Saudi Diabetic Patients Research Articles

The Common Complications and Comorbidities among Saudi Diabetic Patients in Northern Saudi Arabia

Background: Diabetes mellitus (DM), is a group of metabolic disorders in which there are high blood sugar levels over a prolonged period with great harmful consequences, including cardiovascular and neurological complications, diabetic retinopathy, and diabetic nephropathy. Therefore, the objective of this study was to find out the common complications and comorbidities among diabetic Saudi patients in Northern Saudi Arabia. Methodology: Records of 50 diabetic patients were retrieved from King Khalid Hospital, Hail, Saudi Arabia. Different complications and comorbidities were documented and investigated. Results: Peripheral neuropath, retinopathy, diabetic septic foot, and amputation were identified among 40%, 38%, 14%, and 4%, correspondingly. Out of the 50 patients, 12 (24%), 18 (36%) and 8 (16%) were detected with thyroid diseases, dyslipidemia and renal complications, respectively. Conclusion: Hypertension, peripheral neuropathy, dyslipidemia, retinopathy, kidney complications and diabetic septic food represent the major complications and/or comorbidities among diabetic Saudi patients in northern Saudi Arabia. These complications and/or comorbidities must be well thought-out in epidemiological studies, so as to display disease burden and quality of diabetes care.

Assessment of the prevalence and risk factors of ophthalmoplegia among diabetic patients in a large national diabetes registry cohort.

BackgroundThere are limited data on the epidemiology and risk factors of ophthalmoplegia among diabetic patients. This study aims to determine the prevalence and important risk factors related to ophthalmoplegia among diabetic patients.MethodsThis is an observational registry-based study using the Saudi National Diabetes Registry (SNDR) database to select diabetic patients regardless of their diabetes type. A total of 64,351 Saudi diabetic patients aged more than 18 years and registered in SNDR between January 2000 and December 2010 were analyzed to identify ophthalmoplegic cases. Demographic, clinical, and biochemical parameters were studied and STROBE guidelines were used to design and report the results of this study.ResultsThe overall prevalence of ophthalmoplegia cases was 0.32 %, further distributed into: 53.11 %, 36.36 %, and 2.8 % for cranial nerves VI, III, IV palsies respectively. Ophthalmoplegic cases were predominantly type 2 diabetic males with older age and longer diabetes duration. The most important and significant risk factors were age ≥ 45 years, diabetes duration ≥ 10 years, male gender and presence of retinopathy and nephropathy.ConclusionsOphthalmoplegia is a rare entity associated mainly with type 2 diabetes. Clinicians have to consider its risk factors when screening or planning for prevention of this condition.

The Relationship between Serum 25-Hydroxyvitamin D and Resistin Levels in Saudi Diabetic Patients

Objectives: The aim of this study was to investigate the relationship between the levels of 25-hydroxyvitamin D and the adipokine resistin in Saudi diabetic patients and those at high risk to develop atherosclerotic cardiovascular diseases. Methodology: One hundred and sixty seven subjects were recruited for the cross-sectional study at King Fahad Medical City, Saudi Arabia. Blood samples were analyzed for biochemical parameters. Serum 25-hydroxyvitamin D and resistin levels were measured for all the participants. Result: Fifty six type-1, 55 type-2 diabetic patients and 56 healthy controls were recruited. Serum 25-hydroxyvitamin D level in the control group was 44.21 ± 41.80 μg/ml compared to 50.67 ± 35.60 μg/ml in the diabetic group (P = 0.427) with no significant different between type-2 diabetes mellitus and type-1 diabetes mellitus (P = 0.628). Resistin level in the control group was 14.00 ± 7.39μg/ml compared to 20.21 ± 16.94 μg/ml in the diabetic group (P ≤ 0.01), no significant difference between type-2 diabetes mellitus and type-1 diabetes mellitus (P = 0.817). Resistin in those taking vitamin D supplementation was 21.34 ± 18.27 μg/ml; and in those not taking vitamin D supplementation, it was 17.4 ± 11.19 μg/ml; (P = 0.237). There was significant negative correlation between 25-hydroxyvitamin D and resistin in type-2 diabetes mellitus (P ≤ 0.043) and no significant correlation was found between vitamin 25 (OH) D and resistin level in type-1 diabetes mellitus (P = 0.538). Blood urea and creatinine showed significant positive correlation with vitamin 25 (OH) D in one hand and resistin level on the other hand. Discussion and Conclusions: Several in vitro and in vivo studies have confirmed that the vitamin 25 (OH) D have numerous important functions in the body. The circulating vitamin 25 (OH) D and resistin levels were associated with general inflammation in renal diseases. This study showed significant negative correlation between resistin level and vitamin 25 (OH) D in type 2 diabetes mellitus reflecting their roles in glucose homeostasis. The positive correlation of resistin and vitamin D with urea may reflect their involvement in kidney dysfunction. The level of serum resistin showed slight increase in diabetic patients compared to control group and it was higher in type-2 diabetes mellitus. More efforts are needed to explore the physiological mechanism of vitamin 25 (OH) D and resistin action in metabolic disorders.

