Novel approach to systematic random sampling in population surveys: Lessons from the United Arab Emirates National Diabetes Study (UAEDIAB)

Background: The prevalence of diabetes has risen rapidly in the Middle East, particularly in the Gulf Region. However, some prevalence estimates have not fully accounted for large migrant worker populations and have focused on minority indigenous populations. The objectives of the UAE National Diabetes and Lifestyle Study are to: (i) define the prevalence of, and risk factors for, T2DM; (ii) describe the distribution and determinants of T2DM risk factors; (iii) study health knowledge, attitudes, and (iv) identify gene-environment interactions; and (v) develop baseline data for evaluation of future intervention programs. Methods: Given the high burden of diabetes in the region and the absence of accurate data on non-UAE nationals in the UAE, a representative sample of the non-UAE nationals was essential. We used an innovative methodology in which non-UAE nationals were sampled when attending the mandatory biannual health check that is required for visa renewal. Such an approach could also be used in other countries in the region. Results: Complete data were available for 2719 eligible non-UAE nationals (25.9% Arabs, 70.7% Asian non-Arabs, 1.1% African non-Arabs, and 2.3% Westerners). Most were men<65 years of age. The response rate was 68%, and the non-response was greater among women than men; 26.9% earned less than UAE Dirham (AED) 24000 (US$6500) and the most common areas of employment were as managers or professionals, in service and sales, and unskilled occupations. Most (37.4%) had completed high school and 4.1% had a postgraduate degree. Conclusion: This novel methodology could provide insights for epidemiological studies in the UAE and other Gulf States, particularly for expatriates.