Prevalence of undiagnosed diabetes and quality of care in diabetic patients followed at primary and tertiary clinics in Abu Dhabi, United Arab Emirates

Health and Wellness Characteristics of Employees Enrolled in a Workplace Wellness Study in the United Arab Emirates: A Descriptive Analysis of a Pilot Study

INTRODUCTION

Modifiable health behaviors have the power to increase (or decrease) the risk of chronic diseases, impacting a population's health. Health and wellness programs can potentially play a major role in initiating and supporting positive changes in health behaviors, which may lead to reducing the risk of premature mortality. A better understanding of the health and well-being status of the population is crucial to the design of proper and effective interventions. This pilot study aimed to describe the health and well-being status of a cohort of employees in the United Arab Emirates (UAE).

METHODS

This pilot study reports the demographic characteristics, body composition, cardiovascular fitness, functional fitness, biological age, and well-being of employees from a large health sector company enrolled in a workplace wellness study in the UAE. Employees were invited to participate in an intervention that was designed to validate the efficacy of weekly health and wellness challenges. Descriptive statistics were used to describe the employees' distribution.

RESULTS

Of the 123 selected, 116 employees participated in the study. The mean age of participants was 39.2 years old, 80% of them were non-Emirati, and the majority were from Middle-Eastern and South Asian ethnicities. The prevalence of overweight, obesity, hypercholesterolemia, hyperlipidemia, prediabetes, and diabetes was 35%, 29%, 34%, 79%, 30%, and 7%, respectively. Almost half of the participants (47%) were prehypertensive for systolic blood pressure (BP), 80% had the fitness category of poor-very poor, and the majority (60%) reported exercising <150 minutes/week. The mean functional fitness score was 12.2 points, which indicated an increased risk of injury with physical activity.

CONCLUSION

The findings of this pilot study suggest that despite the advancements in healthcare in the UAE, several key preventable risk factors are still prevalent in its population. The introduction of comprehensive health and wellness programs at a broader scale holds the potential to facilitate the adoption of healthier lifestyle behaviors, thereby contributing to improvements in the overall quality of life across the population.

Health literacy levels in patients with type 2 diabetes in an affluent Gulf country: a cross-sectional study

OBJECTIVES

To identify health literacy levels in patients with type 2 diabetes mellitus in the United Arab Emirates (UAE).

INTERVENTION

Nationwide cross-sectional survey.

SETTING AND PARTICIPANTS

Individuals with type 2 diabetes mellitus attending outpatient diabetes clinics in all emirates of the UAE were surveyed between January 2019 and May 2020. Out of 832 patients approached, 640 met the inclusion criteria and agreed to participate.

OUTCOME VARIABLES

The outcome variable of interest was the health literacy level, which was measured using the Eastern-Middle Eastern Adult Health Literacy 13 Questionnaire. The association of health literacy level with age, gender and education was conducted using the Χ² test.

RESULTS

Only 11% of respondents had adequate health literacy levels. Age and education were directly correlated with health literacy levels. Patients under age 50 years had statistically significant higher rates of marginal (106 of 238, 44.5%) and adequate literacy (67 of 238, 28.2%, p<0.001) than the older population. Participants with bachelor's or postgraduate degrees also had significantly higher adequate health literacy levels (24 of 79, 30.4%, p<0.001).

CONCLUSIONS

The low health literacy levels found in outpatients with diabetes may be a major challenge to optimising diabetes care in the UAE. In addition to health services strategies, targeted educational and behavioural interventions for the older population and those with less formal education are necessary.

Prevalence and Associated Factors of Delayed Diagnosis of Type 2 Diabetes Mellitus in a Tertiary Hospital: A Retrospective Cohort Study

Objective: To determine the prevalence and associated factors of delayed diagnosis of type 2 diabetes mellitus (DM) among outpatients in a tertiary hospital.

Methods: This retrospective cohort study was conducted among outpatients aged ≥35 years with twice fasting plasma glucose (FPG) levels ≥126 mg/dl between 1 January 2018, and 31 December 2020. The prevalence and pattern of delayed diagnosis of DM were defined using the Thai Clinical Practice Guideline (CPG) for Diabetes, 2017, and the American Diabetes Association (ADA) 2017. The cut-off time for FPG level confirmation of 3 months was used to evaluate delayed diagnoses and associated factors. Multiple logistic regression was used to identify variables associated with delayed diagnoses.

