The consultant of Internal Medicine, Endocrinology and Diabetes, Dr. Safeyyah bint Murad Al-Sherbini, has affirmed that the diabetics planning to set out for Hajj have to follow a number of tips meant to control the level of blood sugar, if they want to have a healthy Hajj. She pointed out that keeping to a balanced diet exercise, as well as the hypoglycemic pills or insulin, would be very effective and beneficial in facilitating the performance of the Hajj rites, Allâh willing, both easily and safely.
Interviewed at the MOH's Media Information and Health Awareness Center, within the context of the service dubbed “Pilgrims health is our concern!”, launched by the Ministry of Health for the 7th consecutive year through the toll-free number: 8002494444, Dr. Safeyyah underscored the importance of consulting a doctor a sufficient period before a diabetic should set out for Hajj, so as to get an elaborate report on his health condition, as well as the medications to be taken. She also advised pilgrims with diabetes to carry around an e-card recording the key information related to his health status, medications and doses.
She stressed that diseased pilgrims should take all their medicines in adequate quantities, so as to suffice the entire period of Hajj, making clear that no one other than the doctor could determine whether the diabetic patient can or cannot perform the Hajj rites, especially in case the diabetic suffers from weakness of the kidneys or arteriosclerosis. Some diabetics will have to undergo comprehensive examination, to check on the functions of kidneys, as well as the hemoglobin.
Dr. Safeyyah called upon pilgrims with diabetes to bear in mind that the acceptable ratio of blood sugar is: 80-130 mg/dl in case of fasting, and less than 180 mg/dl two hours after eating.
Moving on to the physical effort made by diabetics during circumambulating the Ka'ba (Tawaf) and walking between Safa and Marwa (Sa'i), and its impact on blood-sugar, Dr. Safeyyah advised pilgrims taking insulin to undergo the blood-sugar test prior to embarking on these rites. In case the result shows that the ratio of blood sugar is less than 80 mg/dl, then the performance of these rites should be put off until after they have a meal. But in case the ratio is 100-180 mg/dl, pilgrims can perform the Hajj rites safely, and have a snack hereafter. Patients with a blood-sugar ratio higher than 250 mg/dl will have to refrain from performing such rites, as this ratio will get inevitably even higher, especially pilgrims with first-type diabetes. Pilgrims with second-type diabetes, on the other hand, can perform the rites safely, but it is advisable to have a snake before embarking on action.
Dr. Safeyyah placed special emphasis on consulting a doctor in case of the incidence of any of the symptoms of low or high blood sugar, or in case of the incidence of any other disease (such as high temperature, diarrhea or excessive dieresis), since the ratio of blood-sugar gets high as a result of the incidence of such symptoms. She explained that high blood-sugar entails excessive dieresis, thirst, itching, non-healing wounds, exhaustion and fatigue, weight loss and numbness of the limbs. As for the symptoms of low blood-sugar, she mentioned excessive perspiration, hunger, shiver, paleness, dizziness and lack of concentration, heart palpitations, in addition to comas and cramps.
As for the medical kit to be carried around by pilgrims with diabetes, Dr. Dr. Safeyyah stressed it should include adequate quantities of the prescribed medicines, whether pills or insulin doses, as well as a blood-sugar analysis device for those who take pills or insulin doses. Diabetics taking insulin, particularly, should conduct the blood-sugar analysis not less than 4 times a day, she added.
According to Dr. Safeyyah should also include additional batteries, medical swabs and the like, especially in case the pilgrim suffers from other chronic diseases (which is very frequent indeed).
Pilgrims taking insulin, Dr. Safeyyah said, should take with them glucagon injections. Glucagon is necessary for succoring the diabetic patient in case of the incidence of abrupt low blood-sugar (hypoglycemia), or when he is inflicted with a coma, Allâh forbid! This injection modifies the ratio of sugar-blood directly and quickly. Sugar-coma, she warned, may occur in cases of both low and high blood-sugar. Older persons and those who do not take the prescribed medication regularly are more susceptible to comas than other, she said.
Addressing diabetics using insulin, Dr. Dr. Safeyyah advised to buy an “Insulin Protector” to keep insulin at a proper temperature. Meanwhile, she warned them against keeping insulin in suitcases, or transporting it by land, sea or air, and keeping it, instead in a handbag, since the temperature at cargo planes is too low, and may freeze the insulin drug.
Among the tips Dr. Al-Sherbini provided for pilgrims with diabetes was to keep in their handbags some sugar loaves, sweets and juices to use in cases of low blood-sugar during pilgrimage.
Dr. Safeyyah called upon the diabetic patient should take care of his feet, including hygiene and monitoring any changes undergoing the foot to evade infection. This is brought about by wearing socks and comfortable leather shoes especially, during Sa'i and Tawaf, given the prevention of infection is much easier than treatment. But if you notice any injury, soreness or swelling you should see your doctor. Dr. Safeyyah advised diabetic patients to do the following: trimming nails straight across to avoid nail damage, good drying and then using Vaseline or petroleum jelly to avoid cracks and wounds, and wearing cotton socks that helps in absorbing sweat, in addition to paying constant attention to the vulnerability of diabetics patient to undetected injuries, because of the numbness in his feet in some cases.
Besides, Dr. Safeyyah advised patients with diabetes suffering from peripheral nerve damage and constant numbness in the leg, to use wheelchairs in Sa'i and Tawaf instead of walking on their feet.
It followed that Dr. Safeyyah stressed that diabetic patients must get influenza vaccination before coming to Hajj, noting that the local and international studies and recommendations reported that diabetic patients must get influenza vaccination before the onset of winter each year, and get pneumococcal vaccination once in a lifetime.
She also advised diabetic patients to consider the following: a) caring for teeth and gums, and using a toothbrush and toothpaste to avoid mouth ulcers and sore and bleeding gums, b) caring for skin because the diabetic patients may be more susceptible to skin infections, c) eating healthy meals that would include all the key elements and not eating unhealthy food, in addition to distribution of daily calories into three main meals and one or more snacks, and d) drinking a lot of water because the diabetic patients is more prone to drought.
The consultant of Internal Medicine, Endocrinology and Diabetes, Dr. Safeyyah bint Murad Al-Sherbini concluded by saying, the pilgrim should take adequate rest and sleep, by sleeping at least 8 hours a day, since lack of sleep weakens the immune system and also retards the healing of wounds.