Diabetes patients in Gaza face survival battle amid war shortages

Hamza al-Ghazali, a 20-year-old from the Zeitoun neighborhood south of Gaza City, once again set out in search of an insulin pen. Since the war began in October 2023 and Israel tightened restrictions on medicine imports, this has become a daily struggle.

Before the war, Hamza could easily buy insulin for 25–35 shekels ($8.5–$12) per pen. Now prices have risen to 75–100 shekels ($25–$34), and he needs six to seven pens per month. He is forced to stretch each pen as long as possible by reducing doses.

In addition to insulin shortages, there is an acute lack of glucose meters and test strips. Without them, patients cannot monitor their blood sugar. Hamza notes that sometimes medicines that have been stored improperly appear on the market, raising concerns about their effectiveness.

Last year, when an Israeli blockade led to famine in northern Gaza, Hamza had to eat whatever he could find. But he also had to balance food intake with available insulin – too much food without enough insulin can cause dangerously high blood sugar, while too little food for fear of running out of insulin can lead to severe hypoglycemia.

Hamza says that during evacuations, he always carried his “diabetes bag.” He estimates that more than 80 percent of diabetes patients in some areas cannot test their blood sugar regularly, calling it a “medical disaster.”

According to the Gaza Ministry of Health, between 70,000 and 80,000 diabetes patients are at risk. Endocrinologist Dr. Adli al-Ghouti notes that about 2,500 children with Type 1 diabetes are in a highly critical state. Deterioration of insulin quality, expiration, and improper storage can reduce effectiveness, creating a false sense of security while blood sugar remains uncontrolled, potentially leading to life-threatening diabetic ketoacidosis.