Please select the eligibility criteria that correspond to the clinical trial below.
Title: Identifying and Overcoming Barriers to Diabetes Management in the Elderly: A Cost-effective Intervention Study
Brief Summary: The purpose of this study is to find ways to identify barriers that affect self care in older adult with diabetes and to provide cost effective coping strategies to improve clinical, functional and psychosocial measures.


Options:
A: Inclusion Criteria:

For Patients With Type 1 Diabetes

* Aged 18-65
* Presence of type 1 diabetes mellitus.
* 2-25 year duration.

For Patients With Type 2 Diabetes

* Aged 25-65 years
* presence of type 2 diabetes mellitus.
* 2 years since initial diagnosis.

Exclusion Criteria:

* Renal disease, microalbumin \>300 ug/mg)
* Severe peripheral diabetic neuropathy and/or severe peripheral vascular disease
* Symptomatic severe autonomic neuropathy who may be at risk when increasing activity levels.
* Women who are currently pregnant
* proliferative diabetic retinopathy based on dilated eye examination within one year of study entry. Patients whose eye disease is successfully treated will be included.
* HbA1c levels less than 7.0% (normal range 4.0 - 6.0%).
* HbA1c levels greater than 14.0%
* patients who underwent intensive insulin treatment within one year
* a history of severe, unstable myocardial infarction, congestive heart failure or other severe cardiac disease, severe hypertension (systolic more than 160 mmHg or diastolic 90 mmHg) who may be at risk when mildly increasing physical activity
* a DSMIV diagnosis of eating disorders including anorexia nervosa, bulimia, and severe weight-related insulin omission.
* Patients with recent diagnosis (past 6 months) of bipolar disorder, schizophrenia, mental retardation, organic mental disorder, and alcohol or drug abuse
* Patients whose diabetes diagnosed cannot be clearly classified as type 1 or type 2.
B: Inclusion Criteria:

* Age 70 years and older
* Diagnosis of type 1 or type 2 diabetes
* Seen at Joslin Clinic or Beth Israel Deaconess Medical Center for at least one year
* HbA1c 8% X 2 in past 6 months without fluctuation of more than 0.5% (i.e. stable poor control)
* No major change in medications in past 3 months, e.g. addition of insulin or another hypoglycemic agent

Exclusion Criteria:

* Patients with terminal diseases, e.g. malignancy with expected life expectancy of 12 months or less
* Patients who live more than 25 miles from Joslin Clinic/Beth Israel Deaconess Medical Center
* Patients who live in an institutional setting (e.g. nursing home, group home, etc)
* Patients who are not able to complete outcome assessments, (e.g. poor vision, diminished mental capacity/severe cognitive decline, unable to speak/read/write English
C: Inclusion Criteria:

* English-speaking individuals
* Diagnosed with non-insulin requiring type 2 diabetes
* Outpatients
* Baseline A1c of 7.5% or higher

Exclusion Criteria:

* Patients who are deemed unable to use a mobile phone (e.g. due to vision problems), and/or to comply with home monitoring (e.g. suffering from anxiety or depression)
* Diabetes duration \<1 year
D: 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)

Answer: B