The status of care for youth with type 1 diabetes within and coming from humanitarian crises settings: a narrative review

doi:10.1186/s13031-024-00631-3

Review

. 2025 Jan 14;19(1):2.

doi: 10.1186/s13031-024-00631-3.

The status of care for youth with type 1 diabetes within and coming from humanitarian crises settings: a narrative review

Steven James^{1

2

3

4}, Samira B Jabakhanji^{5

6}, Roopa Mehta⁷, John McCaffrey⁵, Maisoon Mairghani⁵, Dominika Bhatia⁵, Olive James⁸, Sylvia Kehlenbrink⁹, Philippa Boulle¹⁰, Kiran Mejia Mehta¹¹, David Simmons¹², Edward W Gregg^{5

13}

Affiliations

¹ School of Health, University of the Sunshine Coast, Moreton Bay Campus, 1 Moreton Parade, Petrie, 4502, Australia. sjames1@usc.edu.au.
² Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Australia. sjames1@usc.edu.au.
³ School of Medicine, Western Sydney University, Campbelltown, Australia. sjames1@usc.edu.au.
⁴ School of Population Health, RCSI University of Medicine and Health Sciences, Dublin, Ireland. sjames1@usc.edu.au.
⁵ School of Population Health, RCSI University of Medicine and Health Sciences, Dublin, Ireland.
⁶ Centre for Preventive Medicine and Digital Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
⁷ Departamento de Endocrinología y Metabolismo, Unidad de Investigación en Enfermedades Metabolicas, Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, Mexico City, Mexico.
⁸ School of Biomedical Sciences, University of Queensland, St. Lucia, Australia.
⁹ Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Boston, USA.
¹⁰ Médecins Sans Frontières, Geneva, Switzerland.
¹¹ Medicine, St. Georges, University of London, London, UK.
¹² School of Medicine, Western Sydney University, Campbelltown, Australia.
¹³ Department of Epidemiology and Biostatistics, Imperial College London, London, UK.

PMID: 39810247
PMCID: PMC11731439
DOI: 10.1186/s13031-024-00631-3

Review

The status of care for youth with type 1 diabetes within and coming from humanitarian crises settings: a narrative review

Steven James et al. Confl Health. 2025.

. 2025 Jan 14;19(1):2.

doi: 10.1186/s13031-024-00631-3.

Authors

Affiliations

¹ School of Health, University of the Sunshine Coast, Moreton Bay Campus, 1 Moreton Parade, Petrie, 4502, Australia. sjames1@usc.edu.au.
² Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Australia. sjames1@usc.edu.au.
³ School of Medicine, Western Sydney University, Campbelltown, Australia. sjames1@usc.edu.au.
⁴ School of Population Health, RCSI University of Medicine and Health Sciences, Dublin, Ireland. sjames1@usc.edu.au.
⁵ School of Population Health, RCSI University of Medicine and Health Sciences, Dublin, Ireland.
⁶ Centre for Preventive Medicine and Digital Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
⁷ Departamento de Endocrinología y Metabolismo, Unidad de Investigación en Enfermedades Metabolicas, Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, Mexico City, Mexico.
⁸ School of Biomedical Sciences, University of Queensland, St. Lucia, Australia.
⁹ Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Boston, USA.
¹⁰ Médecins Sans Frontières, Geneva, Switzerland.
¹¹ Medicine, St. Georges, University of London, London, UK.
¹² School of Medicine, Western Sydney University, Campbelltown, Australia.
¹³ Department of Epidemiology and Biostatistics, Imperial College London, London, UK.

PMID: 39810247
PMCID: PMC11731439
DOI: 10.1186/s13031-024-00631-3

Abstract

Background: Humanitarian crises bring unique, and potentially growing challenges to people with type 1 diabetes (T1D). We aimed to determine, in youth with T1D (mean age (± 1SD) 0-17.9 years) within and coming from humanitarian crises settings (HCS), the reported prevalence that meet international consensus targets for glycaemic, blood pressure and lipid management, and incidence of severe hypoglycaemia or diabetic ketoacidosis.

Methods: A narrative review of quantitative data was conducted, using a systematic process. MEDLINE (Ovid), Global Health, Web of Science, Scopus, Embase, CINAHL, APA PsycINFO, Cochrane trials, and the reference lists of eligible records were searched (January 2014-February 2024); ten records covering ten separate studies were retrieved.

Results: Glycaemic management was consistently suboptimal in HCS. However, among individuals coming from HCS, glycaemia varied. Across both groups, data relating to blood pressure, lipids, severe hypoglycaemia or diabetic ketoacidosis were either unavailable or limited.

