Baomer A A, el bushra H E
Saudi Arabian Field Epidemiology Training Programme, Ministry of Health, Riyadh, Kingdom of Saudi Arabia.
East Afr Med J. 1998 Apr;75(4):211-4.
The annual pilgrimage to Makkah (Mecca), Hajj, is a very stressful endeavour and requires strenuous physical effort, especially for the diabetic, the elderly and persons with other chronic illnesses. To identify the complications and to assess the needs of the Omani diabetics during Hajj (DOH), a special diabetes clinic was established in the camping site of Omani pilgrims (Hajjees) in Mina, where all Omani Hajjees convene for three days. The socio-demographic characteristics, the diabetes profile and the knowledge about complications of diabetes of all DOH were ascertained; their random blood sugar (RBS) was tested. Of 10,800 Omani who performed the Hajj in 1996, the 169 Hajjees with diabetes mellitus (prevalence rate 16 per 1000) included four per cent insulin dependent (IDDM), seven per cent on dietary control, and 89% on oral hypoglycaemic agents. Almost all DOH (98%) were medically examined before their departure for Hajj. All Hajjees with IDDM and 96% on oral hypoglycaemic agents brought their medicines with them. During the Hajj period, 2.4% of DOH had RBS < 75 mg/dl, 14% 75-110 mg/dl, and 49% were hyperglycaemic (RBS > 200 mg/dL). About half of the DOH (48%) knew the clinical presentation of hyperglycaemia, a fourth (24%) about symptoms of hypoglycaemia. Only 9.5% were trained to test themselves for blood sugar. The median age of DOH was 54 years (inter-quartile range 50-62). Some 7.5% females and 4.9% of males were obese (body mass index > 30). Forty seven (28%) of the DOH had other coronary heart diseases, hypertension or both. DOH moved between Holy places (four journeys; 5-15 km long) on foot (40%), by car or bus (31%), or both (29%). All DOH except one were not wearing protective shoes, 70% did not have identification wrist bands that show their diabetic status and regimen for treatment. Four per cent lost their way during Hajj, four per cent suffered from heat exhaustion, three per cent had cut wounds, 1.2% had pneumonia, and two per cent went into coma. There is a need for a special health education programme and for special services for the diabetics during Hajj. Hajjees should learn about symptoms and signs of hypoglycaemia, were protective shoes and identifying wrist bands. Specialised services for the diabetics would alleviate a lot of the stress during Hajj among the diabetics.
每年前往麦加的朝圣之旅——朝觐，是一项压力极大的活动，需要付出艰苦的体力，对于糖尿病患者、老年人及其他慢性病患者而言尤其如此。为了确定并发症情况并评估阿曼糖尿病患者在朝觐期间的需求，在米纳的阿曼朝圣者（哈吉）营地设立了一家特殊的糖尿病诊所，所有阿曼哈吉会在此聚集三天。我们确定了所有朝觐期间糖尿病患者（DOH）的社会人口学特征、糖尿病概况以及对糖尿病并发症的了解情况；检测了他们的随机血糖（RBS）。在1996年进行朝觐的10800名阿曼人中，169名患有糖尿病的哈吉（患病率为每1000人中有16人）中，4%为胰岛素依赖型（IDDM），7%通过饮食控制，89%服用口服降糖药。几乎所有DOH（98%）在出发前往朝觐前都接受了医学检查。所有IDDM患者以及96%服用口服降糖药的哈吉都随身携带了药物。在朝觐期间，2.4%的DOH随机血糖<75毫克/分升，14%为75 - 110毫克/分升，49%血糖过高（随机血糖>200毫克/分升）。约一半的DOH（48%）知道高血糖的临床表现，四分之一（24%）了解低血糖症状。只有9.5%接受过自我检测血糖的培训。DOH的年龄中位数为54岁（四分位间距为50 - 62岁）。约7.5%的女性和4.9%的男性肥胖（体重指数>30）。47名（28%）DOH患有其他冠心病、高血压或两者皆有。DOH在圣地之间走动（四段行程；5 - 15公里长），40%步行，31%乘坐汽车或巴士，29%两者皆用。除一人外，所有DOH都未穿防护鞋；70%没有表明其糖尿病状况和治疗方案的识别腕带。4%的人在朝觐期间迷路，4%中暑，3%有割伤，1.2%患肺炎，2%昏迷。在朝觐期间，需要为糖尿病患者开展特殊的健康教育项目并提供特殊服务。哈吉应该了解低血糖的症状和体征、防护鞋以及识别腕带。为糖尿病患者提供的专业服务将减轻他们在朝觐期间的许多压力。
