Please select the eligibility criteria that correspond to the clinical trial below.
Title: Advanced Comprehensive Diabetes Care for Veterans With Poorly-Controlled Diabetes
Brief Summary: This study will determine whether Home Telehealth-based implementation of an evidence-based intervention targeting Veterans with persistent poorly-controlled diabetes can improve hemoglobin A1c, patient self-management, and comorbid depressive symptoms in this high-risk, high-cost population. If effective, this intervention (Advanced Comprehensive Diabetes Care) offers a feasible, sustainable, and generalizable approach to managing Veterans with persistent poorly-controlled diabetes, which can be implemented using only existing Home Telehealth services.


Options:
A: Inclusion Criteria:

* Diagnosis of diabetes mellitus (based on fasting glucose, HbA1c, and problem list)
* At least 18 years old
* At least one face-to-face visit with Harvard Vanguard primary care clinician in the last 2 years

Exclusion Criteria:

* Any patient not categorized as either White or Black based on race identifier in the electronic medical record
B: Inclusion Criteria:

* African American male or female aged 30 years or older diagnosed with type 2 diabetes mellitus
* Able to provide 2 contact persons outside his/her household with active, verified telephone numbers

Exclusion Criteria:

* Mentally incompetent to give informed consent
* Refuses to give informed consent
* Comorbid health condition likely to lead to death in next 24 months
C: Inclusion Criteria:

* Adult patients \>= 25 years of age
* Type 2 diabetes for \>= 1 year
* Hemoglobin A1c \>= 7.5% and \<=11%
* Diabetes managed by exercise and diet, prescription oral medication or an injectable incretin mimetic

Exclusion Criteria:

* Type 1 diabetes
* On any type of insulin therapy at start of study
D: Inclusion Criteria:

* Veterans with type 2 diabetes managed for \> 1 year at an eligible site (Durham, Raleigh, Greenville, or Morehead City) will be eligible for enrollment.
* We will identify Veterans with PPDM (defined as the presence of at least 2 A1c values of \> 9.0% during the past year with no readings of \< 9.0% despite ongoing medical care) by reviewing electronic medical records and soliciting referrals from primary physicians.

Exclusion Criteria:

* Exclusion criteria will include lack of telephone access or severe hearing/ speech impairment that would limit:

  * telephone interaction
  * metastatic cancer
  * active psychosis documented in medical record
  * active alcohol or substance abuse
  * diagnosis of dementia
  * known pregnancy (patients becoming pregnant during the study will be withdrawn and referred to appropriate services)
  * documented seizure history
  * documented history of severe complications of hypoglycemia (such as coma or seizure)
  * documented refusal or inability to perform self-monitoring of blood glucose
  * ongoing use of warfarin with prior history of major bleeding event
* Due to challenges with dose adjustment by phone, Veterans on continuous subcutaneous insulin infusion (insulin pumps) will not be eligible for this study.

  * Due to challenges with regulations regarding testing supplies pts will need to be taking insulin (a few patients had enrolled prior to this change.).

Answer: D