Diabetes
Conditions
Keywords
Intervention, Cost Effective, Elderly, Glycemic Control
Brief summary
The purpose of this study is to find ways to identify barriers that affect self care in older adult with diabetes and to provide cost effective coping strategies to improve clinical, functional and psychosocial measures.
Detailed description
This is a study to evaluate whether short term focused intervention by a geriatric diabetes team to help overcome barriers to diabetes care in older adults will result in improved clinical, functional, and quality of life measures compared to usual care in a cost effective manner. In addition, we will assess whether the support network formed during intervention by the geriatric diabetes team will empower patients, resulting in long lasting improvement in parameters after intervention is completed.
Interventions
BEHAVIORALBehavioral
the intervention included developing strategies to help patients cope with their barriers to self care. The intervention were implemented by an office based educator over a six month by phone calls. From six months to twelve months subjects did not have any contact with study staff.
Sponsors
American Diabetes Association
Joslin Diabetes Center
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
69 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age 70 years and older * Diagnosis of type 1 or type 2 diabetes * Seen at Joslin Clinic or Beth Israel Deaconess Medical Center for at least one year * HbA1c 8% X 2 in past 6 months without fluctuation of more than 0.5% (i.e. stable poor control) * No major change in medications in past 3 months, e.g. addition of insulin or another hypoglycemic agent
Exclusion criteria
* Patients with terminal diseases, e.g. malignancy with expected life expectancy of 12 months or less * Patients who live more than 25 miles from Joslin Clinic/Beth Israel Deaconess Medical Center * Patients who live in an institutional setting (e.g. nursing home, group home, etc) * Patients who are not able to complete outcome assessments, (e.g. poor vision, diminished mental capacity/severe cognitive decline, unable to speak/read/write English
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Hemoglobin A1c | 6 and 12 months | The primary outcomes of the study is to measure change in A1c before and after intervention. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| functionality | 6 and 12 months | 6-minute walk test, Tinetti test, number of falls and fear of falls, activities of daily living and instrumental activities of daily living |
| Cognitive function | 6 and 12 months | cognitive function test by modified clock drawing test, verbal fluency and Trail-making tests A and B |
| Depression | 6 and 12 months | Geriatric depression scale |
| Hypoglycemia | 6 and 12 months | Frequency of hypoglycemia by history and by hypoglycemia calendar |
| Problem areas in diabetes | 6 and 12 months | Measure of diabetes-related distress |
| Economic impact | 6 and 12 months | number of emergency room visit, hospitalizations for diabetes-related illnesses, out-patient care utilization in the form of clinic visits |
| Self care inventory - revised | 6 and 12 months | frequency of self-care measures |
Countries
United States
Outcome results
None listed