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Diabetes care for the Hajj

  • Safwaan Adam
    Correspondence
    Corresponding author at: Diabetes and Endocrinology, The Christie Hospital, 550 Wilmslow Road, Manchester M20 4BX, UK.
    Affiliations
    Diabetes and Endocrinology, The Christie Hospital, Manchester, UK
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  • Akheel A. Syed
    Affiliations
    Diabetes and Endocrinology, Salford Royal NHS Foundation Trust and University Teaching Hospital, Salford, Greater Manchester, UK

    Faculty of Medical and Human Sciences, the University of Manchester, Manchester, UK
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Published:September 18, 2015DOI:https://doi.org/10.1016/j.ejim.2015.09.006
      Hajj, the annual pilgrimage to Makkah (https://goo.gl/maps/47x1l), attracts two million Muslim men and women, including over 45,000 Hajjis (pilgrims) from the European Union [
      • Bowron C.
      • Maalim S.
      Saudi Arabia: Hajj Pilgrimage.
      ,
      • Memish Z.
      • Al Hakeem R.
      • Al Neel O.
      • Danis K.
      • Jasir A.
      • Eibach D.
      Laboratory-confirmed invasive meningococcal disease: effect of the Hajj vaccination policy, Saudi Arabia, 1995 to 2011.
      ]. It is an arduous and physically challenging event [
      • Bowron C.
      • Maalim S.
      Saudi Arabia: Hajj Pilgrimage.
      ], and cardiovascular diseases are the principal causes of death during the Hajj [
      • Al Shimemeri A.
      Cardiovascular disease in Hajj pilgrims.
      ]. With a worldwide diabetes prevalence of 8.5% [
      • Whiting D.R.
      • Guariguata L.
      • Weil C.
      • Shaw J.
      IDF diabetes atlas: global estimates of the prevalence of diabetes for 2011 and 2030.
      ], the Hajj will host 170,000 people with diabetes — a gross underestimation as many Hajjis come from areas of much higher urban adult diabetes rates. For instance, European pilgrims are generally from ethnicities with higher prevalence of diabetes with a reported prevalence of 21% amongst travellers from France [
      • Gautret P.
      • Gaillard C.
      • Soula G.
      • Delmont J.
      • Brouqui P.
      • Parola P.
      Pilgrims from Marseille, France, to Mecca: demographics and vaccination status.
      ]. Similarly, most Hajjis from the UK are of south Asian descent, who has an estimated diabetes prevalence of 14% [
      • Holman N.
      • Forouhi N.G.
      • Goyder E.
      • Wild S.H.
      The Association of Public Health Observatories (APHO) diabetes prevalence model: estimates of total diabetes prevalence for England, 2010–2030.
      ]. Furthermore, one observational study reported a diabetes prevalence of 31% amongst pilgrims admitted to a tertiary hospital in Makkah during the Hajj season; [
      • Khan N.A.
      • Ishag A.M.
      • Ahmad M.S.
      • El-Sayed F.M.
      • Bachal Z.A.
      • Abbas T.G.
      Pattern of medical diseases and determinants of prognosis of hospitalization during 2005 Muslim pilgrimage Hajj in a tertiary care hospital. A prospective cohort study.
      ] this may also reflect higher morbidity in diabetic pilgrims. Pre-Hajj screening and intervention have been shown to reduce overall cardiovascular mortality and hospitalisation rates [
      • Al Shimemeri A.
      Cardiovascular disease in Hajj pilgrims.
      ]. In our view, health improvement measures in pilgrims with diabetes would go a long way in reducing mortality and morbidity during the Hajj.

      Keywords

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