RESUMO
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.
RESUMO
BACKGROUND: Diabetes mellitus (DM) is a major health problem in Sudan and is a leading cause of morbidity and mortality. The objective of this study is to determine the prevalence of complications of type 2 diabetes across different cities in the country. METHODS: Individuals with type 2 diabetes, who have been on treatment for DM for at least one year and volunteered to participate, were selected from two diabetes centers in Sudan (Khartoum and Atbara). Participants were interviewed using standardized pretested questionnaire to record medical history, socio-demographic, life style characteristics and presence of complications of diabetes. RESULTS: Four hundred and twenty four individuals with T2DM were included in this study (50.7% males and 49.3% females). Good glycemic control (HbA1c <7) was found in 15.7%. Hypertension was reported in 39.9% and myocardial infarction in 5.9%, while high cholesterol and triglyceride noted in 59.9%, 32.5% respectively. Low HDL was noted in 52.6%. Other complications like peripheral neuropathy, retinopathy and diabetic foot were observed in 68.2%, 72.6% and 12.7% respectively. Factors significantly associated with these complications were longer duration of diabetes (P<0.001), and living in urban areas (P<0.004). CONCLUSION: High prevalence of complications of type 2 diabetes were observed especially in those with longer duration of diabetes and poor control.