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 diabetes patients the presence of co-morbidities act as potential barriers to the patient's ability to manage their diabetes. In a pilot study in older patients with diabetes, comorbidities including cognitive dysfunction, depression, and functional disabilities were associated with poor glycemic control that required specific management interventions. Based on these preliminary data, we hypothesize that a short-term intervention by a geriatric diabetes team (GDT) targeting potential barriers to diabetes management can cost-effectively improves diabetes care, functionality and quality of life in the elderly. Towards this goal, we will investigate 1) whether a focused intervention in elderly diabetes patient by the GDT is superior to usual care with attention control team (ACT) and 2) whether, by empowering elderly patients, the GDT intervention has a persistent effect on outcome measures when compared to the attention control. Patients will be randomized to either the GDT or ACT group. Subjects in the GDT group will undergo targeted geriatric assessment and will have individualized interventions performed. Subjects in the ACT group will have equivalent contact time with the research diabetes team as GDT group, but without geriatric expertise. Clinical, psychosocial, functional, and economic measures taken from both groups will be compared to 6 month intervals. This study may help guide management of elderly patients with diabetes, revealing that interventions combining disease and focused geriatric care management may result in medical, functional, economical and quality of life improvements.
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