Brigham and Women's Hospital, Boston, MA 02115, USA.
Harvard Humanitarian Initiative, Cambridge, MA 02138, USA.
J Clin Endocrinol Metab. 2022 Aug 18;107(9):e3553-e3561. doi: 10.1210/clinem/dgac331.
Amid the growing global diabetes epidemic, the scale of forced displacement resulting from armed conflict and humanitarian crises is at record-high levels. More than 80% of the displaced population lives in lower- and middle-income countries, which also host 81% of the global population living with diabetes. Most crises are protracted, often lasting decades, and humanitarian aid organizations are providing long-term primary care to both the local and displaced populations. Humanitarian crises are extremely varied in nature and occur in contexts that are diverse and dynamic. The scope of providing diabetes care varies depending on the phase of the crisis. This paper describes key challenges and possible solutions to improving diabetes care in crisis settings. It focuses on (1) ensuring a reliable supply of life preserving medications and diagnostics, (2) restoring and maintaining access to health care, and (3) adapting service design to the context. These challenges are illustrated through case studies in Ukraine, Mali, the Central African Republic, and Jordan.
在全球糖尿病流行日益加剧的情况下，武装冲突和人道主义危机导致的被迫流离失所规模达到历史最高水平。超过 80%的流离失所人口生活在中低收入国家，而这些国家也容纳了全球 81%的糖尿病患者。大多数危机都是旷日持久的，往往持续数十年，人道主义援助组织正在为当地居民和流离失所人口提供长期的基本医疗服务。人道主义危机的性质极其多样，发生在多样化和动态的背景下。提供糖尿病护理的范围取决于危机的阶段。本文描述了在危机环境中改善糖尿病护理的关键挑战和可能的解决方案。它侧重于（1）确保生命维持药物和诊断的可靠供应，（2）恢复和维持对医疗保健的获取，以及（3）使服务设计适应环境。这些挑战通过在乌克兰、马里、中非共和国和约旦的案例研究来说明。
