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

• DOI: 10.1370/afm.1853
• Publication Date: 2015-08-24T17:32:59Z
• Authors: J. Yin; R. Wong; S. Au; H. Chung; M. Lau; L. Lin; C. Tsang; K. Lau; R. Ozaki; W. So; G. Ko; A. Luk; R. Yeung; J. C. N. Chan
• Keywords: Adult; Blood Glucose; Counseling; Glycated Hemoglobin; Male; China; Adolescent; Social Support; Middle Aged; Peer Group; Education; 3. Good health; Self Care; Young Adult; 03 medical and health sciences; 0302 clinical medicine; Diabetes Mellitus, Type 2; Humans; Patient Compliance; Female; Aged

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.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.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).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.