Attendees of 15 health centers in Urban and rural areas in the Riyadh region were screened for obesity during May and June 1994. Systemic selection yielded 1580 Saudi males for analysis. The mean age was 33.6 ± 13.5 years and body mass index (BMI) was 26.9 ± 5.7 kg/m 2 . Only 36.6% of subjects were their ideal weight (BMI < 25 kg/m 2 ), while 34.8% were overweight (BMI 25-29.9 kg/m 2 ), 26.9% were moderately obese (BMI 3.0-40 kg/m 2 ) and 1.7% were morbidly obese (BMI > 40 kg/m 2 ). Middle age, lower education and joblessness predicted a higher risk for obesity. Patients living in rural areas had greater BMIs than those living in urban areas (P < 0.01). Forty percent of overweight participants did not think they were so. The high prevalence of obesity and the lack of awareness among those afflicted emphasizes the need for community-based programs for preventing and reducing obesity, since weight control is effective in ameliorating most of the disorders associated with obesity, such as Type II non-insulindependent diabetes mellitus, hypertension, stroke, heart disease, sleep apnea syndrome and osteoarthritis of the knees. Young parents who are at risk of developing obesity and who play a central role in perpetuating it in their offspring should be the target of obesity-prevention programs. Ann Saudi Med 1996; 16(3):269-273. Obesity is a common chronic disorder in affluent societies, with serious effects on health and longevity.1 It is associated with the increased frequency of a number of diseases, such as hypertension, diabetes mellitus, elevated serum cholesterol, arthrosis, gout and gallbladder disease.2 These co-morbidities contribute to the excess mortality observed among the obese. In addition, obesity plays a direct role in the development of coronary artery disease. 3Over the past two decades, Saudi Arabia has undergone remarkable and rapid economic development. 4 This has brought with it some of the diseases associated with affluence, of which obesity is one of the most obvious and important in view of the manner in which it increases the risk for morbidity and mortality.A small retrospective study has shown obesity to be prevalent in Saudis living in the Eastern province. 5 Few other studies have addressed this issue in Saudi Arabia and neighboring Arab Gulf countries. [6][7][8][9][10][11] We have previously reported on the high prevalence of clinically significant obesity among Saudi females, 12 but there are no studies of obesity and its associated risk factors among males in central Saudi Arabia. The present study was designed to determine the prevalence of obesity and its associated risk factors among Saudi men attending primary health care centers in Riyadh. MethodsA cross-sectional study was undertaken which included urban and rural health centers in the Riyadh region. Eleven urban and four rural health centers were randomly selected. Saudi male patients attending these health centers were included.The study was conducted over two months (May and June 1994). Systematic sampling was used to select...

More than 50 million Muslims throughout the world with type 2 diabetes mellitus (T2DM) fast for one lunar month (Ramadan) each year. Health care providers within and outside the Muslim world need to be aware of the nature of these partial days of fasting and their risks (and potential benefits) to people with T2DM, and need to provide Ramadan-adjusted diabetes care. Hypoglycemia during the fasting days represents the greatest health risk for these patients; hence, diabetes-related pharmacotherapy needs to be tailored and adjusted with this risk in mind. With limited trial data available, this review proposes practical modifications to the usual pre-Ramadan antidiabetic regimens that are based on pathophysiological principles, clinical trial evidence (where available), expert opinion, and extended practical experience. Individualization of care is paramount in this regard to take into consideration the patient and societal, cultural, and economic variables.

Aims: Developing countries face a high and growing burden of type 2 diabetes. We surveyed physicians in a diverse range of countries in the Middle East and Africa (Egypt, Kingdom of Saudi Arabia, United Arab Emirates, South Africa and Lebanon) with regard to their perceptions of barriers to type 2 diabetes care identified as potentially important in the literature and by the authors. Methods: One thousand and eighty-two physicians completed a questionnaire developed by the authors. Results: Most physicians enroled in the study employed guideline-driven care; 80-100% of physicians prescribed metformin (with lifestyle intervention, where there are no contraindications) for newly diagnosed type 2 diabetes, with lifestyle intervention alone used where metformin was not prescribed. Sulfonylureas were prescribed widely, consistent with the poor economic status of many patients. About one quarter of physicians were not undertaking any form of continuing medical education, and relatively low proportions of practices had their own diabetes educators, dieticians or diabetic foot specialists. Physicians identified the deficiencies of their patients (unhealthy lifestyles, lack of education and poor diet) as the most important barriers to optimal diabetes care. Low-treatment compliance was not ranked highly. Access to physicians did not appear to be a problem, as most patients were seen multiple times per year. Conclusions: Physicians in the Middle East and South Africa identified limitations relating to their patients as the main barrier to delivering care for diabetes, without giving high priority to issues relating to processes of care delivery. Further study would be needed to ascertain whether these findings reflect an unduly physician-centred view of their practice. More effective provision of services relating to the prevention of complications and improved lifestyles may be needed. What's knownIt is known that the success of care for diabetes depends critically on the delivery of optimised care for diabetic patients. Many barriers to the delivery of such care have been identified. Relatively little is known regarding how these barriers influence the delivery of diabetes care in the Middle East and South Africa. What's newPhysicians generally followed management guidelines in type 2 diabetes care. Perceived barriers to optimal diabetes care mainly focussed on attributes of patients, rather than process issues in care or aspects of the physicians' practice.