Results: Of 260 participants, 96.9% and 85.4% had delayed diagnoses as defined by the Thai CPG and the ADA, respectively. Factors significantly associated with delayed diagnosis were hypertension, non-cash insurance, and &gt;10 years of physician experience.

Conclusion: Undiagnosed diabetes and diagnosis delay should be a concern in tertiary settings. Senior physicians should focus on patients with higher FPG levels, particularly those who have hypertension, and use non-cash insurance schemes.

Levels and Correlates of Numeracy Skills in Lebanese Adults with Diabetes: A Cross-Sectional Study

Diabetes numeracy skills are required in the interpretation of food labels, insulin pump dosage, the interpretation of blood glucose meter data, and the determination of carbohydrate intake. This study assessed the levels and correlates of numeracy skills in Lebanese adults with diabetes to identify those most at risk of uncontrolled diabetes. In total, 299 adults with diabetes, mean age 47.4 ± 19.8 years, took the questionnaire. It consisted of self-developed items on sociodemographic and health-related factors, in addition to the Diabetes Numeracy Test-15 (DNT-15) and the Single Item Literacy Screener. Many participants (62%) scored < 10 on the DNT-15 indicating insufficient numeracy skills. DNT-15 scores were positively associated with literacy, exercise, healthy diet, perceived diabetes control, frequency of glycaemia measurement, ability to afford treatment, and ease of understanding information related to diabetes. Age, BMI, and complications were negatively correlated with DNT-15 score. Numeracy skills were higher in males, single individuals, and in people with type 1 diabetes, fewer complications, controlled HbA1c, higher income, higher education, a prior visit to a dietician, and ability to maintain personal care despite COVID-19. Interventions to strengthen numeracy skills would empower individuals with diabetes, lead to appropriate self-management behaviors, and prevent health complications in at-risk individuals.

Genetic Variants and Their Associations to Type 2 Diabetes Mellitus Complications in the United Arab Emirates

Aim

Type 2 Diabetes Mellitus (T2DM) is associated with microvascular complications, including diabetic retinopathy (DR), diabetic nephropathy (DNp), and diabetic peripheral neuropathy (DPN). In this study, we investigated genetic variations and Single Nucleotide Polymorphisms (SNPs) associated with DR, DNp, DPN and their combinations among T2DM patients of Arab origin from the United Arab Emirates, to establish the role of genes in the progression of microvascular diabetes complications.

Methods

A total of 158 Emirati patients with T2DM were recruited in this study. The study population was divided into 8 groups based on the presence of single, dual, or all three complications. SNPs were selected for association analyses through a search of publicly available databases, specifically genome-wide association study (GWAS) catalog, infinome genome interpretation platform, and GWAS Central database. A multivariate logistic regression analysis and association test were performed to evaluate the association between 83 SNPs and DR, DNp, DPN, and their combinations.

Results

Eighty-three SNPs were identified as being associated with T2DM and 18 SNPs had significant associations to one or more diabetes complications. The most strongly significant association for DR was rs3024997 SNP in the VEGFA gene. The top-ranked SNP for DPN was rs4496877 in the NOS3 gene. A trend towards association was detected at rs833068 and rs3024998 in the VEGFA gene with DR and rs743507 and rs1808593 in the NOS3 gene with DNp. For dual complications, the rs833061, rs833068 and rs3024997 in the VEGFA gene and the rs4149263 SNP in the ABCA1 gene were also with borderline association with DR/DNp and DPN/DNp, respectively. Diabetic with all of the complications was significantly associated with rs2230806 in the ABCA1 gene. In addition, the highly associated SNPs rs3024997 of the VEGFA gene and rs4496877 of the NOS3 gene were linked to DR and DPN after adjusting for the effects of other associated markers, respectively.

Conclusions

The present study reports associations of different genetic polymorphisms with microvascular complications and their combinations in Emirati T2DM patients, reporting new associations, and corroborating previous findings. Of interest is that some SNPs/genes were only present if multiple comorbidities were present and not associated with any single complication.

The First United Arab Emirates National Representative Birth Cohort Study: Study Protocol

BACKGROUND

In recent years, the prevalence of non-communicable diseases (NCDs) has escalated. Evidence suggests that there are strong associations between nutrition in early life and the risk of disease in adulthood. This manuscript describes the study protocol of the First United Arab Emirates National Representative Birth Cohort Study (UAE-BCS), with the objective of investigating nutrition and lifestyle factors in the first 1,000 days of life. The main aims of the study are (1) to address critical issues relating to mother and child nutrition and their effect on growth and development, (2) to profile maternal nutrition, child growth, health, and development outcomes in early life, and (3) to study the associations between these factors among the Emirati population in the UAE.

