Diabetic Foot Care for Umrah & Hajj — A Practical Guide

If you have diabetes, your feet need more care on Umrah or Hajj than almost anywhere else. You will walk far more than usual, often in crowds, on hard floors, sometimes on hot outdoor surfaces, and in sandals rather than your usual shoes. Small injuries that you might not even feel can become serious quickly.

The good news is that most foot problems can be prevented with preparation and a few minutes of care each day. This guide explains how. It is general information; your own doctor or foot specialist knows your feet and should guide your care.

Why feet are the front line

International guidelines on preventing diabetic foot ulcers, from the International Working Group on the Diabetic Foot (IWGDF), focus on people with diabetes who are at risk of foot ulcers, for example because of reduced feeling in the feet or reduced blood flow. Your doctor can tell you whether you are at risk.

On a pilgrimage, the risks add up:

• Long walking: sa'i alone is about 2.8 km, and tawaf, walking to the Haram and daily prayers add much more.
• Hard floors and long periods of standing.
• Hot outdoor surfaces in courtyards and streets. Saudi Arabia's Ministry of Health advises pilgrims to avoid walking on hot surfaces.
• Different footwear: sandals, and for men, ihram footwear that leaves the top of the foot uncovered.
• Crowds, where feet can be stepped on or scraped.
• Tiredness and broken routine, which make daily foot checks easy to forget.

Before you travel — the foot check

See your doctor, diabetes nurse or podiatrist well before you travel. Ask them to:

• check your feet for feeling, circulation, skin condition, corns, calluses and nail problems
• tell you your foot risk level, and what that means for the walking you will do
• treat any problems now, such as corns, calluses or ingrown toenails, rather than travelling with them
• advise on footwear, especially if you already wear special shoes or insoles
• tell you what to pack in a small foot-care kit, and what to do if a problem starts

At home, in the weeks before you go:

• Walk in the footwear you will take, to break it in and find any rubbing.
• Trim your toenails straight across, a few days before travel, not the day before.
• Moisturise dry skin.

Our Fit for Umrah guide has a gentle walking build-up you can follow with your doctor's agreement.

Footwear and the ihram question

International guidance on preventing diabetic foot ulcers advises people at risk not to walk barefoot, in socks without shoes, or in thin-soled slippers, indoors or outdoors. Footwear that fits well and protects the foot matters most.

On a pilgrimage, that meets a religious question:

• Women: the Ministry of Hajj and Umrah's Ihram guide lists only the niqab and gloves as prohibited for women, so women can wear protective shoes and socks. Choose well-fitting, cushioned footwear.
• Men: asked what a pilgrim in ihram should wear, the Prophet ﷺ said he should not wear leather socks "except if he can find no slippers", and then cut below the ankles (Sahih al-Bukhari 1542). Men in ihram therefore usually wear sandals. If you have diabetes, choose sandals with a firm, cushioned sole, and break them in well before you travel.
• If your doctor says your feet need closed shoes or socks for medical reasons, ask a scholar before you travel what to do.
• Outside ihram, wear the protective footwear your doctor recommends.

In the mosque, shoes are removed. Do not walk barefoot outside the mosque, including in the courtyards, and carry a small bag so you can keep your footwear with you.

Daily care during the trip

Make this a routine every evening, however tired you are:

1. Check both feet, including the soles and between the toes. Use a mirror, your phone camera, or ask someone to look if you cannot see well.
2. Look for blisters, cuts, redness, swelling, cracked skin or anything new.
3. Wash your feet and dry carefully, especially between the toes. After wudu, dry your feet well too.
4. Moisturise dry skin.
5. Wear protective footwear outside the mosque, never barefoot or in socks alone.

During the day:

• Take breaks during long walks, and sit down when you can.
• Avoid hot outdoor surfaces, especially between 10 am and 4 pm.

Blisters and warning signs

If you find a blister, cut or sore: the IWGDF guidance is to contact a trained healthcare professional promptly. On the trip, that means seeing a doctor or pharmacist the same day rather than waiting until you are home. Cover it with a clean dressing from your kit until then.

Get medical help promptly if you notice:

• a foot that suddenly becomes red, warm or swollen
• a wound, blister or cut that is not healing
• signs of infection, such as pus, spreading redness or a bad smell
• a change in skin colour, or a foot that is suddenly cold or numb
• severe pain, or new pain in a foot that usually has little feeling

Go to an emergency department immediately if a foot problem comes with a high temperature, shivering or feeling generally unwell. These can be signs that an infection is spreading.

When to seek care in Makkah/Madinah

• Before you need it, find the nearest clinic, pharmacy and hospital to your hotel on your first day.
• For a foot problem that is not improving, see a doctor the same day. Do not wait until you are home.
• In an emergency in the Makkah or Madinah regions, call 911.
• Carry your medical information: a list of your medicines, your diabetes type and treatment, and your doctor's letter.
• Check your insurance. The Umrah visa includes mandatory health insurance for emergencies; read what it covers, and consider separate travel insurance that declares your diabetes.
• When you are home, see your doctor or podiatrist if any foot problem from the trip has not fully healed.

If you or a family member has diabetes with complications, our Medical Desk can help plan the trip around your health, with every medical decision referred to your own doctor.