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1.  Health care services provided to type 1 and type 2 diabetic patients in Saudi Arabia 
Saudi Medical Journal  2015;36(10):1216-1225.
Objectives:
To assess health care services provided to type 1 and type 2 diabetic patients and diabetes health care expenditure in the Kingdom of Saudi Arabia (KSA).
Methods:
This study was part of a nationwide, household, population based cross-sectional survey conducted at the University Diabetes Center, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia between January 2007 and December 2009 covering 13 administrative regions of the Kingdom. Using patients’ interview questionnaires, health care services data were collected by trained staff.
Results:
A total of 5,983 diabetic patients were chosen to assess health care services and expenditure. Approximately 92.2% of health services were governmental and the remaining 7.8% were in private services. The mean annual number of visits to physicians was 6.5±3.9 and laboratories was 5.1±3.9. Diabetic patients required one admission every 3 years with a mean admission duration of 13.3±28.3 days. General practitioners managed 85.9% of diabetic cases alone, or shared with internists and/or endocrinologists. Health care expenditure was governmental in 90% of cases, while it was personal in 7.7% or based on insurance payment in 2.3%.
Conclusion:
Health services and its expenditure provided to diabetic citizens in Saudi Arabia are mainly governmental. Empowerment of the role of both the private sector and health insurance system is badly needed, aside from implementing proper management guidelines to deliver good services at different levels.
doi:10.15537/smj.2015.10.12596
PMCID: PMC4621729  PMID: 26446334
2.  Outcomes of a type 2 diabetes education program adapted to the cultural contexts of Saudi women 
Saudi Medical Journal  2015;36(7):869-873.
Objective:
To explore the outcomes of a pilot intervention of a type 2 diabetes (T2D) education program, based on international standards, and adapted to the cultural and religious contexts of Saudi women.
Methods:
This study is an experiment of a pilot intervention carried out between August 2011 and January 2012 at the primary health clinics in Dammam. Women at risk of or diagnosed with T2D (N=35 including dropouts) were assigned to one of 2 groups; an intervention group participated in a pilot intervention of T2D education program, based on international standards and tailored to their cultural and religious contexts; and a usual care group received the usual care for diabetes in Saudi Arabia. Outcomes included blood glucose, body composition, 6-minute walk distance, life satisfaction, quality of life, and diabetes knowledge. The intervention group participated in a focus group of their program experience. Data analysis was based on mixed methods.
Results:
Based on 95% confidence interval comparisons, improvements were noted in blood sugar, 6-minute walk distance, quality of life, and diabetes knowledge in participants of the intervention group. They also reported improvements in lifestyle-related health behaviors after the education program.
Conclusion:
Saudi women may benefit from a T2D education program based on international standards and adapted to their cultural and religious contexts.
doi:10.15537/smj.2015.7.11681
PMCID: PMC4503910  PMID: 26108595
3.  A community-based survey for different abnormal glucose metabolism among pregnant women in a random household study (SAUDI-DM) 
BMJ Open  2014;4(8):e005906.
Objective
To assess the prevalence and risk factors of gestational diabetes mellitus (GDM) in a population known to have a high prevalence of abnormal glucose metabolism.
Methods
A household random population-based cross-sectional study of 13 627 women in the childbearing age, who were subjected to fasting plasma glucose if they were not known to have been diagnosed before with any type of diabetes. GDM cases were diagnosed using the International Association of Diabetes and Pregnancy Study Group (IAPSG) criteria.
Results
The overall GDM prevalence was 36.6%, categorised into 32.4% new cases and 4.2% known cases. Another 3.6% had preconception type 1 or 2 diabetes. GDM cases were older and had a significantly higher body mass index, in addition to a higher rate of macrocosmic baby and history of GDM. Monthly income, educational level, living in urban areas and smoking were not found to be significantly different between normal and GDM cases. The most important and significant risk factors for GDM were history of GDM, macrosomic baby, obesity and age >30 years. However, hypertension, low high-density lipoprotein, family history of diabetes and increased triglycerides did not show any significant effect on GDM prevalence in this cohort.
Conclusions
This society is facing a real burden of abnormal glucose metabolism during pregnancy, where almost half of the pregnant women are subjected to maternal and neonatal complications. Early screening of pregnant women, especially those at a high risk for GDM, is mandatory to identify and manage those cases.
doi:10.1136/bmjopen-2014-005906
PMCID: PMC4139649  PMID: 25138813
Diabetes & Endocrinology
4.  Prevalence of Anemia and Associated Factors in Child Bearing Age Women in Riyadh, Saudi Arabia 
Objective. To determine the prevalence and risk factors for anemia in child bearing age women in Riyadh, Saudi Arabia. Design. Cross-sectional survey was conducted using two-stage cluster sampling. 25 clusters (primary health care centers (PHCC)) were identified from all over Riyadh, and 45–50 households were randomly selected from each cluster. Eligible women were invited to PHCC for questionnaire filling, anthropometric measurements, and complete blood count. Blood hemoglobin was measured with Coulter Cellular Analysis System using light scatter method. Setting. PHCC. Subjects. 969 (68%) women out of 1429 women were included in the analysis. Results. Mean hemoglobin was 12.35 (±1.80) g/dL, 95% CI 12.24–12.46 with interquartile range of 1.9. Anemia (Hb <12 g/dL) was present in 40% (390) women. Mean (±SD) for MCH, MCV, MCHC, and RDW was 79.21 (±12.17) fL, 26.37 (±6.21) pg, 32.36 (±4.91) g/dL, and 14.84 (±4.65)%, respectively. Multivariate logistic regression revealed that having family history of iron deficiency anemia (OR 2.91, 95% CI 1.78–4.76) and infrequent intake of meat (OR 1.54, 95%CI 1.15–2.05) were associated with increased risk of anemia, whereas increasing body mass index (OR 0.95, 95% CI 0.92–0.97) was associated with reduced risk of anemia. Conclusion. Women should be educated about proper diet and reproductive issues in order to reduce the prevalence of anemia in Saudi Arabia.
doi:10.1155/2013/636585
PMCID: PMC3800602  PMID: 24205435
6.  Missed Opportunities for Immunization 
Canadian Family Physician  1992;38:1087-1091.
Missed opportunities for immunization were studied at five Saudi health centers. Of 383 children studied, 77.8% were up-to-date with their immunization, 10.2% had real contraindications, and 12.0% missed opportunities. Only 48.8% of mothers were up-to-date. We recommend that immunization be made available at all clinics and that presentation of immunization cards be required.
PMCID: PMC2145832  PMID: 21221325

Results 1-6 (6)