Background The awareness of diabetes mellitus (DM) and its complications, especially diabetic retinopathy (DR), is the key to reducing their burden. This study aimed to assess both the awareness of diabetic outpatients and their action towards periodic eye exam, and to determine the causes of non-compliance amongst patients who were aware. Because the Syrian Crisis affected all aspects of Syrians’ life, the study aimed to determine the crisis’ effects on patients’ care-seeking behavior. Our study was the first step in paving the way of prevention strategies. Methods This observational cross-section study was conducted on 260 patients with DM who were visiting the four main hospitals in the Syrian capital, Damascus between August and November 2017. Results The mean (±SD) age of participants was 54.3(±12.8) years. Females were more than half (56.2%). The majority were from areas outside Damascus (72.3%). The mean (±SD) DM duration was 10.6 (±7.1) years. Almost all patients (93.8%) thought that DM could affect the eye. 67.3% believed that it could cause blindness. 86.9% of the patients conceived that DM patients should visit an ophthalmologist regularly. 37% did not visit any ophthalmologists at all, while 63% reported they had visited their ophthalmologists. Only 21.5% had a regular eye exam. Gender, educational level, economic status, province, and family history of DM had statistically an insignificant relation with an ophthalmologist visit. The preponderance of the patients who haven’t visited regularly did not appreciate the necessity of regular eye exam. Diabetic neuropathy was the most common complication of DM that patients were aware of (92%) and suffered from (56.5%). Meanwhile, regarding the effects of the Syrian Crisis: 41.2% of diabetic patients had stopped their medications for at least one month, mainly because the drugs were unavailable (74.7% of them), as some drug companies had been destroyed. Half of the patients had struggled to reach a medical care center. Half of the patients had been displaced, two-third of them were from outside Damascus. Conclusion A screening program for DR should be initiated. Also, awareness about DM and its complications, especially DR, should be raised through doctors and media. Electronic supplementary material The online version of this article (10.1186/s12913-019-4375-8) contains supplementary material, which is available to authorized users.

Background: Obesity is a world-wide pandemic that has many contributing factors. Healthcare personnel has a crucial role in health promotion and is considered the role models for the general population. We aim to evaluate the BMI and physical activity (PA) of medical students their association with multiple variables, including psychological.Methods: This is a cross-sectional study that was conducted in Damascus University. Paper-based questionnaires were distributed that included International PA Questionnaire short version (IPAQ-S7S) and the Depression, Anxiety and Stress Scale (DASS 21).Results: The mean BMI was 23.5. Males had significantly higher BMI than females by 2.5 kg/m2. Shisha smoking, alcohol, family history, daily number of meals, high-fat meals, eating after midnight, physical activity, and having either moderate to severe depression, anxiety, and/or stress were all significantly associated with higher BMI (p<0.05). However, economic status, mean grades, marital status, living conditions, eating vegetables regularly, and number of snacks consumed did not significantly affect BMI. Low PA was found in 23.2% and was only associated with male gender. Conclusion: Our study found an association between obesity and the psychological factors among medical students. Smoking, fatty food and eating rates were also associated with obesity, while economic status was not. Low PA was prevalent among medical students and was associated with worse mental health which might reflect BMI being indirectly affected by war. This high BMI and low PA in medical students are particularly concerning and require rapid intervention.