Closing the rural diabetes research gap: a case for coordinated international collaboration.

Rural, regional and remote communities experience a disproportionate burden of diabetes and persistent barriers to specialist care, including workforce shortages, geographic isolation, transport costs, fragmented services and uneven digital infrastructure. However, much of the evidence guiding diabetes service design is derived from urban settings, while rural studies are often localised, short-term and difficult to compare or scale. This article argues that addressing rural diabetes inequity requires coordinated international research rather than isolated projects or the transfer of urban models into rural contexts. It introduces the International Consortium for Rural Diabetes Research (ICRDR), an international collaboration of clinicians, researchers, health service leaders and diabetes stakeholders established to align research priorities, develop shared methodologies and outcome measures, and support multicentre and cross-jurisdictional studies. The ICRDR will initially develop community-informed research priorities involving people with lived experience, clinicians, researchers, policymakers and funders. Its longer-term agenda includes evaluating contextually appropriate models of care, digital health approaches, workforce capability and connections between primary and specialist care and supporting research capacity in low- and middle-income countries. Coordinated international research infrastructure can strengthen the relevance, implementation and scalability of rural diabetes research and support the translation of evidence into more equitable and sustainable models of care.