“When you need help, people will come”

Dr Iryna Vlasenko is a Ukrainian pharmacist and Vice President of the International Diabetes Federation. She lives with type 1 diabetes. 

She remembers her reaction to being told she had diabetes, 31 years ago: “I could not accept my diagnosis. I was a student. I was a very active person in every way, dancing, doing sport. This couldn’t be happening to me, it wasn’t possible. A condition for which there is no cure? It was a shock for me and for my family, and for a long time I felt like the girl who had lost everything”.

Her doctor told her, “You are educated, this is your problem and you can solve this, treat yourself, it’s in your hands”. She says, “I cried and then began to read”. She looked for the best treatment she could find and went to Moscow, where at that time they advocated education and self-management for people with diabetes. “They explained how I could live, and there was a dramatic change. I decided that I would not follow diabetes, diabetes would follow me. There was no point in crying that my life was over; it wasn’t.”

Her mother made sure from the start that Iryna strategized, and would do what she had to do – always checking her blood sugar twice daily, for example. Scientific innovation has made her existence easier: she now has an insulin pump that releases insulin into her body and a continuous glucose monitoring device, that measures her glucose levels 24 hours a day. This means she does not have to think about her diabetes all the time, worrying if she is hyperglycaemic (with blood-sugar levels too high) or not. With a scrupulous routine to pick up problems, she has had no complications so far. 

For over 10 years she kept her diabetes a secret; however, that has changed dramatically now: “I am very active internationally, very involved in the diabetes community; I am open and don’t keep secrets. Sometimes this helps me to motivate people with diabetes – your diabetes is in your own hands”.

Living through an emergency

On 24 February 2022, Ukraine experienced full-scale invasion by the Russian Federation, and the usual systems that run society were massively under threat. For people with diabetes, who rely on ongoing support from technology and medicine, it was a shock. “Suddenly, pharmacies were closing down, and people leaving. You had to find insulin, and at the beginning of the war you often had to pay for it. You could spend 5 hours in a queue for it. People were stressed out, and all our phones were ringing. I had my 3-month supply so I felt I was okay, but as things got worse, those of us with insulin shared it, because without it people would die.”

Iryna contacted the Ministry of Health, and with close collaboration, they worked out a very practical system, which has continued. The Ministry puts out a daily list online of which pharmacies are open and have insulin, all over the country – depending on active conflict zones, security and events of the day. And for people living in remote areas and villages, volunteers in the cities come forward to get their supplies and deliver them. Communication is crucial when safety of travel is so uncertain from day to day. In the occupied territories, she says, things are much worse.

Iryna is very appreciative of the support internationally and at home, from governments, industry and the general public. “My father always said, ‘There are many kind people all over the world and when you need help, people will come’ and they do. In a democracy, people want to share happiness.” From the very start, the International Diabetes Federation and the diabetes community have supported people with diabetes not only in Ukraine but also in the many countries to which they have fled and become refugees. She is also aware of the needs of people with other chronic diseases, who face similar situations. Everyone needs psychological support. Online support is also important, but not forgetting face-to-face contact with old people who do not use computers.

“We need to keep on living”

Iryna laughs as she recounts her regular sessions at a ballet class, which continue despite power cuts. “These classes help us reduce stress and live a more normal life. We need to keep on living. We also need to do the basics – eat properly, exercise well and always look for new developments. Pharmacists can provide so much help if they are trained to do so. We should not forget how serious this disease is. A month’s attachment to an accident and emergency department with my mother taught me that even with diabetes type 2, this is a life and death condition. But with collaboration between all of us, particularly the diabetes community, we can make it, even in an emergency.”

Person-centred care and community support, which Iryna so values, is part of the approach taken by the recent WHO/Europe publication, “Therapeutic patient education: an introductory guide”. This publication aims to help policy-makers and health professionals provide effective therapeutic patient education for all patients living with chronic conditions. The goal is not only to improve decision-making about clinical care by involving the patient through education, empowerment and support, but to help them live a more meaningful life.

Background on diabetes: what are WHO Member States committed to?

It was in 2022 that WHO Member States first supported the creation of global targets for diabetes, as part of recommendations to strengthen and monitor diabetes responses within national noncommunicable disease programmes.

WHO/Europe and the International Diabetes Federation Europe have agreed to accelerate progress to meet or exceed these global diabetes targets for 2030:

• 80% of people living with diabetes to be properly diagnosed;


• 80% of them to have good control of glycaemia and their blood pressure;


• 60% of people with diabetes and who are 40 or over to receive statins; and


• 100% of people with type 1 diabetes to have access to affordable insulin and blood glucose self-monitoring.