Identifying Disparities in Type 2 Diabetes Among Asian Americans: The Pan Asian C

描述(由申请人提供)：对父母资助的修订，5 R01 DK081371-02：“识别亚裔美国人中2型糖尿病的差异：泛亚洲队列研究”，是对NOT-OD-09-058的回应：“NIH宣布为竞争性修订申请提供恢复法案资金。”家长基金的资助时间为2009年1月15日至2013年12月31日，以响应项目公告PA-07-388：“识别和减少医疗保健系统中与糖尿病和肥胖相关的健康差距(R01)”。这项为期五年的研究解决了亚裔美国人对2型糖尿病和肥胖症缺乏了解的问题，无论是作为一个总体组，还是作为不同的亚组。与非西班牙裔白人相比，亚洲亚群在2型糖尿病风险因素和并发症方面的差异相对较少，许多研究结果为美国的护理实践和公共卫生努力提供了参考。父母基金利用混合的历史和预期纵向队列来解决这些对公共卫生具有重大意义的研究问题，将现有的临床数据库连接起来，以构建加州当代亚洲人的多种族样本的大型(140,000名亚洲成年人)队列。这项为期两年的修订研究旨在另外比较同一电子连接队列中的亚洲亚组中治疗2型糖尿病的口服药物的有效性。众所周知，2型糖尿病在种族/民族中表现不同，种族/民族对相同药物治疗的反应也不同。2型糖尿病的治疗选择很多，以前的研究表明，根据种族/民族，某些口服药物的代谢反应存在差异。这就需要更多针对种族/民族的数据来比较药物使用的效果，以便能够改善美国亚裔美国人的糖尿病护理。在临床队列中获得的丰富的现实生活数据将被用来比较亚洲亚组中治疗2型糖尿病的口服药物的有效性，并研究患者和医生对某些药物的现有偏好。根据这项竞争性修订，将调查最初选择口服药物(在医生和患者中)、现有口服药物对2型糖尿病及其并发症的中期和长期效果以及这些疗法的成本效益的预测因素。这一修订将为医生、患者和公共卫生倡导者提供关于亚裔美国人各种口服2型糖尿病疗法的临床和成本效益的宝贵知识。 公共卫生相关性：亚裔美国人(亚裔印度人、中国人、菲律宾人、日本人、韩国人和越南人)受2型糖尿病的影响不成比例。没有关于口服药物在亚裔美国人亚群中治疗2型糖尿病的比较有效性的数据。我们的研究将解决这一知识差距。

DESCRIPTION (provided by applicant): The revision to the parent grant, 5 R01 DK081371-02: "Identifying Disparities in Type 2 Diabetes Among Asian Americans: The Pan Asian Cohort Study," is in response to NOT-OD-09-058: "NIH Announces the Availability of Recovery Act Funds for Competitive Revision Applications." The parent grant is funded from January 15, 2009 - December 31, 2013 in response to Program Announcement PA-07-388: "Identifying and Reducing Diabetes and Obesity Related Health Disparities within Healthcare Systems (R01)." This five-year study addresses the lack of knowledge regarding type 2 diabetes and obesity in Asian Americans, both as an aggregate group and as distinct subgroups. Relatively little is known about how Asian subgroups differ in type 2 diabetes riskfactors and complications when compared to the Non-Hispanic White population, for which numerous study findings have informed both practice of care and public health efforts in the United States. The parent grant utilizes a mixed historical and prospective longitudinal cohort to address these research questions of significant public health import, linking existing clinical databases to construct a large (140,000 Asian adults) cohort of a multiethnic sample of contemporary Asians in California. The revision, a two-year study, aims to additionally compare the effectiveness of oral drugs for treatment of type 2 diabetes among Asian subgroups in the same electronically linked cohort. It is well-known that type 2 diabetes manifests differently in race/ethnic groups, and that race/ethnic groups respond differently to the same pharmacotherapy. Treatment options for type 2 diabetes are numerous, and previous studies have demonstrated differences in metabolic responses to certain oral drugs according to race/ethnicity. This creates a need for more race/ethnic specific data comparing the effects of medication use to be able to improve diabetes care in Asian Americans in the United States. The wealth of real-life data captured within the clinical cohort will be utilized to compare the effectiveness of oral drugs to treat type 2 diabetes among Asian subgroups and to study existing preferences for certain drugs among patients and physicians. Predictors of initial choice of oral drug (in physicians and patients), intermediate and long-term effectiveness of existing oral drugs on type 2 diabetes and its complications, and the cost-effectiveness of these therapies will be investigated under this competitive revision. This revision will contribute valuable knowledge for physicians, patients, and public health advocates on the clinical and cost effectiveness of various oral type 2diabetes therapies in Asian Americans. PUBLIC HEALTH RELEVANCE: Asian Americans (Asian Indian, Chinese, Filipino, Japanese, Korean, and Vietnamese) are disproportionately affected by type 2 diabetes. There is no data on comparative effectiveness of oral drugs to treat type 2 diabetes in Asian American subgroups. Our study will address this gap in knowledge.