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

Genetic causes of diabetes

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

no

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

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.)

I think a wide range of people

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

certainly diffrences exist from ethnic groups, stage and severity of desease

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

TCF7L2 is the gene whose disruptionm causes diabete. Since TCF7L2 alias TCF4 is part of canonical phatway APC-B-cateni -TCF4-LEF-Wnt-C-myc, a disruption od one of thoses gene may causes activation of gene who is considered cause of diabete. When a mutation is present on APC the canonical pathway is disrupted and cancerogenesis process began. May, on this case also diabetes may be activated. Is it possible that diabetes is a stage of cancerogenesis and not only an accidental and separate pathology that e nhances cancer?

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

I have mutation truncation of APC gene (germinal mutation with deletion of 5 bp that is interpreted as mutation truncation that causes premature stop codon). For a scientific interess may be possible thath on its evolution advance stage FAP-Gardner syndromes present a diabetes risk? phenotipc manifestation of diabetes and gardner'syndrome are similar as retinopathy aand blindness. APC gene govern retinoic acid synthesis.

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)

• Cancer
• Diabetes mellitus

AHRQ Priority Populations

• 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.

i retain topic is important for the implication consideration may have on a complex contest on which cancer, diabetes or other pathology are entities not separate.

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.)

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:

uncertainty is originated for a separate consideration of several pathology insteda a more complex problem

Potential Impact

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

very musch

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

For complexity i retain timeframe is not possible to be calculated.

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

Ethnic groups may differs fron difference of genome, climate, and several other aspects.

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)

very musch

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