War kills and harms in many ways, not just directly, with weapons. After physical survival, health is the second target: in more than half of Ukrainian families there is a person with a chronic disease or a disability, according to the World Health Organization. Lack of drugs and other medical treatments can put the physical and mental well-being of many citizens at risk. And an article on The Lanceta firma dell’endocrinologa Janine Alessi and the Ukrainian author Marina Yankee, affiliated with the Mykolayiv Odessa Diabetic Association, reports deficiencies in the distribution of insulin and medical devices for glucose control in some areas. With potentially significant damage for many diabetic patients. This is what it means to risk being suddenly without treatment.
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Insulin is missing and more
According to the two Ukrainian authors, some services, such as pharmacies and delivery systems, have been interrupted, with the subsequent need for rationing of insulin, a life-saving drug. For some patients, especially with type 1 diabetes, the consequences can be severe, with complications such as diabetic ketoacidosis, potentially fatal. Furthermore, in certain areas, for example in Mariupol, there is a lack of medical facilities and a shortage of food (diabetics often also need sugar) and water, in addition to the blockade of some humanitarian convoys. Disruption of food distribution can be a problem for people with diabetes who must follow a controlled diet. Without forgetting that health workers are very busy caring for the injured and the assistance network is overloaded. Also, as the article on The Lancetthe impact on mental health is enormous, bearing in mind that already the basic risk of depression or anxiety among diabetic patients is 4 times higher than that of the general population.
An emergency within an emergency
“Anxiety disorders, depression, obsessive-compulsive disorder and in some cases eating disorders are on average a little more common in people with diabetes,” he explains. Mara Lastretti, coordinator of the Observatory of Psychology in Chronicity of the Lazio Psychologists Order, “and high levels of stress can negatively affect both mood and pathology itself”. According to the International Diabetes Federation, about 7% of citizens in Ukraine – over 2.3 million people – have type 2 diabetes, while 6,700 children and young people have been diagnosed with type 1 diabetes in the last year. “The diagnosis is in itself a very critical moment – continues the expert – since we learn that we have a chronic disease that leads to having to change habits in a sudden way, in some cases upsetting everyday life”.
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To an often precarious balance is added the serious emergency in progress, associated with the risk of not receiving medicines or other devices. “Fear, anxiety or panic and stress can be frequent emotions and sensations in a dramatic and critical situation such as that of a war – adds Lastretti – we think that even the pandemic, without wanting to make comparisons, has had some effect of this kind, with the many patients worry about not receiving adequate assistance. And even now, in the presence of the conflict, here in Italy some people with chronic diseases are expressing similar fears “.
From campaigns to new help strategies
In this huge crisis it is important to support the Ukrainian population: economic and health support campaigns are already a reality. In our country, the Italian Diabetes Foundation (Fid), together with various other national and international associations, has launched the “Together for Ukraine” initiative, which provides for the collection of funds and medical material to be sent (here all information). The essential aids are insulin, syringes, disinfectants and devices for controlling glucose in the blood, along with sugar.
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Telemedicine and digital tools can also help. “Again, without any comparison, the pandemic has taught us – explains the expert – the management of some problems remotely and psychological and practical support can be essential even in moments of very serious crisis and emergency”. In addition to this support, we read in the work on Lancet, it is essential to negotiate green corridors of respite, through which medicines and humanitarian aid can be sent to vulnerable areas. Reorganizing is important now and for the future: creating a network and having a strategic organization to administer means and aid may also be important tomorrow, in the case of other crises or emergencies, to support patients with diabetes and other diseases.