BACKGROUNDConsumption of performance enhancing agents (PEAs) has a wide range of negative health consequences, but knowledge of these consequences among gym users of PEAs in Saudi Arabia is not well understood.OBJECTIVESIdentify the knowledge, awareness, beliefs and attitudes of gym users about negative health consequences of using PEAs, and the relationship between these factors and use of these agents.DESIGNCross-sectional study.SETTINGFive gyms in Madinah city, Saudi Arabia.SUBJECTS AND METHODSConvenience sampling was used to recruit gym users. An electronic self-administered questionnaire was used to collect data.MAIN OUTCOME MEASURE(S)Level of knowledge about the negative health consequences of PEAs among gym users.RESULTSAbout 70% of 316 participants had used one or more of PEAs over the last six months. Of those, about 68.4% used protein powder supplements and 48.1% used energy drinks. Participants who believed that protein powder supplements (c2=52.3, P<.01) and energy drinks (c2=35.2, P<.01) had health hazards used these agents less often than others during the six months preceding data collection. Participants who had less knowledge about the negative health consequences were more likely to use protein powder supplement (t=2.38, P=.018). On the other hand, those who were more knowledgeable about the negative health consequences of insulin, were more likely to use insulin (t=2.45, P=.015).CONCLUSIONMisuse of PEAs is widespread among gym users in Saudi Arabia. Improving the level of knowledge and awareness of possible serious health consequences would hopefully lead to reduced PEA consumption.LIMITATIONSThe temporal sequence of cause and effect could not be determined in a cross sectional study. Convenience sampling in a single city limited the generalizability of the findings to all regions of Saudi Arabia.

BACKGROUND AND OBJECTIVESFrequent visits to diabetes care clinics linked with better control of diabetes mellitus (DM), but debates exist about how frequently visits should be done. The objective of this study was to assess the effect of frequent visits on diabetes care and control.DESIGN AND SETTINGSA prospective study of 100 diabetic patients attending Prince Abdul-Aziz Bin-Majed Diabetes Care Centre (PAMDCC), Al Madinah Al Munawwarah, Saudi Arabia, during the period from March 2011 through December 2012.METHODSDemographics, lifestyle, and diabetes data were obtained at the index visit. At that and subsequent visits, glycosated hemoglobin (HBA1c), blood pressure (BP) and low-density lipoprotein (LDL) were measured. All these data together with visit number and gap were recorded. Statistical analysis including linear regression analysis was done.RESULTSA significant reduction in the mean of diabetic control parameters was observed at the last visit. The highest mean changes were observed in patients with >6 visits, visit gap ≤1 month, and visit-month index ≥8. Adjusted linear regression showed that each visit significantly lowered HBA1c by 0.25%, BP by 2.1/0.7 mm Hg and 0.2 mmol/L for LDL. The number of visits needed to get HBA1c <7% and BP <130/85 was 8 and 5 visits with a visit-month index of 14 and 5, respectively.CONCLUSIONThe study suggests that frequent visits at short intervals may lead to better diabetes control. Other prospective clinical trial studies are needed to confirm these findings and to outline the appropriate cost-effective intervals and visit gaps.