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A retrospective and prospective study of 1,000 ambulatory and hospitalized diabetic patients was done in Riyadh, Saudi Arabia. Saudis comprised 777 (77.7%) and non-Saudis 223 (22.3%). Sex distribution was equal among Saudis, males 389 (50.1%) and females 388 (49.9%), but non-Saudi males were predominant at 153 (68.6%), nonSaudi females 70 (31.4%) reflecting the preponderant male expatriate labor force. A proportion of different types of diabetes was: IDDM115 (11.7%), non-obese non-insulin dependent diabetes mellitus (NIDDM) 405 (41.0%), obese NIDDM 412 (42.1%), and early onset non-insulin dependent diabetes (diagnosis under 30 years of age), 43 (4.4%). Regarding treatment, 388 (40.6%) received insulin followed by sulfonylurea, alone in 330 (33.5%), diet only in 117 (12.0%), combination sulfonylurea and biguanide in 113 (11.6%), biguanide alone in 13 (1.3%) and insulin plus tablets in 7 (0.8%). Of 472 and 426 patients, 29.7% and 30.0% had elevated total cholesterol or triglycerides respectively, while 77.2% of 373 patients had elevated glycosylated hemoglobin (HbAl). At least once in 998 patients, diabetic ketoacidosis occurred in 7.6%,hypoglycemia (BS ≤ 2.2 mmols/1) in 8.6% and severe hyperglycemia (blood sugar ≥ 27.7 mmols/1) in 16.5%. The frequency of chronic and infective complications was: cataract 42.7%, infection 37.9%, neuropathy 35.9%, retinopathy 31.5%, hypertension 25.6%, nephropathy 17.8%, ischemic heart disease 11.3%, foot lesions 10.5%, stroke 9.4%, renal insufficiency 6.9% and amputation 5.1%. The pattern of diabetes in Saudi Arabia is similar to that in other countries, but the occurrence of early onset NIDDM and the role of consanguinity need clarification. Tropical pancreatic diabetes is rare. The spectrum of complications is a combination of what is observed in developing as well as industrialized countries.

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Crohn's disease is widely described in the Western literature, but it has not been widely observed in the Middle Eastern community. We diagnosed Crohn's disease in seven Arabs, three of whom were Saudi Nationals. Their mean age was 32.4 years (range, 18-40 years) and duration of symptoms varied from three months to ten years. The site of the disease was ileocolic in five patients and colonic in two. Mass lesions in the abdomen were seen in three patients. Four cases were diagnosed from histological specimens obtained at laparotomy and resection and the other three were diagnosed from colonoscopic biopsy specimens. Extraintestinal manifestations were found in three patients. Surgery alone was the treatment in two patients, whereas the remaining required medical therapy, mainly steroids, with or without surgery. We conclude that Crohn's disease does occur in the Arab population, but with milder systemic effects. Crohn's disease is a relatively common disorder in Western populations [1], whereas tuberculosis of the intestine is more frequently seen in the populations of developing countries [2]. The diseases have similar presentations, making diagnosis difficult [3]. There are only scanty reports of Crohn's disease from the Middle East [4,5]. We report here on seven Arabs with Crohn's disease and describe their clinical presentations, compared with those described from the West. Case Reports Patient 1A35-year-old married Saudi woman had had recurrent bouts of diarrhea with abdominal pain, fever, and weight loss over the course of six months. She also had intolerance to milk and dairy products.Examination revealed a febrile and pale woman. Abdominal examination showed central distention with diffuse tenderness. Her hemoglobin was 90 g/L and erythrocyte sedimentation rate (ESR) was 52 mm in the first hour. Repeated stool examinations failed to show any ova, cysts, or parasites, and stool cultures were negative. Liver function tests showed low albumin concentration with raised alkaline phosphatase activity. A small bowel enema showed multiple strictures with dilatation of the proximal ileal loops.Because of the deterioration in her general and nutritional condition, intestinal tuberculosis was suspected. Laparotomy was performed and this showed thickened intestinal loops with adhesions. The patient underwent resection of the terminal ileum with limited right hemicolectomy. The resected segments of the small bowel showed

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