The relation between overweight, obesity and plasma lipids in Saudi adults with type 2 diabetes

Background: Worldwide, epidemic exists with respect to diabetes mellitus, primarily because of increased rates of obesity. Lipoprotein abnormalities are common in overweight and obese patients with diabetes and contribute significantly to its complications. Methods: A cross-sectional study was conducted at the Primary Health Care Clinics at King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia. A total of 2519 Saudi diabetic and non-diabetic patients were randomly selected to assess the association of dyslipidaemia and overweight and obesity in type 2 diabetic patients and non-diabetic controls. Patients were subjected to investigations of glycosylated haemoglobin (HbA1c) and fasting serum lipids. Results: A total of 2519 patients attending the Primary Health Care Clinics were included in this study (45.9% men, 54.1% women). The diabetic group comprised 50.8% (1280) and non-diabetic group comprised 49.2% (1239) of the sample. The mean ± standard deviation age of diabetic and non-diabetic patients was 37.1 ± 7.7 and 32.1 ± 8.1, respectively. The diabetic patients were older, had higher body mass index, serum triglyceride and HbA1c values were significantly higher when compared to non-diabetic subjects. Whereas, total cholesterol, low density lipoprotein (LDL) and high density lipoprotein (HDL) were significantly lower in diabetics. Nineteen percentage of men and 27% of women with diabetes mellitus had increased total plasma cholesterol levels that did not differ significantly (P = 0.2) from the rates in non-diabetic men and women (21% of men and 34% of women). The prevalence of high LDL cholesterol levels in men and women with diabetes mellitus (23% and 31%, respectively) did not differ significantly (P = 0.4) from the rates in non-diabetic men and women (18% and 28%, respectively). The prevalence of high HDL cholesterol levels in men and women with diabetes mellitus (25% and 27%, respectively) did not differ significantly (P = 0.7) from the rates in non-diabetic men and women (23% and 25%, respectively). In contrast, the prevalence of high plasma triglyceride levels in individuals with diabetes mellitus (30% in men and 32% in women) was significantly higher than in those without diabetes mellitus (21% of men and 16% of women), P = 0.02. Conclusion: The study has documented several lipid abnormalities in type 2 diabetic patients and has pointed the significance of diabetic management in the control of lipid abnormalities where the control over overweight and obesity conditions is of importance. The study revealed that obesity and dyslipidaemia were high among diabetic patients and required special attention. This can be done through health education at the primary care level and at the diabetic clinics.

Correlation of serum Adenosine deaminase activity (ADA) with fasting blood sugar levels in Type II Saudi Diabetic Patients.

Aim: This study aims to correlate the association of serum Adenosine deaminase activity (ADA) with fasting blood sugar (FBS) levels. Patients and Methods: Serum FBS levels and serum ADA activity were measured in 71 Type 2 diabetes mellitus (DM) patients and 24 controls. Results: Serum ADA activity and FBS levels were elevated in type 2 DM group in comparison to control group significantly (p

Double diabetes in Saudi Arabia: A new entity or an underestimated condition.

