Recommendations for management of diabetes and its complications during Hajj (Muslim pilgrimage)

Mahmoud Ibrahim, Sulaf I. Abdelaziz, Megahed Abu Almagd, Monira Alarouj, Firas A. Annabi, David G. Armstrong, Ebtesam Ba-Essa, Abdullah Ben Nakhi, Nadia Boudjenah, Amy Hess Fischl, Al Ghomari Hassan, Shabeen Naz Masood, Aly A. Misha'l, A. Samad Shera, Jaakko Tuomilehto, Guillermo E. Umpierrez

Research output: Contribution to journalReview articlepeer-review

3 Scopus citations


Hajj is one of the five pillars of Islam and is a must-do for all adult Muslims once in their life provided they are able to do it. Considering the 8.8% global prevalence of diabetes, coupled with the number of Muslims performing Hajj (∼2.5 million adult Muslims), it could be estimated that Muslims with diabetes performing Hajj may exceed 220 000 per year. According to Islamic rules, Hajj should not cause severe difficulties for Muslims. The Holy Qur'an specifically exempts from this duty Muslims who are unable physically or financially if it might lead to harmful consequences for the individual. This should be applicable to subjects with diabetes considering its severe and chronic complications. During the Hajj, diet, amount of fluid intake and physical activity may be altered significantly. This exemption from the duty is usually not considered a simple permission; Muhammad the Prophet of Islam mentioned, 'God likes his permission to be fulfilled, as he likes his will to be executed'. However, most Muslims with diabetes prefer to do the Hajj duty, and this may cause major medical challenges for Muslims with diabetes and their healthcare providers. So it is very important that healthcare providers are aware of the possible risks that could happen during the Hajj. People with diabetes may face many health hazards during the Hajj, including but not limited to the 'killer triad': hypoglycemia, foot injury and infections. Many precautions are necessary in the prevention and treatment of possible serious complications. Risk stratification, medication adjustments, proper clinical assessment, and education before doing the Hajj are crucial.

Original languageEnglish (US)
Article numbere000574
JournalBMJ Open Diabetes Research and Care
Issue number1
StatePublished - Aug 1 2018
Externally publishedYes


  • adult diabetes
  • hypoglycemia

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism


Dive into the research topics of 'Recommendations for management of diabetes and its complications during Hajj (Muslim pilgrimage)'. Together they form a unique fingerprint.

Cite this