METHODS/DESIGN

In this study, a multidisciplinary team of researchers was established including credible researchers from the UAE, Lebanon, Australia, and the United Kingdom to launch the First United Arab Emirates 3-year birth cohort study. We aim to recruit 260 pregnant Emirati women within their first trimester, which is defined by the study as from 8 to 12 weeks pregnant, from obstetrics and gynecology clinics in the UAE. Participants will be recruited via face-to-face interviews and will receive a total of 11 visits with 1 visit in each trimester of pregnancy and 8 visits after delivery. Maternal data collection includes, socio-demographic and lifestyle factors, dietary intake, anthropometric measurements, physical activity, maternal psychological state, and blood samples for biochemical analysis. Post-partum, visits will take place when the child is 0.5, 4, 6, 9, 12, 18, and 24 months old, with data collection including infant anthropometric measurements, young child feeding practices, dietary intake, supplement use and the eating environment at home, as well as all maternal data collection described above, apart from blood samples. Additional data collection for the child includes early child developmental assessments taking place at three timepoints: (1) within 2 weeks of birth, (2) at 10-14 months and (3) at 22-26 months of age. Early child developmental assessments for the infant include vision, hearing, cognition, motor skills, social-emotional reactivity, neurodevelopmental, and sleep assessments.

DISCUSSION

The United Arab Emirates Birth Cohort study protocol provides a standardized model of data collection methods for collaboration among the multisectoral teams within the United Arab Emirates to enrich the quality and research efficiency in early nutrition, thereby enhancing the health of mothers, infants, and children.

The Impact of Telemonitoring on Improving Glycemic and Metabolic Control in Previously Lost-to-Follow-Up Patients with Type 2 Diabetes Mellitus: A Single-Center Interventional Study in the United Arab Emirates

BACKGROUND

Telemonitoring (TM), mobile-phone technology for health, and bluetooth-enabled self-monitoring devices represent innovative solutions for proper glycemic control, compliance and monitoring, and access to providers.

OBJECTIVE

In this study, we evaluated the impact of TM devices on glycemic control and the compliance of 38 previously lost-to-follow-up (LTFU) patients with type 2 diabetes mellitus (T2DM).

METHODS

This was an interventional single-center study that randomly recruited LTFU patients from the Dubai Diabetes Center (DDC), UAE. After contact and recruitment by phone, patients had an initial visit at which they were provided with home-based TM devices. A follow-up visit was conducted three months later.

RESULTS

The mean HbA1c decreased significantly from 10.3 ± 1.9% at baseline to 7.4 ± 1.5% at the end of follow-up, with a mean difference (MD) of -2.9% [95% CI: -3.6 to -2.2]. The percentage of patients with HbA1c <7% was 50% after three months. Home-based blood sugar monitor devices showed a significant reduction in fasting blood glucose (FBG) after three months (MD = -40.1 mg/dL, 95% CI: -70.8 to -9.3). A significant reduction was observed in terms of body weight after three months (MD = -1.3 kg, 95% CI: -2.5 to -0.08). The mean number of days the participants used a device was the highest for portable pill dispensers (86.5 ± 22.8 days), followed by a OneTouch® blood glucose monitor (72.9 ± 23.5 days).

CONCLUSIONS

TM led to significant improvements in overall diabetes outcomes, including glycemic control and body weight, indicating its effectiveness in a challenging population of T2DM patients who had previously been lost to follow-up.

Outcomes of a novel pharmacy screening intervention to address the burden of type 2 diabetes and cardiovascular disease in an Arabic-speaking country

AIMS

Aim of this study is to evaluate the capacity of a pharmacist-delivered screening model for type 2 diabetes and cardiovascular disease (CVD) in identifying and referring individuals at risk.

METHOD

A screening programme was implemented in 12 community pharmacies in three cities in the United Arab Emirates. Trained pharmacists screened adults (≥40 years) without a previous diagnosis of diabetes or CVD. Most participants were recruited during their visits to the pharmacies; pharmacy-based advertising and social media were also used. The screening included medical history, anthropometric measurements, point-of-care glycated haemoglobin (HbA_1c ) levels, and a lipid panel. High-risk individuals (HbA_1c  ≥ 5.7% [39 mmol/mol], a high diabetes risk score, or a 10-year CVD risk ≥7.5%) were given a referral letter and advised to visit their physician. Risk factors for elevated HbA_1c were identified by logistic regression.

