Exploring diabetic patients experiences during war in Sudan: insights from a multi-city study.

Background: The health system in Sudan was severely compromised by the ongoing conflict, jeopardizing the lives of millions of vulnerable people suffering from chronic health conditions, including diabetic patients. This study explored the experiences of diabetic patients, focusing on the challenges they faced in accessing medical consultations, medications, and blood glucose monitoring during the ongoing war.

Methods: A descriptive facility-based cross-sectional study was conducted across seven hospitals and diabetes centers in Sudan from May to July 2024, enrolling 350 diabetic patients. Convenient sampling was used to select the participants from the outpatient clinics of the targeted health facilities. Data was collected by interviewing patients using a structured questionnaire.

Results: Sixty percent of participants faced challenges accessing medications, with drug shortages (65.9%), the closure of pharmacies (44.1%), and safety concerns (39.8%) being the major barriers. Insulin users experienced significant difficulties, with 69.1% reporting problems storing their medications due to frequent power outages. The majority of patients (81.1%) faced challenges accessing medical care during the war. The most common difficulties included transportation issues and long wait times or overcrowding. The war disrupted the healthy eating habits of 34.9% of patients. Moreover, 54.3% of patients experienced a decline in blood sugar testing frequency, often due to the unavailability of laboratories and financial constraints. Displaced patients and patients in Al Mangal City suffered the most from these challenges.

Conclusion: This study reveals the devastating impact of the ongoing conflict on diabetes care in Sudan. Severe disruptions to healthcare access, including medication shortages and limited resources, have forced patients to adopt hazardous coping mechanisms. Urgent action is needed, including humanitarian aid and innovative interventions, to ensure equitable and sustainable diabetes care for all Sudanese patients.