Please select the eligibility criteria that correspond to the clinical trial below.
Title: Evaluation of a Toolkit to Improve Cardiovascular Disease Screening and Treatment for People With Type 2 Diabetes
Brief Summary: Diabetes is a common and serious chronic disease. However, there is a large gap between the level of care that people should receive (based on research and guidelines) and the level of care they actually receive. With the release of their 2008 Clinical Practice Guidelines, the Canadian Diabetes Association has a strategy to improve heart disease screening and treatment for people with diabetes. This study will evaluate whether the strategy works. The focus of the strategy was to give all family physicians in Canada a Toolkit in June 2009 to help them delivery better care for their diabetic patients. In Ontario, only half of doctors received this Toolkit. We will compare the quality of care received by diabetic patients whose doctors received this Toolkit versus those who doctors did not.


Options:
A: Inclusion Criteria:

* Age 18 years or older
* Diabetes, defined as either 1) filled a prescription for insulin or an oral hypoglycemic agent; or, 2) had two outpatient or one inpatient or two outpatients encounter claims with an ICD9-CM or CPT code indicating diabetes.
* Gap in a key diabetes management metric as evidenced by no claim for a dilated eye examination in the prior 15 months and no claim for one or more of the following tests: glycated hemoglobin, LDL-cholesterol, or microalbumin. (Individuals with evidence of having received ACE-inhibitors or angiotensin receptor blockers were considered to have had a microalbumin test.)

Exclusion Criteria:

* No primary care clinician in the data base
* Those who had previously asked the health plan to exclude them from research or quality improvement
* Women whose claim records contained diagnoses suggesting gestational diabetes
B: Inclusion Criteria:

* Type 2 diabetes
* age \> 18 years old who are at high risk based on any one of the following criteria:

  * HbA1C \> 8.5
  * LDL \> 130
  * BP \> 140/90 within the last 6 months

Exclusion Criteria:

* patients who are pregnant upon entry in the study (however if a patient becomes pregnant in the course of the study, she can continue with the study)
* unable to communicate in either English or Spanish
* in nursing homes (and therefore unable to attend outpatient visits)
C: Inclusion Criteria:

* Patient with diagnosed diabetes
* Seen in the office of a participating family physician at least once between July 2009 and April 2010
* At high risk for cardiovascular events:

  * Previous cardiovascular disease (including AMI, angina, stroke, TIA, claudication); or
  * Men aged \>= 45 years, women aged \>= 50 years; or
  * Men aged \< 45 years, women aged \< 50 years with at least one of the following:

    1. Macrovascular disease (silent myocardial infarction, or evidence of peripheral arterial, carotid or cerebrovascular disease)
    2. Microvascular disease (nephropathy or retinopathy)
    3. Family history of premature coronary or cerebrovascular disease in a first-degree relative
    4. Duration of diabetes \> 15 years with age \> 30 years
D: Inclusion Criteria:

* ages 18-79
* diagnoses of diabetes, hypertension, and/or congestive heart failure

Exclusion Criteria:

* pregnant
* unable to understand randomization process

Answer: C