RESULTS

Of the 568 screened participants, 332/568 (58%) were identified to be at risk: HbA_1c levels were consistent with diabetes 67/560 (12%) or prediabetes 148/560 (26%), high diabetes risk score 243/566 (43%), CVD risk score > 7.5% 79/541 (15%). Obese people were more likely to have prediabetes or diabetes OR (95% CI): 3.2 (1.3, 7.5), as were those who spent more than 11 h/day sitting: 5.7 (1.8, 17.6). Of the 332 at-risk participants, 206 (62%) responded to a telephone follow-up at six weeks; one-third had discussed screening results with their physician.

CONCLUSIONS

Community pharmacists detected and referred individuals at risk for diabetes or CVD, although participant follow-up with their physician could be improved. Pharmacy screening is feasible and will potentially improve outcomes.

Prevalence of type 2 diabetes in Middle-East: Systematic review& meta-analysis

BACKGROUND & OBJECTIVES

Type 2 diabetes is increasing in both developed and developing countries due to popularity of western lifestyle and population structure. Then, this systematic review aimed to identify the prevalence and trend of diabetes in the Middle-East region.

METHOD

We searched Google Scholar, PubMed and Medline from 2000 up to 2018. MeSH terms were a combination of "diabetes", "prevalence", "diabetes mellitus", "type 2 diabetes", "Name of Countries" and "Middle East". Pooled estimates were obtained by means of random effect models to account for variation between studies.

FINDING

Of the initially 669 identified articles, a total of 50 reports with 4,263,662 subjects met inclusion criteria. The combined prevalence of diabetes in the region was about 14.6% (95% CI: 11.6-17.5) which varied from 2.6% (95% CI: 2.5-2.6) to 21.9 (95% CI: 16.8-17.5) amongst countries. Therefore, approximately a total of 46 million individuals are now suffering from diabetes in the Middle East based on above-mentioned pooled estimate.

CONCLUSION

The pattern and growing trend of diabetes during last 20 years in the study area is alarming and underline the point that maximal risk reduction for developing diabetes should be at the top of health priorities.

The prevalence of undiagnosed type 2 diabetes and prediabetes in Eastern Mediterranean region (EMRO): A systematic review and meta-analysis

BACKGROUND

Previous studies of diabetes in Eastern Mediterranean Region (EMRO) did not assess the prevalence of either unknown diabetes or prediabetes. We conducted a systematic review and meta-analysis to estimate the prevalence of undiagnosed type 2 diabetes and prediabetes as well as variations by region in EMRO, using the relevant publications since 2000.

METHODS

We carried out a comprehensive electronic search on electronic databases from January 1, 2000 to March 1, 2018. We selected cross-sectional and cohort studies reporting the prevalence of undiagnosed type 2 diabetes, prediabetes, or both. Two independent reviewers initially screened the eligible articles; then, synthesized the target data from full papers. Random- or fixed-effect models, subgroup analysis on Human Development Index (HDI), and publication year and sensitivity analysis to minimize the plausible effect of outliers were used.

RESULTS

Amongst 849 identified citations, 55 articles were entered into meta-analysis, involving 567,025 individuals. The forest plots estimated 5.46% (confidence intervals [CI]: 4.77-6.14) undiagnosed diabetic and 12.19% (CI: 10.13-14.24) prediabetics in EMRO. Low HDI countries and high HDI countries had the highest (7.25%; CI: 4.59-9.92) and the lowest (3.98%; CI: 3.11-4.85) undiagnosed diabetes prevalence, respectively. Very high HDI countries and low HDI countries had the highest (13.50%; CI: 8.43-18.57) and the lowest (7.45%; 1.20-13.71) prediabetes prevalence, respectively. In addition, meta-regression analysis showed a statistically significant association between publication year and prevalence of prediabetes (Reg Coef = 0.059, P = 0.014). But such finding was not observed for undiagnosed diabetes and publication year (Reg Coef = 0.034, P = 0.124), prediabetes and HDI (Reg Coef = 0.128, P = 0.31) and undiagnosed diabetes and HDI (Reg Coef = - 0.04, P = 0.96).

CONCLUSION

The prevalence of undiagnosed diabetes and prediabetes was high and increasing. The notion of universal health coverage is a priority; that is the integration of the primary, secondary and tertiary health levels, as well as employing the available action plans. Therefore, future studies, using identical screening tool and diagnostic criteria, are warranted to make an accurate picture of diabetes in EMRO.

