Briefly describe a specific question, or set of related questions, about a health care test or treatment that this program should consider.

For people of color with Type 2 Diabetes, what is the most effective way to control blood glucose levels, comparing time released medication such as Lantus with short term effect medication like Novolog.

Does your question include a comparison of different health care approaches? (If no, your topic will still be considered.)

yes

If yes, explain the specific technologies, devices, drugs, or interventions you would like to see compared:

Time released medications (lantus) vs single dose/short term realease (Novolog). Does one work better in people of color vs the general population diagnoised with Type 2 Diabetes.

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.)

Male and female ages 25years to 60years. Patients of color versus the general population of those diagnosed with Type 2 Diabetes.

Are there subgroups of patients that your question might apply to? (For example, an ethnic group, stage or severity of a disease.)

African Americans beginning stage of Type 2 Diabetes through diagnosed 2-5years

Describe the health-related benefits you are interested in. (For example, improvements in patient symptoms or problems from treatment or diagnosis.)

Improvment in treatment. More individualized and targeted control of blood glucose levels.

Describe any health-related risks, side effects, or harms that you are concerned about.

Cookie cutter treatment of all patients without consideration of cultural, enviornment and life-style differences that negate the effectiveness of standardized treatments.

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.?

unsure

Which priority area(s) and population(s) does this topic apply to? (check all that apply)

EHC Priority Conditions (updated in 2008)

• Diabetes mellitus
• Obesity

AHRQ Priority Populations

• Low income groups
• Minority groups
• Women
• Elderly
• Individuals with special health care needs, including individuals with disabilities or who need chronic care or end-of-life health care

Federal Health Care Program

• Medicaid
• Medicare

Importance

Describe why this topic is important.

Rising diagnosis of diabetes in general population and the high incidence of the disease in minority populations.

Onset of diabetes leads to health complications beyond the initial problem.

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.)

Dilemma, minority patient diagnosed with type 2 diabetes, prescribed name brand time released medication pill blood glucose at accreptable levels. Pharmacy inadvertently switch to generic brand of same medication to cut costs. Blood glucose became uncontrolled. Reported to physcian, who did not prescribe return to name brand time pill but prescripbe time realease injection and intervention with short term single dose injections.

Dilemma; Increased costs to patient, blood glucose still not at acceptable levels.

Dilemma; another patient of color in similar situation and outcome however, blood glucose is in better control due to hospital stay in which physcian prescribe time released medication.

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.)

yes

If yes, please explain:

It may; in that the treatment of diabetes usually is individualized due to the blood glucose reaction to variety of medications. However could it also be biological makeup of people of different ethnic backgrounds, as well as, life style and culture with inhibits the use of certain standarized progressions of treatment for the diease?

Potential Impact

How will an answer to your research question be used or help inform decisions for you or your group?

Will launch targeted treatment with higher control and improvement of blood glucose levels in all populations because the treatment is more effective by being more specific. Diminshing the incidents of that damage other organs.

Describe the timeframe in which an answer to your question is needed.

The sooner the better. However the study should encompass 2 years-5 years.

Describe any health disparities, inequities, or impact on vulnerable populations your question applies to.

African- Americans and those of Spanish/Latino decent. Low

Nominator Information

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)

Will launch targeted treatment with higher control and improvement of blood glucose levels in all populations because the treatment is more effective by being more specific. Diminshing the incidents of that damage other organs.

Are you making a suggestion as an individual or on behalf of an organization?

Individual

Please tell us how you heard about the Effective Health Care Program