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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.