AIMTo determine the clinical and biological characteristics of double diabetes (DD) among young people in Saudi Arabia.METHODSThis was a retrospective descriptive chart review study including 312 young newly diagnosed diabetic patients (aged 12-20 years), whom were admitted over a five year period (January 2009 to December 2013). Family history of diabetes mellitus (DM) (first degree), physical body mass index (BMI), acanthosis nigricans, history of auto-immune disease and laboratory information for glycosylated hemoglobin, basal C peptide level and diabetes autoantibody response (anti-GAD, anti-IA2 and anti-ICA) were collected from medical report. A mean follow-up of 3 years for these patients was performed.RESULTSPatients were categorized into 4 groups, based on the autoantibody response (Ab+ or Ab-) and C-peptide secretion (β+ for fasting level 0.4-2.1 ng/mL and β- if < 0.4 ng/mL). Group1 (type 1a): Ab+ β- (21%), group 2 (type 1b): Ab- β- (9%), group 3 (DD): Ab+ β+ (31%) and group 4 (classic type 2 DM): Ab- β+ (39%). The mean age of the DD patients in our study was 15.1 ± 6.4 years. A total of 41% of the study population presented with diabetic ketoacidosis and 61% of the study population presented with positive family history of DM. The mean BMI was 26.8 kg/m2 with 64% of overweight or obese patients. Ninety two percent of the patients were started on insulin at the time of diagnosis. During a mean follow-up of 3 years, only 32% of the patients with DD required insulin and 78% were on metformin alone or with insulin.CONCLUSIONOur findings enable us to arrive at the conclusion that almost one-third of the young Saudi diabetic patients reveal atypical forms of DM (double diabetes) expressing features resulting from both T1D and T2D.

Diagnostic Value of Serum Adenosine Deaminase in Type II Saudi Diabetic Patients

Diagnostic Value of Serum Adenosine Deaminase in Type II Saudi Diabetic Patients

Gamma glutamyl transferase and C-reactive protein in type 2 Saudi diabetic patients in relation to management modality and components of metabolic syndrome

Gamma glutamyl transferase and C-reactive protein in type 2 Saudi diabetic patients in relation to management modality and components of metabolic syndrome

This issue of ACTA, printed and electronic

This issue of ACTA, printed and electronic

Correlation among the Glycemic Control and Lipogram Indices with Chronic Complications in Saudi Diabetic Patients : Al-Jouf Status

Correlation among the Glycemic Control and Lipogram Indices with Chronic Complications in Saudi Diabetic Patients : Al-Jouf Status

Erectile Dysfunction and Other Sexual Activity Dysfunctions among Saudi Type 2 Diabetic Patients

The aim of the study is to determine the prevalence of Erectile Dysfunction (ED) in Type 2 diabetic Saudi patients, to determine the effect of Type 2 diabetic on other sexual activities (intercourse satisfaction, orgasmic function, sexual desire, overall satisfaction), and to assess whether glycemic control and duration of diabetes have an influence on sexual activities or not. A cross-sectional study was conducted among 376 of Type 2 diabetic male Saudi patients. Erectile dysfunction and other sexual activities dysfunctions were evaluated using the International Index of Erectile Function (IIEF) by a fill coded questionnaire. Additionally, the level of glycosylated hemoglobin was measured to classify the diabetes control status in patients. Erectile Dysfunction was reported by 83% of male Saudi diabetic patients. The results show that there was a significant association between the presence of ED and both the age and the duration of diabetes. Family income, occupation, and educational level of the patients show a significant association between them and erectile dysfunction (ED). Moreover, glycemic control did not show a significant association with ED in our sample. The findings showed that prevalence of ED among male Saudi diabetic patients is high. It increases with age and duration of diabetes. Also, the study showed that the glycemic control did not correlate with ED. It is recommended that the family physician and diabetologist should ask routinely for this complication in patients with diabetes just like any other diabetes complication.

Surveillance of risk factors for diabetic foot ulceration with particular concern to local practice

IntroductionDiabetes mellitus is a global health problem with rising prevalence worldwide. Diabetes mellitus is a multisystem disease affects many systems and tissues. Foot problems are not uncommon with diabetes and foot ulceration is one of theses problems. Risk factors for foot ulcerations may differ from community to community based on many factors. ObjectivesTo determine the risk factors for diabetic foot ulceration among Saudi diabetic patients with type 2 diabetes attending primary care center. MethodologyCross sectional study was designed. Four hundred subjects were selected randomly. Inclusion criteria were settled. Three hundred and fifty subjects (350) were participated. Especial assessment form was designed. Data was collected and analyzed using SPPS ver 14. ResultsThree hundred and fifty subjects were participated (57% male and 43% female). The prevalence of peripheral vascular disease was 15%, hulux vulgus 22.5%, inappropriate foot wear 41%, peripheral neuropathy 47.5%. Peripheral neuropathy and inappropriate foot wear were the commonest risk factors for foot ulceration. ConclusionPeripheral neuropathy and inappropriate foot wear were the commonest risk factors for foot ulceration.