Multiple genetic variations confer risks for obesity and type 2 diabetes mellitus in arab descendants from UAE

BACKGROUND

The United Arab Emirates (UAE) is one of the countries most threatened with obesity. Here we investigated associations between hundreds of single-nucleotide polymorphisms (SNPs) and the following obesity indicators: body mass index (BMI), waist circumference (WC), and height. We also investigated the associations between obesity-related genes with type 2 diabetes mellitus (T2DM).

METHODS

We tested 87, 58, and 586 SNPs in a previous genome-wide significance level for associations with BMI (n = 880), WC (n = 455), and height (n = 897), respectively. For each trait, we used normally transformed Z scores and tested them with SNPs using linear regression models that incorporated age and gender as covariates. The weighted polygenic risk scores for significant SNPs for each trait were tested with the corresponding Z scores using linear regression models with the same covariates. We further tested 145 obesity loci with T2DM (464 cases, 415 controls) using a logistic regression model including age, gender, and BMI Z scores as covariates.

RESULTS

The Mean BMI was 29.39 kg/m², and mean WC was 103.66 cm. Hypertension and dyslipidemia were common obesity comorbidities (>60%). The best associations for BMI was in FTO, LOC284260 and USP37, and for WC in RFX7 and MYEOV. For height, the best association was in NSD1 followed by MFAP2 and seven other loci. The polygenic scores revealed stronger associations for each trait than individual SNPs; although they could only explain <1% of the traits' Z scores variations. For T2DM, the strongest associations were with the TCF7L2 and MC4R loci (P < 0.01, OR ~1.70), with novel associations detected with KCNK3 and RARB.

CONCLUSIONS

In this first study of Arab descendants, we confirmed several known obesity (FTO, USP37, and RFX7), height (NSD1, MFAP2), and T2DM (TCF7L2, MC4R) associations; and report novel associations, like KCNK3 and RARB for T2DM.

Clinical profiles, comorbidities and complications of type 2 diabetes mellitus in patients from United Arab Emirates

OBJECTIVE

To assess clinical profiles of patients with type 2 diabetes in the United Arab Emirates (UAE), including patterns, frequencies, and risk factors of microvascular and macrovascular complications.

RESEARCH DESIGN AND METHODS

Four hundred and ninety patients with type 2 diabetes were enrolled from two major hospitals in Abu Dhabi. The presence of microvascular and macrovascular complications was assessed using logistic regression, and demographic, clinical and laboratory data were collected. Significance was set at p<0.05.

RESULTS

Hypertension (83.40%), obesity (90.49%) and dyslipidemia (93.43%) were common type 2 diabetes comorbidities. Most of the patients had relatively poor glycemic control and presented with multiple complications (83.47% of patients had one or more complication), with frequent renal involvement. The most frequent complication was retinopathy (13.26%). However, the pattern of complications varied based on age, where in patients <65 years, a single pattern presented, usually retinopathy, while multiple complications was typically seen in patients >65 years old. Low estimated glomerular filtration rate in combination with disease duration was the most significant risk factor in the development of a diabetic-associated complication especially for coronary artery disease, whereas age, lipid values and waist circumference were significantly associated with the development of diabetic retinopathy.

CONCLUSIONS

Patients with type 2 diabetes mellitus in the UAE frequently present with comorbidities and complications. Renal disease was found to be the most common comorbidity, while retinopathy was noted as the most common diabetic complication. This emphasizes the need for screening and prevention program toward early, asymptomatic identification of comorbidities and commence treatment, especially for longer disease duration.

Patients' management of type 2 diabetes in Middle Eastern countries: review of studies

The increased prevalence of diabetes in Middle Eastern countries is a health policy priority. Important risk factors for diabetes have been identified. Lifestyle interventions and adherence to medications are central to disease prevention and management. This review focuses on the management of type 2 diabetes mellitus in Middle Eastern countries. The aim is to identify the ways in which knowledge, health beliefs, and social and cultural factors influence adherence to medication and lifestyle measures. Thirty-four studies were identified following a systematic search of the literature. The studies describe the influence of knowledge, health beliefs, culture, and lifestyle on the management of type 2 diabetes mellitus in the Middle East. Findings indicate a lack of health knowledge about diabetes among populations, which has implications for health behaviors, medication adherence, and treatment outcomes. Many identified health beliefs and cultural lifestyle factors, such as religious beliefs, beliefs about fasting during Ramadan, and sedentary lifestyles played a role in patients' decisions. For better management of this disease, a collaborative approach between patients, their families, health care professionals, and governments should be adopted. Implementing behavioral strategies and psychological interventions that incorporate all health care professionals in the management process have been shown to be effective methods. Such services help patients change their behavior. However, the utilization of such services and interventions is still limited in Arabian countries. Physicians in the Middle East are the health care professionals most involved in the care process.

