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Title: Older People With Type 2 Diabetes-Individualizing Management With a Specialized (OPTIMISE) Community Team: Protocol for a Safety and Feasibility Mixed Methods Study.
Austin Authors: Ogrin, Rajna;Neoh, Sandra;Aylen, Tracy;Audehm, Ralph;Churilov, Leonid ;Thurgood, Lorenna;Major, Georgia;Zajac, Jeffrey D ;Ekinci, Elif I 
Affiliation: Austin Health, Heidelberg, Australia
Bolton Clarke, Forest Hill, Australia
Department of General Practice, University of Melbourne, Parkville, Australia
National Ageing Research Institute, Parkville, Australia
Department of Endocrinology, Austin Health, Heidelberg, Victoria, Australia
RMIT Unversity, Melbourne, Australia
The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Heidelberg, Victoria, Australia
Bolton Clarke Research Institute, Bolton Clarke, Bentleigh, Australia
Austin Health Clinical School, The University of Melbourne, Heidelberg, Victoria, Australia
Issue Date: 7-Jun-2019 2019-06-07
Publication information: JMIR research protocols 2019; 8(6): e13986
Abstract: The prevalence of diabetes is rising in older people. In 2018, over 574,000 Australians reported having diabetes. The highest prevalence (19.4%) of diabetes has been observed in people aged 85 years and older. Clinical guidelines recommend that diabetes management should be individualized; however, there is limited information regarding the current management patterns of diabetes in older people, given most clinical trials exclude participants from this age group. Available data identify that few individuals achieve optimal glycemic levels in the general population, potentially leading to adverse health outcomes and impact on quality of life. The data on glycemic profiles of older population are limited. The aim of this study is to examine individualized diabetes management intervention for older people through home visits with a credentialed diabetes educator (CDE) and telehealth consultations with an endocrinologist located at a tertiary hospital. This paper describes the design and methodology of a mixed methods feasibility and safety study to identify the current management of type 2 diabetes in people aged 65 years or older. We will implement and evaluate a personalized approach to management in the community of an Australian metropolitan city. This management approach will utilize flash glucose monitoring and home visits with the support of a community home nursing service CDE and telehealth consultation with an endocrinologist located at a local tertiary hospital. The study commenced in February 2017 and has recruited 43 participants, with final data collection to be completed by July 2019. Data analysis will commence after final data collection, with results expected to be published by the end of 2019. This study is the first of its kind to explore individualized diabetes management for community-dwelling older people, with an aim to achieve optimal glycemic levels (glycated hemoglobin between 53 and 69 mmol/mol [7%-8.5%] depending on the fitness and frailness of the older individual). The data drawn from this study may be used to inform policy makers, service providers, clinicians, and older adults living with diabetes. DERR1-10.2196/13986.
DOI: 10.2196/13986
ORCID: 0000-0002-4192-7254
PubMed URL: 31199316
ISSN: 1929-0748
Type: Journal Article
Subjects: aged
type 2 diabetes mellitus
Appears in Collections:Journal articles

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