Hyperglycaemic and hypoglycaemic emergencies among patients with diabetes mellitus who participated in pilgrims of the 2019/1440H Hajj season

Abdulaziz Alfadhly; Hussain Darraj; Basim Alamlki; Saad Alfaez; Mohammed Alzahrani; Ali Mubarak; Safar Albogami; Daifallah Almalki; Khalid Alshehri; Ali Alqarni; Ali Alzahrani; Hamzah Khalid; Rami Altwairiqi; Adhari Alselmi; Afnan Almajnouni; Turki Kamal; Mohammed Kamal; Fahad Almatrfi; Mugtaba Osman; Abdulkareem Alotaibi

doi:10.4103/jfmpc.jfmpc_1096_21

Hyperglycaemic and hypoglycaemic emergencies among patients with diabetes mellitus who participated in pilgrims of the 2019/1440H Hajj season

J Family Med Prim Care. 2022 Jan;11(1):312-318. doi: 10.4103/jfmpc.jfmpc_1096_21. Epub 2022 Jan 31.

Authors

Abdulaziz Alfadhly¹, Hussain Darraj², Basim Alamlki¹, Saad Alfaez¹, Mohammed Alzahrani¹, Ali Mubarak¹, Safar Albogami¹, Daifallah Almalki¹, Khalid Alshehri¹, Ali Alqarni¹, Ali Alzahrani¹, Hamzah Khalid³, Rami Altwairiqi¹, Adhari Alselmi¹, Afnan Almajnouni¹, Turki Kamal¹, Mohammed Kamal¹, Fahad Almatrfi¹, Mugtaba Osman⁴, Abdulkareem Alotaibi¹

Affiliations

¹ Diabetes Centre, Prince Mansour Military Hospital, Taif, Saudi Arabia.
² Jazan Health Affairs, Jazan, Ministry of Health, Makkah, Saudi Arabia.
³ Endocrinology Unit, Department of Internal Medicine, King Abdulaziz Hospital, Makkah, Saudi Arabia.
⁴ Armed Forces Center for Psychiatric Care, Taif, Saudi Arabia.

Abstract

Background: Diabetic emergencies are serious acute life-threatening complications of diabetes mellitus (DM). The Hajj season requires the health system in Saudi Arabia to prepare efficiently for the healthcare of millions of pilgrims, particularly for diabetic emergencies. Thus, diabetic emergencies need rapid recognition, diagnosis and treatment. This study aimed to explore the frequency and associated factors of diabetic emergencies among the pilgrim's patients with DM during Hajj, Mecca 2019.

Methods: This is a prospective study which was conducted on 153 patients with DM. They were selected from three major healthcare-providing facilities during Hajj, which are Arafat, Muzdelefah and Muna healthcare centres. The study was conducted from Aug 5 to 12, 2019. All the patients who presented with any of the hypoglycaemic or hyperglycaemic emergencies had their demographic and clinical characteristics recorded to estimate the prevalence of each emergency and identify its significant associated factors.

Result: More than 90% of the study participants were patients with type 2 diabetes mellitus (T2DM), while around 7% had type 1 diabetes mellitus (T1DM). Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycaemic state (HHS) and hypoglycaemia were presented in (n = 11, 7.2%), (n = 19, 12.4%) and (n = 28, 18%), respectively, of the participants. Moreover, the study found that "younger age" (odds = 30.4, P = 0.0115) and "type of medication" are significantly associated with DKA. Furthermore, "older age", "type of medication", "having Cardiovascular Disease (CVD)" and "diabetes duration" were found to have a significant association with HHS. Moreover, hypoglycaemia was associated with neuropathy complication (odds = 3.54948, P = 0.0187).

Conclusions: Among the pilgrims with diabetes participating in Hajj, a considerable proportion with a range of diabetic emergencies present to the onsite medical facilities. Preparation is required in terms of logistics and health education about diabetic emergencies to meet the needs of pilgrims with DM, especially those who use insulin and have longstanding diabetes. Further research on DM and the creation of guidelines for health providers and patients with DM during Hajj are important focuses for the future.

Keywords: Diabetes mellitus; diabetic emergencies; diabetic ketoacidosis; hyperglycaemia; hypoglycaemia; type 1; type 2.