Association of the endothelial nitric oxide synthase gene G894T polymorphism with the risk of diabetic nephropathy in Qassim region, Saudi Arabia—A pilot study

BackgroundDiabetic nephropathy (DN) is a chronic microangiopathic complication of type 2 diabetes mellitus (DM).Vascular endothelial dysfunction resulting from impaired nitric oxide synthase (NOS) activity in the vascular endothelial cells has been suggested as playing an important role in the pathogenesis of diabetic nephropathy (DN). Endothelial nitric oxide synthase (E-NOS) gene G894T polymorphism has been reported to be associated with endothelial dysfunction leading to DN.Our objective was to evaluate the association of G894T polymorphism of eNOS gene with the risk of DN among type 2 diabetic Saudi patients. MethodsOne hundred and twenty subjects were included in this study. They were divided into three groups. Group I, 40 controls. Group II, 40 type 2 diabetic patients without nephropathy. Group III, 40 type2 diabetic patients with nephropathy. Endothelial nitric oxide synthase (eNOS) G894Tpolymorphism was detected by polymerase chain reaction–restriction fragment length polymorphism (PCR–RFLP). Plasma nitric oxide (NO) levels were estimated. ResultsE-NOS genotype frequency showed non-significant differences among the all studied groups (p>0.05). Both diabetic groups had significantly higher plasma nitrate levels than in controls with a significant increase in group III than in group II patients (all p<0.0001). E NOS 894TT genotype was associated with higher plasma nitrate levels in all groups. ConclusionE-NOS gene SNP is not considered as genetic risk factor for DN among type 2 diabetic Saudi patients. The higher plasma levels of nitrates as a marker of oxidative stress in diabetic patients with nephropathy suggest the possible role of oxidative stress but not e-NOS gene SNP in pathogenesis of the DN.

Determinants of misconceptions about diabetes among Saudi diabetic patients attending diabetes clinic at a tertiary care hospital in Eastern Saudi Arabia.

Objective:To identify the determinants of misconceptions about diabetes in patients registered with a diabetes clinic at a tertiary care hospital in Eastern Saudi Arabia.Materials and Methods:This cross-sectional survey was carried out at a diabetes clinic of a tertiary care hospital in Eastern Saudi Arabia, from January to December 2012. A total of 200 diabetic patients were interviewed using a questionnaire comprising 36 popular misconceptions. The total misconception score was calculated and categorized into low (0-12), moderate (13-24) and high (25-36) scores. The association of misconception score with various potential determinants was calculated using Chi-square test. Step-wise logistic regression was applied to the variables showing significant association with the misconception score in order to identify the determinants of misconceptions.Results:The mean age was 39.62 ± 16.7 and 112 (56%) subjects were females. Type 1 diabetics were 78 (39%), while 122 (61%) had Type 2 diabetes. Insulin was being used by 105 (52.5%), 124 (62%) were self-monitoring blood glucose and 112 (56%) were using diet control. Formal education on diabetes awareness had been received by 167 (83.5%) before the interview. The mean misconception score was 10.29 ± 4.92 with 115 (57.5%) subjects had low misconception scores (<12/36). On the Chi-square test, female gender, rural area of residence, little or no education, <5 or >15 years since diagnosis, no self-monitoring, no dietary control and no diabetes education were all significantly (P < 0.05) associated with higher misconception scores. Step-wise logistic regression suggested that diabetes education, gender, education and time since diagnosis were significant (P < 0.05) predictors of misconception scores.Conclusions:The strongest determinants of misconceptions about diabetes in our study population were female gender, rural area of residence, illiteracy or little education, <5 or >15 years since diagnosis, no self-monitoring, no diet control and no education about diabetes.

