Engaging with patients in humanitarian crises: learning from access to insulin in Ukraine

Iryna Vlasenko, Sylvia Kehlenbrink

Abstract 

The 10th Cardiovascular Outcomes Research Summit (CVOT): Congress on Cardiovascular, Renal and Metabolic Outcomes was held online on 5–6 December 2024. This year, discussions on cardiovascular (CV) and renal research focused on the latest results from studies involving empagliflozin (EMPACT-MI), semaglutide (STEP- HFpEF-DM and FLOW), tirzepatide (SURMOUNT-OSA and SUMMIT), and finarenon (FINEARTS-HF). These studies demonstrate significant progress in reducing the risk of major adverse cardiovascular events (MACE) and improving metabolic outcomes in heart failure with preserved ejection fraction (HFpEF), chronic kidney disease (CKD), and obstructive sleep apnea (OSA). The Congress also included sessions on new and existing therapies for heart failure with preserved ejection fraction, CKD, and obesity; guidelines for the treatment of CKD and metabolic-associated steatosis (MAS); cross-organ interactions and the development of cardiorenometabolic syndrome (CRMS); precision medicine and personalized treatment of diabetes, obesity, cardiovascular disease (CVD) and CKD; early detection of type 1 diabetes mellitus (DM) and strategies to delay its onset; continuous glucose monitoring (CGM) and automated insulin delivery (ADI); cardiac autonomic neuropathy (CAN) and the diabetic heart; the role of primary care in the early detection, prevention and treatment of diseases associated with CKD. The contribution of environmental plastic pollution to CVD risk, the growing understanding of the efficacy and safety of incretin therapy in the treatment of CKD, and the latest evidence on incretin-based nutritional strategies in the treatment of CKD were also topics of interest to a broad audience of endocrinologists, diabetologists, cardiologists, nephrologists, and primary care physicians who actively participated in the online discussions. The 11th CVOT Summit will be held online on November 20–21, 2025 (http://www.cvot.org).
Keywords: Cardiovascular disease, Chronic kidney disease, CGM, CKM, Diabetes, Finerenone, GLP-1 RA, Guidelines, Heart failure, MASLD, Obesity, SGLT2 inhibitor, Tirzepatide.

References:
  1. Jenkins AJ, Ogle GD, Scibilia R, Schwarz P, Brennan FP. People who need insulin areparticularly vulnerable in disasters and conflicts. BMJ 2024;385:q1109. doi:10.1136/bmj.q1109
  2. Vlasenko IO, Komarida OO, Davtian LL. Study of the needs and pharmaceutical provision of patients with diabetes during time of state of martial law.Farm Zh 2022;3:22-32. doi:10.32352/0367-3057.3.22.03
  3. Resolution adopted by the General Assembly on 14 November 2022 (A/ES-11/L.6)] ES-11/5. https://www.securitycouncilreport.org/atf/cf/%7B65BFCF9B-6D27-4E9C-8CD3-CF6E4FF96FF9%7D/a_res_es_11_5.pdf
  4. Aebischer Perone  S, Martinez  E, du Mortier  S, et al. Non-communicable diseases in humanitarian settings: ten essential questions. Confl Health2017;11:17. doi:10.1186/s13031-017-0119-8 pmid:28932259
  5. Kehlenbrink  S, Mahboob  O, Al-Zubi  S, et al. An inter-humanitarian agency study of diabetes care and surveillance in humanitarian settings. Lancet Diabetes Endocrinol2022;10:159-62. doi:10.1016/S2213-8587(22)00036-5 pmid:35143782
  6. Kehlenbrink  S, Ansbro  É, Besançon  S, Hassan  S, Roberts  B, Jobanputra  K. Strengthening diabetes care in humanitarian crises in low- and middle-income settings. J Clin Endocrinol Metab2022;107:e3553-61.doi:10.1210/clinem/dgac331 pmid:35639997
  7. Sharma  V, Feldman  M, Sharma  R. Telehealth technologies in diabetes self-management and education. J Diabetes Sci Technol2024;18:148-58. doi:10.1177/19322968221093078 pmid:35485769
  8. Pamplin  JC, Scott  BK, Quinn  MT, et al. Technology and disasters: the evolution of the national emergency tele-critical care network. Crit Care Med2021;49:1007-14. doi:10.1097/CCM.0000000000005001 pmid:34135273
  9. Diabetes DRC. Insulin switching guides. https://diabetesdisasterresponse.org/international
  10. Malykhin O, Kaupuzs A, Aristova N, et al. Anxiety among school-age children in war-affected areas in Ukraine and ways to reduce it: parents’ views. Proceedings of the International Scientific Conference 2023:1:553-63.doi:10.17770/sie2023vol1.7088

Published
2025

How to Cite

Iryna Vlasenko, Sylvia Kehlenbrink (2025). Engaging with patients in humanitarian crises: learning from access to insulin in Ukraine. Diabetes Obesity Metabolic Syndrome. 5(14), 48-50.