Diabetes patients in the Gaza Strip are fighting two battles without respite - the fallout from an Israeli offensive that began nearly three years ago despite a ceasefire announced almost a year ago, and a daily struggle to secure medication as Israel tightens restrictions on the entry of drugs and other medical supplies, despite appeals from UN and health organizations. The war has forced people with chronic illnesses to use expired medication as access to safe treatment has dwindled. Habib Abu Daqqa, 11, who was diagnosed with diabetes a year before the war, has spent more than three months at Nasser Medical Complex after falling into a coma following an injection of expired diabetes medication. His mother, Maysaa Abu Daqqa, who also has diabetes, told Asharq Al-Awsat that her son has become severely distressed and needs regular, safe treatment before he can leave the hospital. She resorted to the expired injection because of his condition, despite warnings from some doctors, while others had told her it could still be used. He subsequently developed diabetic ketoacidosis and was admitted to intensive care. Before the war, she recalled, both had reliable access to medication and appropriate food and followed regular treatment and dietary plans. She attributed their deteriorating health partly to the period of famine in Gaza. In 2024, the Palestinian Health Ministry estimated that around 350,000 people with chronic illnesses in Gaza lacked necessary healthcare, including about 71,000 diabetes patients, 225,000 people with hypertension and 45,000 with cardiovascular disease. Al-Baraa Abdel Aal, 14, who has Type 1 diabetes, also required intensive care after medication shortages forced him to take expired drugs. “Before the war, I had access to all kinds of medication, especially insulin,” Abdel Aal told Asharq Al-Awsat. Suitable food was also readily available. “I spent eight days in intensive care. I saw death,” he recalled, adding that expired medication and substitutes left him severely fatigued. Wafaa Washah, 36, a Jabalia refugee camp resident displaced to Khan Younis who has had diabetes for 13 years, explained that economic hardship and her husband’s unemployment had deprived her of suitable food and even clean drinking water. She recounted that she nearly slipped into a coma several times after using expired medication because no alternatives were available. During the famine, shortages of food, particularly flour, left her suffering frequent dizziness and fever. Farah Lafi, 19, noted that the crisis extends beyond insulin to glucose test strips needed for frequent blood-sugar monitoring. She estimated that expired medications retain only about 30% of their effectiveness, undermining patients’ daily activity and ability to function. Ibrahim Dhair, a diabetes consultant at hospitals in southern Gaza, described diabetes patients as among those hardest hit by severe drug shortages. Much of the available medication is expired and can lead to complications including diabetic ketoacidosis and admission to intensive care. Even when insulin is available, proper refrigeration poses another problem, he explained. Many residents live in tents without basic services, while extreme heat can spoil medicines that must be stored at specific temperatures. Dhair added that doctors sometimes issue guidance on how to manage available medicines, but with stocks continuing to run out, he described the current situation as a crisis beyond the healthcare system’s capacity to handle.
