An evaluation of the effectiveness of a multi-modal intervention in frail and pre-frail older people with type 2 diabetes--the MID-Frail study: study protocol for a randomised controlled trial.
BACKGROUND
Diabetes, a highly prevalent, chronic disease, is associated with increasing frailty and functional decline in older people, with concomitant personal, social, and public health implications. We describe the rationale and methods of the multi-modal intervention in diabetes in frailty (MID-Frail) study.


METHODS
The MID-Frail study is an open, randomised, multicentre study, with random allocation by clusters (each trial site) to a usual care group or an intervention group. A total of 1,718 subjects will be randomised with each site enrolling on average 14 or 15 subjects. The primary objective of the study is to evaluate, in comparison with usual clinical practice, the effectiveness of a multi-modal intervention (specific clinical targets, education, diet, and resistance training exercise) in frail and pre-frail subjects aged ≥70 years with type 2 diabetes in terms of the difference in function 2 years post-randomisation. Difference in function will be measured by changes in a summary ordinal score on the short physical performance battery (SPPB) of at least one point. Secondary outcomes include daily activities, economic evaluation, and quality of life.


CONCLUSIONS
The MID-Frail study will provide evidence on the clinical, functional, social, and economic impact of a multi-modal approach in frail and pre-frail older people with type 2 diabetes.


BACKGROUND
ClinicalTrials.gov: NCT01654341.
Leocadio
L
Rodríguez-Mañas
Antony J
AJ
Bayer
Mark
M
Kelly
Andrej
A
Zeyfang
Mikel
M
Izquierdo
Olga
O
Laosa
Timothy C
TC
Hardman
Institute of Diabetes for Older People (IDOP), University of Bedfordshire, Putteridge Bury Campus, Hitchin Road, Luton, Bedfordshire LU2 8LE, UK. alan.sinclair@beds.ac.uk.
Alan J
AJ
Sinclair
Severina
S
Moreira
Justin
J
Cook
D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D002985:Clinical Protocols; D003131:Combined Modality Therapy; D003362:Cost-Benefit Analysis; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000191:economics / Q000628:therapy*; D004032:Diet / Q000009:adverse effects / Q000191:economics; D005060:Europe; D016330:Frail Elderly; D017048:Health Care Costs; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D010353:Patient Education as Topic / Q000191:economics; D011788:Quality of Life; D012107:Research Design; D055070:Resistance Training / Q000191:economics; D013997:Time Factors; D016896:Treatment Outcome