General Guidelines for Diabetic People who intend to Perform Hajj

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General Guidelines for Diabetic People who intend to Perform
Hajj Pilgrimage
Introduction
The Saudi Diabetes and Endocrine Association is pleased to
present these guidelines to diabetic people who intend to
perform Hajj, aiming to help them to have safe and blessed
Hajj without health complications. Diabetes is widespread in
the community due to many factors; such as genetics,
unhealthy lifestyle, lack of exercise and obesity. Diabetic
pilgrims are advised to consult their doctors and to follow
the below guidelines to avoid health complications prior and
during Hajj. Hajj period is limited to a few days in which
diabetic pilgrims have to perform many rites which require
extra effort and exercise, accordingly; they have to prepare
themselves for additional activities than normal days during
the Hajj period.
The government of Saudi Arabia has made a lot of effort to
ensure the safety and security of the pilgrims and issued
educational guidelines for them to follow. In addition, the
government has assigned thousands of security and health
care personnel for the sake of pilgrims’ safety and
established hundreds of Emergency Centers all over the
area. In addition, the government has installed fire resistant
tints and compounds, safe accommodations, ensured safe
and adequate transportation, ensured adequate safe food
and water supply, planted thousands of trees for shading,
installed cold water sprinklers to control high temperature,
constructed safe highways and bridges and made all the
needed facilities and utilities according to the International
standards, of health, safety and environment.
In order to avoid high or low blood sugar, pilgrims are
advised to observe the following:
• Hot weather is one of the primary causes
of
Dehydration and sunstroke, if the pilgrim is under direct
sun too long.
Acute kidney failure, resulting from dehydration and
sunstroke.
Increase in blood viscosity, which many cause
stroke/heart attack.
Dizziness.
Exhaustion.
To avoid these complications, the pilgrim is advised to avoid
staying in the sun unnecessarily and to use an umbrella or to
stay in the shade as much as possible. Wetting the head and
body with water many times during the day is another way
to keep the body cool.
Diabetics should drink a lot of fluids, especially water, during
the day and night, to replace sweat and urine loss. Less urine
output and dark color of the urine indicate the need for more
water.
• Medications
Insulin must be kept in a refrigerator at the residence or in the
coolest area of the room or in an iced thermos or in insulated bags,
during transfer from one place to another. Otherwise the insulin will
not be effective.
Oral medication should be kept in a cool place.
Medication should be placed in safe and secured places and not to
be placed in the gloves cabinets of the vehicles or within the air
traveling luggage or under direct sun or in heated areas.
• Diet
Diabetic pilgrims should follow their diet plans during the Hajj
period and to eat their meals and snacks as advised by their doctors
and dietitians. Food exchange lists are to be used to select food
items that are available on the road and at Mecca & Madina in order
to meet their diet requirements and to keep their blood sugar at
normal levels. They should avoid foods that are prepared under
unhygienic conditions and avoid consuming unhealthy foods to
avoid food poisoning. They should always check the foods’ expiry
dates, read food labels, and consume pasteurized or long life food
items.
Diabetic pilgrims are advised to eat their healthy meals and snacks
based on the time schedule set for them by their doctors and
dietitians. The meals should be low fat, moderate in salt, rich in
fiber and well-balanced. The meals schedule should be integrated
with the pilgrims’ activities and medication regimen.
Diabetic pilgrims, if they wish to fill Zamzam water, should ensure
the hygienic condition of their bottles and containers.
• Blood Sugar Monitoring
Diabetics, especially those using insulin and oral medications, are
advised to check their blood sugar levels twice a day, minimum, to
ensure that their blood sugar is within normal level. The results
should be recorded before taking medication. In case of frequent
low blood sugar, the patients are advised go to the nearest
Emergency Center to adjust their medication doses, as the activity
level of pilgrims during Hajj reduces the required dosages.
Helpful Tips
• The general guidelines are divided into three stages:
1. Prior to traveling to Mecca in order to prepare diabetic pilgrims
for healthy and safe Hajj.
2. On the way to Mecca, either by air or land or sea.
3. At Mecca during performance of Hajj rites.
• Diabetic pilgrims are advised to take all the necessary
vaccinations prior to commencing their Hajj, as require
by the government of Saudi Arabia, and to do all the
required tests to ensure about their physical and healthy abilities to
perform Hajj safely and healthfully.
• If diabetic pilgrims have been cleared by their doctors to perform
Hajj, they should inform their companions at the vehicles and
residences that they have diabetes. The pilgrims’ organizers have to
be informed that diabetic people are included within their pilgrims
so that help can be provided should the need arise.
• If diabetic pilgrims choose to travel via air, they are advised to
contact their airlines and inform them about their food needs and
other requirements. They should not keep their medications with
the luggage, as these should be hand carried with them.
• Diabetic pilgrims should carry their diabetic ID cards and
cubes of sugar, candy or juices, in order to be prepared for
a possible episode of low blood sugar. Low blood sugar
symptoms: are hunger, trembling, weakness, sweating,
confusion, irritability, and tingling of mouth and fingers.
• Diabetic pilgrims are advised to take with them an
adequate supply of medication, in addition to Glucagon Kit
if they are on insulin. This kit will be used in case of low blood sugar
coma. Family members or companions should be trained to
administer Glucagon injection once needed. Diabetic pilgrims are
advised to take First Aid Kit with them, along with their personal
items; such as seizers, eye glasses, alcohol swaps, tooth paste and
brush, towels, etc.
• Diabetic pilgrims are advised to perform their Hajj away from
crowded areas and to take deep breaths in order to inhale more
oxygen, as less oxygen is available in crowded areas. They should
take care of their feet in crowded areas to avoid injury.
• Diabetic pilgrims are advised not to share their personal items
with others, and are advised to practice safety and hygiene, wash
their hands more often with water and antiseptic soap. They also
are advised to stay away from sick people and cover their mouths
and noses when coughing or sneezing.
• Foot care is very important for diabetic pilgrims; therefore, they
are advised to keep their feet clean, dry, and use proper
footwear to protect their feet. They also are advised not
to walk barefoot on hot surfaces or sharp objects, to
check their feet regularly, and use the transportation
available in order to avoid walking long distances.
• To prevent the consequences of low blood sugar event during the
journey, diabetic pilgrims are advised to ask a member of their
families, or companions, to drive.
• Diabetic pilgrims they also are advised to report to the nearest
Emergency Center in case of sudden sickness, chest pain, infection,
severe diarrhea, vomiting, foot injury or falls.
The Saudi Diabetes & Endocrine Association hopes that
the above guidelines will be helpful for pilgrims to
perform safe, healthy and holy Hajj
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