Conclusion: Findings expose the dearth of data relating to defined youth with T1D within and coming from HCS, leaving the status of this population largely uncharacterised. With limited data indicating suboptimal T1D management, there is a pressing need for the development of a consensus guideline on, and core indicators relating to such youth within and coming from HCS, plus monitoring systems and outcome data.

Keywords: Humanitarian crises; Narrative review; Refugee; Type 1 diabetes; Youth.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

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References

1. International Diabetes Federation. IDF diabetes atlas. Tenth edition. 2021. International Diabetes Federation: Brussels.
1. Chan J, Lim L, Wareham N. The Lancet Commission on diabetes: using data to transform diabetes care and patient lives. Lancet. 2021;396:2019–82. 10.1016/S0140-6736(20)32374-6. - PubMed
1. Ogle G, James S, Dabelea D, Pihoker C, Svennson J, Maniam J, et al. Global estimates of incidence of type 1 diabetes in children and adolescents: results from the International Diabetes Federation Atlas, 10th edition. Diab Res Clin Pract. 2021;183:109083. 10.1016/j.diabres.2021. - PubMed
1. Gregory G, Robinson T, Linklater S, Wang F, Colagiuri S, de Beaufort C, et al. Global incidence, prevalence, and mortality of type 1 diabetes in 2021 with projection to 2040: a modelling study. Lancet Diabetes Endocrinol. 2022;10(10):741–60. 10.1016/S2213-8587(22)00218-2. - PubMed
1. Jonas D, Crotty K, Yun J. Screening for prediabetes and type 2 diabetes: updated evidence report and systematic review for the US Preventive Services Task Force. JAMA. 2021;326:744–60. 10.1001/jama.2021.10403. - PubMed

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[1] International Diabetes Federation. IDF diabetes atlas. Tenth edition. 2021. International Diabetes Federation: Brussels.

[2] International Diabetes Federation. IDF diabetes atlas. Tenth edition. 2021. International Diabetes Federation: Brussels.

[3] Chan J, Lim L, Wareham N. The Lancet Commission on diabetes: using data to transform diabetes care and patient lives. Lancet. 2021;396:2019–82. 10.1016/S0140-6736(20)32374-6. - PubMed

[4] Chan J, Lim L, Wareham N. The Lancet Commission on diabetes: using data to transform diabetes care and patient lives. Lancet. 2021;396:2019–82. 10.1016/S0140-6736(20)32374-6. - PubMed

[5] Ogle G, James S, Dabelea D, Pihoker C, Svennson J, Maniam J, et al. Global estimates of incidence of type 1 diabetes in children and adolescents: results from the International Diabetes Federation Atlas, 10th edition. Diab Res Clin Pract. 2021;183:109083. 10.1016/j.diabres.2021. - PubMed

[6] Ogle G, James S, Dabelea D, Pihoker C, Svennson J, Maniam J, et al. Global estimates of incidence of type 1 diabetes in children and adolescents: results from the International Diabetes Federation Atlas, 10th edition. Diab Res Clin Pract. 2021;183:109083. 10.1016/j.diabres.2021. - PubMed

[7] Gregory G, Robinson T, Linklater S, Wang F, Colagiuri S, de Beaufort C, et al. Global incidence, prevalence, and mortality of type 1 diabetes in 2021 with projection to 2040: a modelling study. Lancet Diabetes Endocrinol. 2022;10(10):741–60. 10.1016/S2213-8587(22)00218-2. - PubMed

[8] Gregory G, Robinson T, Linklater S, Wang F, Colagiuri S, de Beaufort C, et al. Global incidence, prevalence, and mortality of type 1 diabetes in 2021 with projection to 2040: a modelling study. Lancet Diabetes Endocrinol. 2022;10(10):741–60. 10.1016/S2213-8587(22)00218-2. - PubMed

[9] Jonas D, Crotty K, Yun J. Screening for prediabetes and type 2 diabetes: updated evidence report and systematic review for the US Preventive Services Task Force. JAMA. 2021;326:744–60. 10.1001/jama.2021.10403. - PubMed

[10] Jonas D, Crotty K, Yun J. Screening for prediabetes and type 2 diabetes: updated evidence report and systematic review for the US Preventive Services Task Force. JAMA. 2021;326:744–60. 10.1001/jama.2021.10403. - PubMed

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The status of care for youth with type 1 diabetes within and coming from humanitarian crises settings: a narrative review

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The status of care for youth with type 1 diabetes within and coming from humanitarian crises settings: a narrative review

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