This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.This is a study to evaluate whether short term focused intervention performed by a geriatric team helping to overcome barriers to diabetes care in older adults, will result in improved diabetes control, physical function, and quality of life while decreasing healthcare costs. In addition, we will assess whether the support network formed during intervention by the geriatric team will empower patients, resulting in long lasting improvement in parameters after intervention is completed. We will also explore whether improved blood glucose control will improve blood circulation in the brain that is compromised in elderly with diabetes.In this study, we will enroll 100 patients from the Joslin Diabetes Clinic who continue to have elevated blood glucose levels despite 1 year of care by Joslin providers. These patients will be randomly assigned to either the geriatric diabetes team (GDT) or an attention control team (ACT). The GDT will perform a comprehensive assessment of each subject and create treatment plans tailored to the needs and abilities of each patient. The ACT will provide usual diabetes care ( ie. Diabetes education and nutritional counseling), matching the 'attention time' given to the subjects seen by the GDT. The intervention period will last for 6 months, at which time improvement in blood glucose control, overall physical health, and quality of life will be measured. After six months, study subjects will enter and 'independent period' lasting another 6 months. During this period, study patient will manage their care on their own without any intervention to see if improvements in parameters achieved during the 6 month intervention period are sustainable over longer period of time. In addition , Doppler studies to evaluate circulation in brain arteries will be evaluated at study entry, 6 months and 112 months to assess any improvement in blood flow in the brain with improved blood glucose control.
Showing the most recent 10 out of 642 publications