Direct Medical Cost and Glycemic Control in Type 2 Diabetic Saudi Patients

The prevalence of diabetes mellitus continues to increase globally. Furthermore, it is projected that healthcare expenditure on this epidemic will mount to US$490 billion in 2030. Information on the economic burden of diabetes care in Saudi Arabia is largely lacking. This retrospective observational study evaluated the direct medical cost of type 2 diabetes mellitus (T2DM) in a Saudi population in relation to glycemic control at a governmental institution from a payer's perspective. Three hundred subjects attending a university hospital were classified into three groups (n = 100 each) based on HbA1c values to <7 %, 7-9 %, and >9 %. The total direct medical costs were calculated for drug therapy, diagnostic procedures, hospitalization, and outpatient visits. The year of valuation for the costings was 2010/2011. The total annual direct medical cost per group was found to be US$1,384.19 for HbA1c <7 %, US$2,036.11 for HbA1c 7-9 %, and US$3,104.86 for HbA1c >9 % (p < 0.001). There was also a statistically positive relationship in the total care cost of diabetic patients and the number of co-morbidities (p < 0.001). A direct association of the cost of medications that have been disbursed for diabetic patients and the medical specialty of the treating physician (r = 0.390; p < 0.0001), and the cost of laboratory analyses (r = 0.351; p < 0.0001), was observed as also between the cost of laboratory diagnosis and days of hospitalization (r = 0.478; p < 0.0001). Multivariate analysis showed that the relationship between HbA1c and total cost is independent of age and gender, while co-morbidities remain as a significant predictor for the total cost. Collectively, the estimated direct annual medical cost of diabetes care in Saudi Arabia would be enormous. The current study offers more insight into the economic burden of diabetes on the country.

Evaluation of risk factors for cardiovascular diseases among Saudi diabetic patients attending primary health care service

BackgroundCardiovascular disease is currently the primary cause of morbidity and mortality in patients with diabetes. For each risk factor present, the risk of cardiovascular death is about three times greater in people with diabetes than people without diabetes. ObjectivesTo determine the risk factors for cardiovascular disease among patients with type 2 diabetes. To stratify the patients into risk categories to develop coronary arteries disease (CAD) based on the British Joint Societies risk chart. To assess the awareness and implementation of the risk assessment charts by primary care physicians Subject and methodsCross sectional study was designed. Sixty six (66 patients) diabetic patients were selected randomly by simple selection, from them 29 were males and 37 were females. Patients’ medical records were reviewed. The following parameters were detected; blood pressure, lipid profile, weight, height, smoking and degree of glycemic control.A questionnaire was designed and distributed to randomly selected physicians working in primary health care assessed their awareness and implementation of risk assessment charts was done. ResultsUncontrolled diabetes was found to be the common risk factor followed by uncontrolled lipid profile, obesity, uncontrolled systolic blood pressure and smoking. Seven percent (7%) of male group felled in highest risk group in comparison with 1% in female group (P<0.05), while 31% in male group felled in mild risk group in comparison with 90% in female group (P<0.05). Sixty two percent (62%) in male group felled in high risk group in comparison with 9% in female group (P<0.05). Criteria for ranking in risk class differed between male and female group. Forty one physicians were contacted and received the questionnaire. Twenty nine (70.7%) physicians were responded to the questionnaire. Twenty two (22) informed that they were aware about risk assessment score systems. Fourteen (14) physicians informed that they were aware about the BJSs charts but only two informed that they had used it to assess their patients. ConclusionClustering of multi risk factors is a serious event which may raise the risk category of diabetic patients. For each risk category the risk factors may differed between male and female patients. More studies are recommended to study distribution of risk factors between male and female diabetic patients. Attention should be directed toward raising the awareness about the risk assessment scoring system and encouraging physicians to use it.

The Effect of Glycemic Status on the Serum Amino Acid Profile of Diabetic Saudi Patients

Background: The disturbance in amino acids serum profile in Diabetes Mellitus has been studied previously; however, very obscured in the Saudi diabetic population. The aim of the current study is studying the relationship between the glycemic status and the amino acid profile in Saudi diabetic patients. Methods: Representative sample of Saudi Diabetes Mellitus type-I patients were included in accordance with the national population distribution; and a panel of 17 amino acids of different categories (essential, semi- essential and metabolic indicator amino acids) were assessed in response to their glycemic status. Blood samples of normoglycemic and hyperglycemic patients were withdrawn and assayed for glucose, total cholesterol, triglyceride, high density lipoprotein and low density lipoprotein. General biochemical serum profile was assessed (alkaline phosphatase (ALP), creatinine kinase (CK), aspartate transaminase (AST), alanine transaminase (ALT) and blood urea nitrogen (BUN)). Results: Transient hyperglycemia significantly decreased three metabolic indicator amino acids (AAA, ALA and ORN); in addition to one essential amino acid (TYR) and one semi-essential amino acid (CYS2). The total level of amino acids, total level of essential amino acids, and total level of semi-essential amino acids did not change due to glycemic status. Only the total metabolic amino acids (AAA, ALA, CIT, HCY2 and ORN) significantly decreased in response to hyperglycemia. Conclusion: Some amino acids (THR, CYS2, AAA, ALA and ORN) are sensitive to the glycemic status and can be used as surrogate marker for transient hyperglycemia.

