Effects of Providing Peer Support on Diabetes Management in People With Type 2 Diabetes

Ann Fam Med. 2015 Aug;13 Suppl 1(Suppl 1):S42-9. doi: 10.1370/afm.1853.

Abstract

Purpose: We examined the effects of participating in a "train-the-trainer" program and being a peer supporter on metabolic and cognitive/psychological/behavioral parameters in Chinese patients with type 2 diabetes.

Methods: In response to our invitation, 79 patients with fair glycemic control (HbA1c <8%) agreed to participate in a "train-the-trainer" program to become peer supporters. Of the 59 who completed the program successfully, 33 agreed to be peer supporters ("agreed trainees") and were each assigned to support 10 patients for 1 year, with a voluntary extension period of 3 additional years, while 26 trainees declined to be supporters ("refused trainees"). A group of 60 patients with fair glycemic control who did not attend the training program and were under usual care were selected as a comparison group. The primary outcome was the change in average HbA1c levels for the 3 groups from baseline to 6 months.

Results: At 6 months, HbA1c was unchanged in the trainees (at baseline, 7.1 ± 0.3%; at 6 months, 7.1 ± 1.1%) but increased in the comparison group (at baseline, 7.1 ± 0.5%; at 6 months, 7.3 ± 1.1%. P = .02 for between-group comparison). Self-reported self-care activities including diet adherence and foot care improved in the trainees but not the comparison group. After 4 years, HbA1c remained stable among the agreed trainees (at baseline, 7.0 ± 0.2%; at 4 years: 7.2 ± 0.6%), compared with increases in the refused trainees (at baseline, 7.1 ± 0.4%; at 4 years, 7.8 ± 0.8%) and comparison group (at baseline, 7.1 ± 0.5%; at 4 years, 8.1 ± 0.6%. P = .001 for between-group comparison).

Conclusions: Patients with diabetes who engaged in providing ongoing peer support to other patients with diabetes improved their self-care while maintaining glycemic control over 4 years.

Keywords: diabetes self-care; peer support; social support; type 2 diabetes mellitus.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Blood Glucose / analysis
  • China
  • Counseling / education*
  • Counseling / methods
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / psychology
  • Diabetes Mellitus, Type 2 / therapy*
  • Education / methods
  • Female
  • Glycated Hemoglobin A / analysis
  • Humans
  • Male
  • Middle Aged
  • Patient Compliance / psychology
  • Peer Group*
  • Self Care / methods*
  • Self Care / psychology
  • Social Support*
  • Young Adult

Substances

  • Blood Glucose
  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human