Physicians’ attitudes towards provision of primary care services in community pharmacy in the United Arab Emirates

Objectives

This study aims to explore physicians' views of pharmacists' roles in providing primary care services through community pharmacies in the United Arab Emirates (UAE).

Methods

A qualitative approach involving semi-structured interviews conducted one-to-one or in group discussions was employed. The interviews explored participants' views of pharmacists' primary care services including screening and monitoring of disease, health advice, referral, lifestyle and preventive care, supply of printed information, counselling on medications, patient record keeping, and pharmacist intervention in chronic disease management. Data were analysed using the Framework approach.

Key findings

Fifty-three physicians participated; 27 were interviewed individually and 26 participated in five group discussions. Four major themes were identified: competence, business orientation, territorial control and service delivery. Participants were supportive of verbal counselling about medications, checking for drug dosing, interactions, duplications and errors, and keeping patient medication profiles. Physicians generally did not favour pharmacists' involvement in screening or monitoring of disease, providing information about diseases, diagnosis or long-term management of disease, or intervention directly with patients, mainly due to perceived lack of competence, territorial encroachment and business orientation of community pharmacy.

Conclusions

Despite some reservations, participants showed support for pharmacist involvement in providing primary care services, provided certain quality and territorial issues were addressed. Understanding physicians' attitudes will facilitate interventions to enhance the contribution of community pharmacists to primary care in the UAE, and possibly in other regions with similar healthcare systems.

Prevalence of diagnosed and undiagnosed diabetes mellitus in adults aged 19 years and older in Basrah, Iraq

BACKGROUND

Six of the top ten countries in the world with the highest prevalence of diabetes mellitus are in the Middle East. The objective of this investigation was to evaluate the prevalence of diabetes in Basrah, Southern Iraq.

METHODS

A population-based, cross-sectional, simple random study screened 5,445 persons aged 19-94 years in Basrah, with glycated hemoglobin measured in 88.3% of the population and fasting plasma glucose in 18.7%. Body mass index and other demographic parameters were also measured.

RESULTS

Of the 5,445 persons screened, 8.7% had already been diagnosed with diabetes and 11% were found by screening to have undiscovered diabetes, giving an age-adjusted prevalence of diabetes of 19.7%, with 55.7% of those with diabetes being previously undiagnosed. In addition, 29.1% of the screened population had prediabetes, giving a prevalence of dysglycemia of 48.8%, with only 51.2% of the persons screened being normoglycemic. The prevalence of diabetes in both sexes peaked at age 46-60 years. Diabetes was slightly more prevalent in females than in males, and about 70.3% of diabetic individuals had a body mass index ≥25 kg/m(2).

CONCLUSION

The prevalence of diabetes in Basrah, Iraq, is very high, affecting one in five adults. The epidemic of diabetes will result in strain on the financial resources of health care systems.

Characteristics, management, and in-hospital outcomes of diabetic patients with acute coronary syndrome in the United Arab Emirates

We describe the baseline characteristics, management, and in-hospital outcomes of patients in the United Arab Emirates (UAE) with DM admitted with an acute coronary syndrome (ACS) and assess the influence of DM on in-hospital mortality. Data was analyzed from 1697 patients admitted to various hospitals in the UAE with a diagnosis of ACS in 2007 as part of the 1st Gulf RACE (Registry of Acute Coronary Events). Of 1697 patients enrolled, 668 (39.4%) were diabetics. Compared to patients without DM, diabetic patients were more likely to have a past history of coronary artery disease (49.1% versus 30.1%, P < 0.001), hypertension (67.2% versus 36%, P < 0.001), and prior revascularization (21% versus 11.4%, P < 0.001). They experienced more in-hospital recurrent ischemia (8.5% versus 5.1%; P = 0.004) and heart failure (20% versus 10%; P < 0.001). The mortality rate was 2.7% for diabetics and 1.6% for nondiabetics (P = 0.105). After age adjustment, in-hospital mortality increased by 3.5% per year of age (P = 0.016). This mortality was significantly higher in females than in males (P = 0.04). ACS patients with DM have different clinical characteristics and appear to have poorer outcomes.