War Zones and Fragile States Face Dire Diabetes Gaps

What Was Studied and Why It Matters

Researchers examined how well 22 countries in the WHO Eastern Mediterranean Region — stretching from Morocco to Pakistan — are meeting diabetes prevention and treatment goals. Ten of these countries are classified as "fragile, conflict-affected and vulnerable" (FCV), meaning they face ongoing war, political instability, or humanitarian crises. The study asked a direct question: are people with diabetes in these settings being left behind? The answer, unfortunately, is yes — by a wide margin.

What the Researchers Found

The gaps between conflict-affected countries and more stable ones were stark across every measure studied:

• National diabetes action plans: Only 1 in 10 conflict-affected countries had one, compared to 8 in 12 stable countries.
• Insulin access in primary care: Just 50% of fragile-state clinics had reliable insulin, versus 83% in stable countries — meaning many patients cannot get the medication they need to survive.
• Clinical guidelines: Only 30% of fragile states had detailed national guidelines for managing diabetes, compared to 83% of stable nations.
• Prevention tools: Taxes on sugary drinks — a proven prevention strategy — were in place in 75% of stable countries but only 10% of fragile ones.
• Data tracking: Only 30% of conflict-affected countries maintained a national diabetes registry, making it nearly impossible to monitor the disease or plan care.

What This Means for Real Patients

If you or a loved one manages diabetes in a stable country, it can be easy to take reliable access to insulin, test strips, and medical guidance for granted. For millions of people living through conflict or instability, these essentials are often out of reach. Without insulin, people with Type 1 diabetes face life-threatening emergencies. Without blood glucose monitoring supplies, even people with Type 2 diabetes cannot manage their condition safely.

This research is a reminder that consistent, affordable access to diabetes supplies — from insulin to glucose meters and test strips — is not a luxury. It is a lifeline. Organizations like MDS Diabetes understand this reality and work to ensure patients have dependable access to the supplies they need for daily management.

What Experts Recommend

The study's authors call for:

• Embedding diabetes care into emergency health response plans
• Strengthening primary healthcare in fragile regions
• Ensuring insulin and essential medications reach conflict zones
• Building national registries to track who has diabetes and what care they receive
• International collaboration and dedicated funding for diabetes in crisis settings

Bottom Line

People with diabetes in war-torn or politically unstable countries face dramatically worse access to care than those in stable nations — from insulin and clinical guidelines to basic tracking systems. This global inequity costs lives. The research urges health systems worldwide to treat diabetes care as an essential, non-negotiable part of humanitarian and emergency response. For patients everywhere, the message is clear: access to reliable diabetes supplies and medication is a matter of survival, not convenience.