Peer-reviewed article
Type 2 diabetes mellitus in wartime Ukraine: famine, metabolic programming, and generational health consequences (2022–2024)
Христина Козловська, Alina Urbanovych, Федір Ланюш ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5-5This narrative review looks at how famine-like conditions during the war in Ukraine from 2022 to 2024 may be linked to type 2 diabetes. It draws on hospital reports, humanitarian assessments, early birth cohort data from three perinatal centers and published research on famine, including the Holodomor. The authors report more new diabetes diagnoses in adults, high rates of gestational diabetes in Mariupol, and early metabolic changes in infants and children. They argue that undernutrition before birth and in early life could create a generational metabolic problem and call for nutrition support, early screening and mental health care.
Key points
- Hospitals in eastern and southern regions reported a 25–30% rise in newly diagnosed adult-onset type 2 diabetes between mid-2022 and late 2023.
- Preliminary birth cohort data (n = 1,500+) from three perinatal centers showed elevated HOMA-IR scores, reduced C-peptide levels and early signs of metabolic syndrome in infants by 12 months.
- Case studies from Mariupol documented gestational diabetes incidence above 40% and BMI drops of 3–6 kg/m2 in pregnant women.
- In Kharkiv, screening found a 45% increase in pre-diabetes cases and elevated fasting glucose in children aged 5–10 years.
- Up to 80% of diabetic patients in conflict-affected zones had to self-fund medications because the healthcare system had collapsed.
Limitations
This is a narrative review that combines mixed sources, including preliminary cohort data and case studies, and it describes associations rather than proving that war-related hunger caused the changes. It does not report how sources were selected or weighed, and the birth cohort findings are described as preliminary.
Abstract
Background. Famine-like conditions resulting from the 2022 Russian invasion of Ukraine have created an acute humanitarian crisis with serious long-term metabolic health implications. Drawing on the Developmental Origins of Health and Disease (DOHaD) framework and historical evidence from the Holodomor (1932–1933), this review examines the emerging association between war-induced nutritional deprivation and type 2 diabetes mellitus (T2DM) in Ukraine between 2022 and 2024. Materials and methods. This narrative review synthesized data from national health records, regional hospital reports, humanitarian organization assessments (World Food Programme, UNICEF, Médecins Sans Frontières), birth cohort studies from three Ukrainian perinatal centers, and peer-reviewed literature on famine-related metabolic outcomes. Sources were identified through PubMed, Scopus, Web of Science, and Embase databases as well as official reports from the Ukrainian Ministry of Health and international humanitarian agencies. Results. Hospitals in eastern and southern regions reported a 25–30 % increase in newly diagnosed adult-onset T2DM between mid-2022 and late 2023. Up to 80 % of diabetic patients in conflict-affected zones were forced to self-fund medications due to healthcare system collapse. Preliminary birth cohort data (n = 1,500+) from three perinatal centers revealed elevated HOMA-IR scores, reduced C-peptide levels, and early signs of metabolic syndrome in infants by 12 months of age. Case studies from Mariupol documented gestational diabetes mellitus incidence exceeding 40 % and body mass index drops of 3–6 kg/m2 in pregnant women. In Kharkiv, screening programs identified a 45 % increase in pre-diabetes cases and elevated fasting glucose in children aged 5–10 years. Biological mechanisms identified include impaired pancreatic β-cell development, activation of the thrifty phenotype, chronic low-grade inflammation, HPA axis dysregulation, and mitochondrial dysfunction — all driven by prenatal and early-life undernutrition. Conclusions. The convergence of famine, chronic psychosocial stress, and healthcare collapse has accelerated T2DM onset and created conditions for a generational metabolic epidemic in Ukraine. Urgent, long-term public health strategies integrating nutritional rehabilitation, early metabolic screening, and mental health support are required to prevent a chronic disease crisis in future decades.