Prevalence of Obesity among Type 2 Diabetic Patients: Non-Smokers Housewives Are the Most Affected in Jeddah, Saudi Arabia

Objective: To identify the high risk group for developing obesity among a cohort of Saudi diabetic patients. Methods: A cross sectional study on a random sample of known type 2 diabetic patients who were visiting seven primary health care centers in Jeddah,Saudi Arabiawas conducted. Participants were categorized according to their Body Mass Index BMI into 4 groups. Prevalence of obesity was correlated to patients’ gender, age, smoking, educational level and employment status to identify the significant ones. Results: A total of 723 diabetics were included. Males to females’ ratio were almost equal (50.8% and 49.2% respectively). The mean BMI of group was 29.3 ± 6.1. Only (21.9%) of the studied diabetics were in their ideal range of body weight. The remaining was almost equally categorized as overweight or obese. More than one third (38.3%) were obese; among the obese: 22.4% had mild obesity, and 15.9% severe obesity. Percentage of severely obese females were almost triple that of males. The housewives were the least to have normal BMI ratio (15.2%). According to the calculated BMI it is found that being a non-smoker housewife is the significant predicting factor for being obese p 0.05. Conclusion: Prevention and educational programs should target non-smokers housewives Saudi diabetic patients who are at higher risk for developing obesity.

Risk Factors for Thyroid Dysfunction among Type 2 Diabetic Patients in a Highly Diabetes Mellitus Prevalent Society

Diabetes and thyroid dysfunction found to exist simultaneously. In this regard, the present study looked into the prevalence of different forms of thyroid dysfunction and their risk factors among Type 2 diabetic Saudi patients. Methodology. A cross-sectional retrospective randomized hospital-based study of 411 Type 2 diabetic Saudi patients of >25 years of age was conducted to test the prevalence of different types of thyroid dysfunction and their risk factors. Results. The prevalence of different types of thyroid dysfunction is 28.5%, of which 25.3% had hypothyroidism, where 15.3%, 9.5%, and 0.5% are clinical, subclinical, and overt hypothyroidism, respectively. The prevalence of hyperthyroidism is 3.2%, of which subclinical cases accounted for 2.7% and overt hyperthyroidism accounted for 0.5%. Risk factors for thyroid dysfunction among Saudi Type 2 diabetic patients are family history of thyroid disease, female gender, and duration of diabetes of >10 years, while the risk was not significant in patients with history of goiter and patients aged >60 years. Smoking and parity show a nonsignificant reduced risk. Conclusion. Thyroid dysfunction is highly prevalent among Saudi Type 2 diabetic patients, and the most significant risk factors are family history of thyroid disease, female gender, and >10 years duration of diabetes.

The management of elderly diabetic Saudi patients with acute coronary syndrome

Background and Purpose:Elderly Diabetics (DM) who present with Acute Coronary Syndrome (ACS) constitute a very high risk group. We present the pattern of management of elderly patients (>65 years) in the Kingdom of Saudi Arabia (KSA) in comparison to the international data extrapolated from a Multicenter International Diabetes-Acute Coronary Syndromes (MIDAS).Materials and Methods:DM patients presenting with unstable angina or non-ST-segment elevation myocardial infarction (MI) at the time of admission to the hospital were collectively enrolled into the MIDAS study. A total of 3624 patients were enrolled; 142 were from Saudi Arabia. Primary clinical outcome measure was in-hospital death or MI. We present the data of KSA based on the age of the patients in comparison to the international registry.Results:Baseline characteristics were typical for DM presenting with ACS, with mean age of 67 ± 15 years, males, constituted 36% of patients while 94% of patients were DM type 2. There was marked underutilization of glycoprotein IIb/IIIa inhibitors in those aged over 65 years with a decrease from 22.5 to 12.7 in KSA (Odds ratio 0.56) patients. The percentage of early coronary angiography approach in KSA was less than that of the international data with further reduction of the percentage in Saudi elderly population (from 49.3% to 25.5% with Odds ratio 0.52).Conclusions:In elderly Saudi diabetic patients admitted with ACS, there is tendency for underutilization of GP IIb/IIIa, early coronary angiography, and revascularization that needs to be addressed.