Identifying and Overcoming Barriers to Diabetes Management in the Elderly: An Intervention Study; Annual rept. 1 Jun 2007-31 May 2008

摘要

During this research period, we have identified patients over age 70 with diabetes and poor glycemic control as defied by A1c>8%, and randomized them to either geriatric diabetes intervention team (GDT) or attention control group. Subjects in GD group underwent comprehensive geriatric assessment and have individualized intervention plan formed. The interventions are now being implemented with help of a geriatric life specialist (GLS). Intervention by GDT includes focused strategies to overcome barriers in the areas of clinical care, education, social environment, and finances. In addition, study subjects in GDTarm also underwent cerebral blood flow study. At the end of 6 months of intervention, goal is to develop support network that will empower patients to sustain improvements seen during the intervention. The subjects in the control group will have similar contact time as GDT group with research diabetes team without geriatric expertise. Clinical functional, quality of life and economical outcome measures in both groups are assessed at baseline and will be compared at 6 and 12 months intervals. These time points (0, 6 and 12 months) patients will also be evaluated for effect of improved glycemic control on change in the cerebral perfusion. The first patient was recruited on January 8, 2008, and there are no findings at this time.