Please select the eligibility criteria that correspond to the clinical trial below.
Title: RENEWING HEALTH Large-scale Real-life Study in Finland
Brief Summary: The purpose of this trial is to determine if by structured telephone based health coaching programme supported by remote monitoring system among type 2 diabetes, coronary artery disease and heart failure patients the investigators are able to improve their quality of life as measured by the SF-36 questionnaire and reduce a value of HbA1c under 6,5 % among those type 2 diabetes patients who had elevated value of HbA1c when recruited.


Options:
A: Inclusion Criteria:

* Age \> 18 years
* Capability of filling in questionnaires in Finnish language.
* Be able to use Remote Patient Monitoring System
* Be able to use the devices provided
* Has adequate cognitive capacities to participate
* In their medical records, one or both of the following diagnoses:

  a) Type 2 Diabetes, for enrolment
* diagnosed over 3 months prior to the enrolment and
* HbA1c \> 6,5 % b) Heart Disease, for enrolment
* Ischemic heart disease or
* Heart Failure or
* Atrial fibrillation or
* Other arrhythmia
* Be able to walk

Exclusion Criteria:

* Not willing to participate (e.g., not willing to sign the consent)
B: Inclusion Criteria:

* Primary care at one of two participating sites,
* HbA1c \>= 7.5%, Systolic BP \> 140 OR Diastolic BP \> 90 on 2 consecutive measurements

Exclusion Criteria:

-Primary care provider excludes patient from study, -Patient states that primary care is shared with non-VA primary care provider, -New enrollment in endocrine clinic within the last 6 months, -Patient is reluctant to participate in group visit for any reason, -Reduced life expectancy, as determined by any of the following: -New York Heart Association Class IV congestive heart failure, -Lung disease requiring supplemental oxygen, -End-stage renal disease on dialysis, -Current malignancy with any evidence of disease or currently undergoing chemotherapy or radiation therapy, -Cirrhosis of the liver, or -AIDS (HIV disease does not exclude a patient in the absence of an AIDS diagnosis), -Five or more errors on Short Portable Mental Status Questionnaire, Psychotic illness with hospitalization within three years prior to enrollment
C: Inclusion criteria

Males and females aged ≥ 18 years who are diagnosed with:

1. T2DM or HPT or both
2. Seen at least once in the last one year at the primary care clinic for the above conditions

Exclusion criteria

1. Type 1 Diabetes Mellitus
2. Receiving renal dialysis
3. Presenting with severe HPT (Systolic BP \>180mmHg and/or Diastolic BP \>110 mmHg)
4. Diagnosed with conditions resulting in secondary hypertension
5. Diagnosed to have circulatory disorders needing referral to secondary care over the last 1 year e.g. unstable angina, heart attack, stroke, transient ischaemic attacks
6. Receiving shared care between primary and secondary care for complications of T2DM and/or HPT
7. Pregnancy
8. Enrolled in another study

All patients in the intervention arm are required to be seen at least twice by the CDM team of each clinic during the 1-year intervention period. Those who do not comply are considered as lost to follow-up. There is no limit to the number of clinic visits a patient is allowed to make in either arm during the course of the study.
D: Inclusion Criteria:

* Full time family physicians (FP) \>25 hours per week in office
* Ability to generate a listing of patients with type 2 diabetes (T2DM) from their practice or billing records.
* Generation of a practice list of patients with T2DM
* A minimum of 50 patients with type 2 diabetes in their practice.
* Support the generation of a Diabetes Practice Profile prior to the deadline established
* A minimum of 6 insulin-eligible patients
* Attendance at the scheduled Workshop (if unable to attend the Workshop must be available to be educated and trained by diabetes nurse educator(DNE) using a Workshop DVD)

Exclusion Criteria:

* FP does not attend Workshop or complete educational training using Workshop DVD with DNE guidance
* FPs who anticipate retiring within the post-intervention period, moving their practice to another city, or having locum coverage of their practice for more than 4 weeks during the post-intervention period
* FPs currently participating in a diabetes behaviour-change intervention trial
* FPs working in an academic environment
* FPs unlikely to comply with protocol, (uncooperative attitude, unlikelihood of completing the study).

Answer: A