To assess the status of diabetes mellitus (DM) control in the Eastern province of Saudi Arabia, all Saudi Arabian residents aged 30 years and above were invited to participate in a screening campaign. Of 197 681 participants screened 15.7% had a previous diagnosis of DM. Sociodemographic and clinical data were collected from these patients. Only 33.8% of patients were achieving their glycaemic control target (fasting or random capillary blood glucose < 130 mg/dL or < 180 mg/dL respectively). Multiple logistic regression analysis showed that higher age, current smoking and lower level of physical activity were significantly associated with uncontrolled DM. Hypertension was positively associated with glycaemic control. The overall rate of diabetes control is unacceptably low in the general population of this province. 1Directorate of Health Affairs, Ministry of Health, Dammam, Saudi Arabia (Correspondence to N.A. Al-Baghli: nadiraa@windowslive.com

Rather than skepticism about the concept, the main barriers to the use of EBM by physicians appeared to be a lack of knowledge and basic skills. Therefore, targeted education in EBM and a system that quickly delivers high-quality evidence are needed. This includes the allocation of an adequate infrastructure and time and the availability of relevant evidence.

Objective:To estimate the awareness of cardiovascular disease (CVD) and their determinants in a screening campaign in the eastern province of Saudi Arabia.Materials and Methods:All national residents in the eastern province of Saudi Arabia aged 30 years and above, were invited to participate in a screening campaign for the early detection of diabetes and hypertension at more than 300 examination posts throughout the eastern province. A pre-structured questionnaire was designed to collect data on age, gender, marital status, education level, occupation, lifestyle habits, and history of heart attack, angina, arterial disease, stroke, and transient ischemic attack. Weight, height, blood pressure, and glucose concentration were measured.Results:Out of 197,681 participants, 5372 (2.7%) were aware of a history of a CVD. The prevalence correlated well with age. It was higher in women, widows, and subjects with lower level of education. More than 75% of affected subjects had two or more risk factors.Conclusion:A substantial proportion of those with a history of CVD had multiple risk factors, necessitating an effective, focused policy for the prevention and treatment. Increased effort is required to promote an awareness of cardiac disease and also probably target primary care providers involved in the screening process.

All Saudi Arabian residents of the Eastern province of Saudi Arabia aged 30+ years completed a structured interview questionnaire about smoking. The prevalence of current smoking (smoked > 100 cigarettes or any tobacco products including waterpipe in lifetime and still smoking daily or occasionally for 1 month or more) among 196 268 respondents was 16.9% (28.7% among men and 4.5% among women). There was a significantly higher prevalence of smoking at younger ages in men and older ages in women. Multiple logistic regression analysis showed that factors independently associated with smoking were lower socioeconomic status, lower education, being divorced and occupations such as the military and self-employed.

BACKGROUND AND OBJECTIVES:Body mass index (BMI) is the most widely used measure to define obesity and predict its complications, such as diabetes and hypertension, but its accuracy and usefulness in Saudi subjects is unknown. This study aimed to assess the validity of standard BMI cut-point values in the Saudi population.SUBJECTS AND METHODS:197 681 adults participated in a cross-sectional study to detect diabetes and hypertension in the Saudi Eastern province in 2004/2005, with blood pressure, fasting blood sugar, height and weight measurements taken. Sensitivities, specificities, areas under the curves, predictive values, likelihood ratios, false positive, false negatives and total misclassification ratios were calculated for various BMI values determined from receiver operating characteristic (ROC) curves. The significance of the association between risk factors and BMI was assessed using regression analysis.RESULTS:For the definition of overweight, ROC curve analysis suggested optimal BMI cut-offs of 28.50 to 29.50 in men and 30.50 to 31.50 in women, but the levels of sensitivity and specificity were too low to be of clinical value and the overall misclassification was unacceptably high across all the selected BMI values (>0.80). The relationship between BMI and the presence of diabetes and/or hypertension was not improved when a BMI of 25 was used. Using regression analyses, the odds ratios for hypertension and/or diabetes increased significantly from BMI values as low as 21-23 with no improvement in the diagnostic performance of BMI at these cutoffs.CONCLUSION:In Saudi population, there is an increased risk of diabetes and hypertension relative to BMI, starting at a BMI as low as 21 but overall there is no cutoff BMI level with high predictive value for the development of these chronic diseases, including the WHO definition of obesity at BMI of 30.