Khan Yasmin, Albache Nizar, Almasri Ibrahim, Gabbay Robert A
Joslin Diabetes Center, Boston, MA.
Hotel Dieu du Creusot Hospital, le Creusot, France.
Diabetes Spectr. 2019 Aug;32(3):264-269. doi: 10.2337/ds18-0070.
Humanitarian crises represent a major global health challenge as record numbers of people are being displaced worldwide. The Syrian crisis has resulted in >4 million refugees and 6 million people who are internally displaced within Syria. In 2017, there were 705,700 reported cases of adult diabetes in Syria. During periods of conflict, people with diabetes face numerous challenges, including food insecurity, inadequate access to medications and testing supplies, and a shortage of providers with expertise in diabetes care. Access to insulin represents a major challenge during a crisis, especially for individuals with type 1 diabetes, for whom the interruption of insulin constitutes a medical emergency. In the short term (days to weeks) during a crisis, it is vital to ) prioritize insulin for patients with type 1 diabetes, ) ensure continuous access to essential diabetes medications, and ) provide appropriate diabetes education for patients, with a focus on hypoglycemia and sick-day guidelines. In the long term (weeks to months) during a crisis, it is important to ) provide access to quality diabetes care and medications, ) train local and international health care providers on diabetes care, and ) develop clinical guidelines for diabetes management during humanitarian crises. It is imperative that we work across all sectors to promote the health of people with diabetes during humanitarian response.
人道主义危机是一项重大的全球健康挑战，因为全球流离失所的人数创下了纪录。叙利亚危机已导致400多万难民以及600万在叙利亚境内流离失所的人。2017年，叙利亚报告了705700例成人糖尿病病例。在冲突期间，糖尿病患者面临诸多挑战，包括粮食不安全、药物和检测用品获取不足，以及缺乏糖尿病护理专业知识的医疗服务提供者。在危机期间，获取胰岛素是一项重大挑战，尤其是对于1型糖尿病患者而言，胰岛素中断构成医疗紧急情况。在危机的短期（数天至数周）内，至关重要的是：1）优先为1型糖尿病患者提供胰岛素；2）确保持续获取基本糖尿病药物；3）为患者提供适当的糖尿病教育，重点是低血糖和患病日指南。在危机的长期（数周至数月）内，重要的是：1）提供优质糖尿病护理和药物；2）培训当地和国际医疗服务提供者的糖尿病护理知识；3）制定人道主义危机期间糖尿病管理的临床指南。我们必须跨部门合作，在人道主义应对期间促进糖尿病患者的健康。
