Topic Suggestion Description
View Topic Suggestion Disposition
Date submitted: April 24, 2012
- Briefly describe a specific question, or set of related questions, about a health care test or treatment that this program should consider.
- What is the comparative effectiveness of interventions for preventing or delaying progression to diabetes?
- Does your question include a comparison of different health care approaches? (If no, your topic will still be considered.)
- If yes, explain the specific technologies, devices, drugs, or interventions you would like to see compared:
- Counseling: group vs individual
- Nutritional interventions: group vs individual
- Physical activity
- Weight loss interventions and counseling
- Specific medications (metformin vs weight loss drugs)
- What patients or group(s) of patients does your question apply to? (Please include specific details such as age range, gender, coexisting diagnoses, and indications for therapy.)
- • Obese individuals, prediabetic, impaired glucose tolerance
• High risk groups including minorities
- Are there subgroups of patients that your question might apply to? (For example, an ethnic group, stage or severity of a disease.)
- • Pregnant women
• Hispanic individuals
• African Americans
- Describe the health-related benefits you are interested in. (For example, improvements in patient symptoms or problems from treatment or diagnosis.)
- • Diabetes prevention
• Prevention of diabetes-related complications (e.g. micro and macrovascular disease)
• Prevention of chronic disease
- Describe any health-related risks, side effects, or harms that you are concerned about.
- • Medication harms and side effects
• Social stigmatization
Appropriateness for EHC Program
- Does your question include a health care drug, intervention, device, or technology available (or likely to be available) in the U.S.?
- Which priority area(s) and population(s) does this topic apply to? (check all that apply)
- EHC Priority Conditions (updated in 2008)
- Diabetes mellitus
- Pregnancy, including preterm birth
- AHRQ Priority Populations
- Low income groups
- Minority groups
- Federal Health Care Program
- State Children's Health Insurance Program (SCHIP)
- Describe why this topic is important.
- The lifetime risk of type 2 diabetes is high, yet our ability to predict and prevent type 2 diabetes in the general population is limited. Subjects at high-risk are appropriate candidates for preventive interventions and include those with impaired fasting glucose, impaired glucose tolerance, obesity, close relatives with type 2 diabetes, or who are members of certain ethnic groups (Asian, Hispanic, black). These individuals are at higher risk of developing type 2 diabetes and the subsequent health problems associated. Three factors have been evaluated in an attempt to prevent type 2 diabetes: exercise, weight loss, and drug therapy. In various studies, each of these methods has been evaluated, but currently, no single agent is definitively recommended for diabetes prevention. A review of the evidence would inform health policy and provide practical guidance to clinicians.
- What specifically motivated you to ask this question? (For example, you are developing a clinical guideline, working with a policy with large uncertainty about the appropriate approach, costly intervention, new research you have read, items in the media you may have seen, a clinical practice dilemma you know of, etc.)
- This question was prioritized by stakeholders engaged in the Topic Identification project conducted by the Oregon Evidence-based Practice Center on “Prevention in Women’s Health.”
- Does your question represent uncertainty for clinicians and/or policy-makers? (For example, variations in clinical care, controversy in what constitutes appropriate clinical care, or a policy decision.)
- If yes, please explain:
- Three factors have been evaluated in an attempt to prevent type 2 diabetes (diet, exercise, drug therapy) but the most effective method is unclear.
- How will an answer to your research question be used or help inform decisions for you or your group?
- This report will help identify effective approaches for preventing progression to Type 2 Diabetes Mellitus.
- Describe the timeframe in which an answer to your question is needed.
- Not aware of a specific timing issue
- Describe any health disparities, inequities, or impact on vulnerable populations your question applies to.
- Women, adolescents, children, high risk groups including minorities, and pregnant women
- Other Information About You: (optional)
- Please choose a description that best describes your role or perspective: (you may select more than one category if appropriate)
- Are you making a suggestion as an individual or on behalf of an organization?
- Organization - This question was prioritized by stakeholders engaged in the Topic Identification project conducted by the Oregon Evidence-based Practice Center on “Prevention in Women’s Health.”
- Please tell us how you heard about the Effective Health Care Program