The impact of a multi-disciplinary management approach on diabetic control in young Saudi patients.

The increasing incidence of diabetes mellitus worldwide makes traditional approaches to its management inadequate. The involvement of young people in this diabetic "epidemic" provides an opportunity to apply a multidisciplinary approach to its management, to help reduce the huge burden of the disease and its complications. In 1998, we established a diabetic clinic for young adults, located within a privately owned company health center, because they were not receiving adequate attention in the adult clinic. Our purpose was to optimize diabetes control by teaching about diet, exercise, medications, and other practical diabetic management issues. In this special communication, we describe the organization of the clinic and present our experience with 105 patients in the first 4 years. Diabetic control as measured by serial glycosylated haemoglobin levels (HbA1c) and the occurrence and severity of diabetic ketoacidosis improved in our patients over those 4 years. Studies in the West have shown that small reductions in HbA1c have translated into dramatic decreases in microvascular complications. Application of this model to a larger population group is needed. Further study may help determine whether to adopt this pattern of care more widely, with its obvious benefits in reduction of diabetic morbidity, mortality and health care cost. We also identified three groups that may require special attention: females, young adults who develop the disease as children, and adolescents who have no regular adult supervision.