Diabetes mellitus (DM) is the sixth leading cause of death in Saudi Arabia, with a prevalence of 14.1%. This cross–sectionalstudy aimed to assess the use of DM guidelines by physicians in primary health centersand factors that may improve their use.A total of 185 of 303 physicians completed the questionnaire (response rate, 61.1%). Only 10.8% of physicians did not follow the guidelines. The majority of physiciansreported that DM guidelines influenced their management plan (83%), and using themimproves patient outcomes (85.4%). Adherence to DM guidelines was significantly higher among physicians who were seeing less patients per day (P= .001), trained in usingDM guidelines (P=0.000), hadhigher level ofknowledge of DM guidelines (P=.000), and received a paper (P = 0.48) or an email copy (P = 0.23) of the guidelines.