonetheless we believe they offer a valuable perspective on common health care issues and commend the article to our readers.