Exploratory study of the impact of war on management of type 1 diabetes mellitus among children in Gaza.

Abstract

Background: The war in Gaza has led to the destruction of health centres and medication shortages, impacting the most vulnerable groups, including children with type 1 diabetes mellitus (T1D).

Aim: To determine how the conflict in Gaza has affected the care of children with T1D.

Methods: We collected data from 29 patients with T1D, aged ≤18 years, between June and July 2024 using an online questionnaire, and analysed the data using SPSS version 21. The data included their sociodemographic characteristics, medical history, diabetes-related data, the impact of war on T1D, and lifestyle changes.

Results: Of the 29 patients, 86.2% of their parents reported a decline in their children's activity levels, 17.2% due to fear, and 58.6% reported that their child's average weight loss was 2.6±2.7 (range 0-10) kg. Most patients (79.3%) were unable to receive adequate diabetes care during the war. As a result, 10.3% were hospitalized due to a diabetic emergency. At the family level, 79.3% of the patients' families experienced food insecurity and 96.6% had limited food choices. And 41.4% said their foods may not have been compliant with a diabetes diet requirement.

Conclusion: Children with T1D in Gaza could not receive adequate diabetic care due to the war and experienced food insecurity with limited food choices, medication shortages and poor glycaemic controls. There is a critical need to prioritize chronic disease management in conflict-affected areas and among populations with restricted access to healthcare, to prevent the consequent detrimental health effects.