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Diabetes and War: The Critical Role of Diabetes Organizations during Humanitarian Emergencies

The International Diabetes Federation, IDF Europe and Ukrainian Diabetes Federation have played key roles for people managing diabetes in Ukraine.



A glucometer is used to identify high blood glucose levels in patients with diabetes. Managing diabetes becomes even more challenging during humanitarian crisis, when medical care and food supplies are interrupted, along with medications like insulin needed to manage health. (Direct Relief file photo)

Editor’s Note: An unabridged version of this post was originally published on the International Diabetes Federation website on June 21, 2022.

According to the International Diabetes Federation 2021 Diabetes Atlas, there are 2.3 million people living with diabetes in Ukraine in 2022, of which 230,000 are receiving insulin.

The war with Russia created about 8 million internally displaced people who have been forced to move to the western regions of Ukraine with millions more fleeing the country. War, displacement, and the daily struggle with diabetes are now a combined threat to thousands of Ukrainians. Most refugees abroad in European countries are provided with the necessary equipment and treatment, often with the help of national diabetes associations that are part of IDF Europe. For people living with diabetes in conflict zones and occupied territories in Ukraine, the situation is much harder with access to care and treatment being very limited.

Ukrainian nationals living with diabetes are defending the homeland both in the ranks of territorial defense and on the front lines, “volunteering” in all areas, supplying first aid kits to the front lines, snacks to bomb shelters and new equipment to children’s endocrinology departments. The Ukrainian Diabetes Federation has greatly intensified its operations across the country and new regional diabetes organizations are being created.

2,400 pounds of insulin from Direct Relief arrived on April 1 in Ukraine to support people managing diabetes. The four-pallet shipment was delivered to Ukraine’s Ministry of Health and was distributed across the country to support health services. Glucose strips and meters, as well as prescription medications to manage diabetes have also been shipped in the months since the war broke out in February 2022. (Courtesy photo)

“On February 24, at the beginning of the war… we experienced grief, tears, the deaths of our children, our elders, our women and our brave soldiers who have stood up to defend their country. In this difficult stage of our lives and the life of our beloved Ukraine, we matured, became wiser, stronger and more attentive to each other. People with diabetes were left alone with their huge burden until they united and helped each other. It was difficult to get access to insulin, and test strips for a glucometer, but doctors and volunteers were able to finally regulate the supply for those in need,” said Alexander Galaev, director of the Odessa branch of UDF and UDF volunteer for 10 years.

The war has deprived people living with diabetes of their usual contact with their caregivers and endocrinologists. Two endocrinologists had to leave Chernivsti and five left Kharkiv. In Dnipro and Zaporizhzhia, everything is in place. In Mykolaiv, heroic doctors work even in a hospital that was partially destroyed due to a direct missile hit.

Access to Insulin

There is currently no shortage of insulin in the country. The prescription fee for insulin has also been canceled. The state covers the cost of insulin drugs in full. Logistics issues and the number of working pharmacies that sharply decreased during the first month of the war created short-term interruptions of the supply of insulin. The unstable operation of the internet also had a negative impact on the availability of insulin across the country.

Due to the inability to guarantee compliance with the temperature regime, UDF had no choice but to refuse to receive humanitarian insulin and provided information support instead (information about working pharmacies and the availability of medicines).

Almost 30,000 glucose meters with strips provided for people with diabetes by Direct Relief were distributed by UDF to cities and villages, to children’s hospital emergency rooms in military hospitals and to ophthalmology clinics across Ukraine.

As of July 12, 2022, Direct Relief’s efforts to respond to the crisis in Ukraine have resulted in the delivery of more than 800 tons of emergency medical supplies.

Delivering all these medical supplies to areas in need has been challenging. Volunteers and the Red Cross have managed to deliver supplies to occupied cities and communities along the line of conflict. Ukrposhta has been delivering UDF’s heavy parcels across the country, at the request of regional and district hospitals, to territorial social assistance centers, diabetes NGOs, and UDF branches.

“Organizing the logistics of so many emergency goods is not an easy task in peacetime and even more so in times of war. I am glad that despite all the difficulties, we coped and were able to deliver aid to those who needed it, even in the temporarily occupied territories and war zones,” said Kirill Goncharuk, UDF board member and CheckEye CEO.

Before the war, the state provided glucose meters only for children and pregnant women. Adults living with diabetes had to buy self-monitoring devices at their own expense. As the war deprived people with diabetes of their usual contact with endocrinologists, the availability of self-monitoring devices became even more important. People with diabetes had to switch to an unfamiliar insulin preparation on their own by adjusting the dose to an unfamiliar regimen while sometimes experiencing a poor diet.

In just one month, more than 500 people in the most remote corners of Ukraine received test strips for ONE TOUCH SELECT glucose meters on the basis of applications from people living with diabetes.

Looking Forward

A new opportunity has arisen in these terrible times to put an end to endless reforms in the area of diabetes care. Drawing on the experience of successful National Diabetes Program implementation in other countries and the rise of new technologies to build a modern structure of diabetes care, UDF received a Direct Relief grant to help instate a program in Ukraine. The focus of the program will be on a modular management system of diabetes care, innovative technologies, reliable statistics and prevention.

Valentina Ocheretenko is board chair of the Ukrainian Diabetes Federation.

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