MENA Expert Consensus Position Statement on Diabetes Management During Hajj

Abstract

Hajj is a physically demanding mass gathering that poses significant risks for people with diabetes. A substantial proportion of pilgrims originate from high-prevalence regions, and approximately 20% of pilgrims in some cohorts have diabetes. Major risks include hypoglycemia, hyperglycemia (including diabetic ketoacidosis and hyperosmolar hyperglycemic state), dehydration and heat illness, foot injuries, and infections. We recommend that all individuals with diabetes undergo structured pre-travel assessment, individualized treatment planning, and that targeted education be provided. During Hajj, strict glucose monitoring, adequate hydration, and foot care are essential. Post-Hajj follow-up is essential for identifying complications and adjusting therapy. This statement provides evidence-based, practical recommendations for clinicians and health systems to minimize morbidity and ensure safe participation in Hajj.