Diabetes Management for a Healthy and Safe Hajj Diabetes Management during Hajj During the period of Hajj, the life routines of people with diabetes change as they travel to a different place where diet habits, levels of physical activity, weather and geography are different. Therefore, diabetes management, which depends on establishing a certain stable routine, would be affected. Before Hajj Consult your doctor and together put a management plan. The objective of the plan is to maintain normal blood glucose level and prevent complications. If you are going with a group, inform the group organizers that you have diabetes, your diet plan and how to assist you when you have low blood glucose. What should you bring with you to Hajj? Blood glucose monitoring tools including glucometer, lancets, strips, alcohol swabs, band aids, extra batteries for the glucometer. Enough quantities of all the medication you are using. Thermos for storing the insulin and other medications that should be kept in a cold and dry place. Diabetes identification card which you should carry with you all the time. Sugary food such as juice, chocolate, candy, sugar cubes, etc., to use in case of low blood glucose. Copy of your medical record in case you need medical care during Hajj. Comfortable and good fitting shoes and cotton socks. An umbrella for protection from the sun. A mask to use in crowded places to prevent airborne infections. Hand sanitizers to clean your hands after handling anything and before eating if water and soap are not readily available. During Hajj Some health conditions are common during Hajj. It is very important to know how to prevent and manage these health conditions. Low blood glucose Why is low blood glucose common during Hajj? o People are usually pre-occupied with their rites and do not take their medication on time or forget to take it at all o Respiratory infections such as the common cold are very common in Hajj and these infections increase risk for low blood glucose o Change in meal times and types of food consumed. o Level of physical activity increases. o Dehydration is common during Hajj, which can lead to low blood glucose. o During Hajj, your daily routine changes, therefore, you should plan how to achieve a balance between medication, meals and level of physical activity. How can you prevent low blood glucose? o Plan your meals in advance. o Always carry a light snack and a sugary food with you when you are away from your residence. o Drink plenty of water to avoid dehydration. o Protect yourself from infections by following good personal hygiene. o In addition, make sure your influenza and meningitis vaccines are up to date before Hajj. o Test your blood glucose levels twice a day or as recommended by your doctor. How can you treat low blood glucose? o Eat sugar-containing food (e.g., ½ to ¾ cup of non-diet soda, ½ cup fruit juice, 2 tablespoons of raisins, 1 cup of milk, candy, 3 glucose tablets [5 grams each). If you don’t feel better 15 minutes after having sugar, or if your blood glucose level is still below 70 mg/dl, have another dose of sugar. o Remember to tell your colleagues in Hajj that you have diabetes. Inform them how they can help you when you have low blood glucose. They can rub honey or other sugary items on your gums if you are unconscious and unable to swallow food or drinks. Foot problems Why are foot problems common in Hajj? Hajj involves walking long distances and sometime walking barefoot. Therefore, foot problems such as foot burns are very common in Hajj. This burn injury, when it occurs to a diabetic foot can cause serious complications. How can you prevent foot problems during Hajj? Never walk barefoot; always wear comfortable shoes and cotton socks. Always keep your feet clean and dry. Try not to stand for a long time. Use transportation instead of walking long distances on your feet. Always inspect your feet and treat injuries immediately. See a doctor if you notice any abnormal changes in your foot such as blisters and cuts. Diarrhea Why is diarrhea common in Hajj? During Hajj, eating habits are likely to be different from your normal routine. In addition, the heavy traffic in Makkah leads to air pollution which could affect food hygiene. How to prevent diarrhea during Hajj? Follow good personal hygiene; always wash your hands before and after eating, after using the rest room and after handling things. Avoid foods that are prepared under unhygienic conditions. Follow your diet plan and eat at regular times to avoid stomach upset due to changing your eating habits. When you have diarrhea drink plenty of fluids, rest, continue using your medications and avoid going out in the sun to prevent dehydration. Dehydration Why is dehydration common during Hajj? • The weather in Makkah is usually hot and dry. • You will be busy with your rites and might forget to drink enough fluids. • Hajj involves a lot of strenuous physical activity such as walking long distances or standing for long times in the sun, thus, the body loses fluids. • Diarrhea is common in Hajj and if not managed properly will lead to dehydration. How can you prevent dehydration? • Drink plenty of fluids every day, a minimum of two liters (8 cups) per day and preferably more if you lose fluids due to sweating, diarrhea or any other reason. • When standing in the sun, use an umbrella. Respiratory Infections Why are respiratory infections common during Hajj? Makkah is usually very crowded during Hajj season so infections can spread very quickly. Low hygiene level. People usually do not eat well during Hajj or have enough rest which lowers their immunity and makes them more vulnerable to infections. How can you prevent infections? When you are in a crowded place, wear a mask that covers your mouth and nose. Wash your hands regularly or use hand sanitizers if water and soap are not readily available. Boost your energy by eating healthy food. Fruits and vegetables are good sources of vitamins, so make sure you consume them as per your diet plan on a daily basis. Drink plenty of fluids. We wish you a safe, holy and healthy Hajj and we would like to remind you to: Inform the people travelling with you that you have diabetes. Teach the people traveling with you about the signs and treatment of low blood glucose. Carry your diabetes identification card all the time. Continue to follow your diet and medication plans. Carry a brief medical record and a signed statement from your doctor, indicating your treatment and medication.