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.In elderly with diabetes, the presence of significant co-morbidities act as barriers to the patient's ability to manage their diabetes and requires patient specific intervention for effective management. In a pilot study, we have identified multiple co-morbidities including cognitive dysfunction, depression and functional disabilities in older patients with diabetes and have observed associated poor glycemic control. Specific intervention to overcome geriatric specific barriers was found to improve glycemic control in a subset of elderly with diabetes. Based on these preliminary data, we hypothesize that a short term focused intervention by a geriatric multidisciplinary diabetes team (GDT) specifically directed at potential barriers to diabetes management can cost-effectively improve diabetes control, functional status and quality of life in the elderly. Patients over age 70 with diabetes will be randomized to care by either a geriatric diabetes intervention team (GDT) or attention control group. Subjects in the GDT group will undergo comprehensive geriatric assessment and will have individualized intervention performed. The subjects in the other gruop will have similar contact time as the GDT group. Improvement in clinical functional quality of life and economic outcome measures in both groups will be compared at 6 and 12 month intervals.
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