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

Mohamed Hisham Alamin; Manasik Mamoun; Leina Elfatih Salah Mohamed Ali Elomeiri; Sarah Hashim Mohammed Osman; Shrouk M Abdou; Fatima Mohamed Osman Yasin; Ekhlass Ahmed Musa Mohamed; Abdelrahman Idris Mohamed Idris; Marwa Adil Abdelwahab Hag Ahmed; Lina Ahmed Ali Mohmmed Ahmed; Abdalmahmoud Asadig Kanan Ahmed; Mariam Abdelgadir Hago Taha; Moneer Ali Abdallah Ali; Esra Abdallah Abdalwahed Mahgoub

doi:10.1186/s13031-025-00671-3

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

Confl Health. 2025 Jun 23;19(1):35. doi: 10.1186/s13031-025-00671-3.

Authors

Mohamed Hisham Alamin^{1

2}, Manasik Mamoun^{3

4}, Leina Elfatih Salah Mohamed Ali Elomeiri^{3

5}, Sarah Hashim Mohammed Osman⁵, Shrouk M Abdou^{3

6}, Fatima Mohamed Osman Yasin⁷, Ekhlass Ahmed Musa Mohamed^{3

8}, Abdelrahman Idris Mohamed Idris^{9

10}, Marwa Adil Abdelwahab Hag Ahmed^{4

11}, Lina Ahmed Ali Mohmmed Ahmed⁴, Abdalmahmoud Asadig Kanan Ahmed¹², Mariam Abdelgadir Hago Taha⁴, Moneer Ali Abdallah Ali⁴, Esra Abdallah Abdalwahed Mahgoub^{13

14}

Affiliations

¹ Faculty of Medicine, International University of Africa, Khartoum, Sudan. stronggaf@gmail.com.
² One Percent Research Initiative, Khartoum, Sudan. stronggaf@gmail.com.
³ One Percent Research Initiative, Khartoum, Sudan.
⁴ Faculty of Medicine, Al Neelain University, Khartoum, Sudan.
⁵ Faculty of Medicine, University of Khartoum, Khartoum, Sudan.
⁶ Biology Department, School of Sciences and Engineering, The American University in Cairo, Cairo, Egypt.
⁷ Faculty of Medical Laboratory Science, Gadarif University, Gadarif, Sudan.
⁸ Faculty of Economic and Political Sciences, Statistics, Omdurman Islamic University, Omdurman, Sudan.
⁹ Department of Medicine, Kassala Teaching Hospital, Kassala, Sudan.
¹⁰ Faculty of Medicine and Surgery, University of Kassala, Kassala, Sudan.
¹¹ Aldabbah Central Hospital, Aldabbah, Northen State, Sudan.
¹² Faculty of Medicine, University of Gazira, Gazira, Sudan.
¹³ One Percent Research Initiative, Khartoum, Sudan. esramahgoub91@gmail.com.
¹⁴ Faculty of Medicine, Al Neelain University, Khartoum, Sudan. esramahgoub91@gmail.com.

Abstract

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.

Keywords: Armed conflicts; Diabetes mellitus; Displaced persons; Health services; Noncommunicable diseases; Sudan.