Metabolic and psychosomatic features in type 2 diabetes mellitus and their impact on quality of life in patients during wartime

Aim: to analyze metabolic changes, psychosomatic features, and the impact of wartime stressors on the quality of life in patients with type 2 diabetes mellitus (T2DM). Materials and methods. A systematic review of scientific literature published between 2020 and 2025 was conducted, including publications indexed in PubMed and Scopus databases. An analytical review of studies on metabolic disorders, psychosomatic changes, and quality of life indicators in T2DM patients during armed conflict was performed. The influence of chronic stress, post-traumatic stress disorder, and social constraints on disease progression and quality of life was evaluated. Results. The course of T2DM during armed conflict significantly worsens under the influence of multiple interrelated factors. Limited access to medical care, shortage of medications, disrupted nutrition, decreased physical activity, and high levels of psycho-emotional stress substantially impair disease compensation. Patients exhibit significant increases in glycated hemoglobin levels and higher rates of diabetic complications. In addition to metabolic disturbances, patients demonstrate a high prevalence of psycho-emotional disorders: depression, anxiety, post-traumatic stress disorder, psychogenic hyperglycemia, cognitive impairments, and functional somatic disorders. Chronic stress activates the hypothalamic-pituitary-adrenal axis, promoting the secretion of counter-regulatory hormones (cortisol, adrenaline), which aggravates insulin resistance, activates inflammatory processes, and complicates the course of diabetes. Particular attention is given to the quality of life of T2DM patients during wartime. Psychosocial factors (loss of housing, social connections, constant threat to life, and reduced social support) significantly decrease physical, emotional, and cognitive functioning, as well as life satisfaction. The use of validated psychometric scales enables objective assessment of patients’ psycho-emotional state and quality of life, serving as a basis for the development of individualized strategies for comprehensive medical and psychosocial support in crisis situations. Conclusions. T2DM in wartime is characterized by a complicated metabolic course, which is caused by both physiological and psycho-emotional factors. The combination of metabolic, psychosomatic, and social factors requires a personalized comprehensive approach to patient management with the involvement of interdisciplinary teams.