"Peer Support" intervention to improve glycemic control in type 2 diabetes mellitus: A literature review

Hyperglycemia is one of the complications of Type 2 Diabetes Mellitus (T2DM). Continuation of this situation in T2DM will lead to more serious complications such as morbidity and death. There are improvements and advances in the management of T2DM at present, but they are accompanied by an increase in medical costs. To solve these problems, an organized approach is needed to control hyperglycemia through peer support interventions which are considered to be able to reduce treatment costs. Peer support may take advantage of the ability of diabetes patients to support each other in managing their daily lives, which is very useful as a step to promote the type of daily behavioral efforts needed to prevent disease progression. This study aimed to identify the effect of peer support intervention in improving glycemic control in patients with T2DM. This study was a literature review using seven databases including PubMed, ScienceDirect, ProQuest, Clinical Key, Cochrane, Ebsco, and DOAJ. Inclusion criteria were: articles published in the last 10 years, in full text and in English version. Five studies were reviewed that met the inclusion criteria. The results of this review showed the effectiveness of peer support in improving glycemic control in diabetes patients. Peer support significantly lowered HbA1c and also led to a significant reduction in fasting blood sugar. Peer support may reduce glycosylated blood hemoglobin levels, increase knowledge regarding insulin use and increase diabetes self-management skills, especially in patients who do not have literacy skills. In conclusion, peer support can be used as a non-pharmacological therapy to improve glycemic control in patients with T2DM.

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Peer Support Intervention’s Impact on Glycemic Control Among Type 2 Diabetes Mellitus Patients

Jurnal Ners dan Kebidanan Indonesia ◽

10.21927/jnki.2020.8(4).308-314 ◽

2021 ◽

Vol 8 (4) ◽

pp. 308

Author(s):

Dita Hanna Febriani

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Glycemic Control ◽

Peer Support ◽

Positive Impact ◽

Inclusion Criteria ◽

Support Intervention ◽

Peer Support Intervention

Several models have been developed to provide support for patient self-management to control their blood glucose. Peer support intervention believed to bring positive impact on glycemic control in patient with type 2 diabetes mellitus. The aim of this review was to identify the effect of several peer support interventions on glycemic control among adult with type 2 diabetes mellitus. An integrative search was conducted in electronic databased Pub Med, CINALH, and Cochrane. The inclusion criteria of studies included were employed peer support intervention, randomized control trial in patient with type 2 diabetes mellitus, glycemic control as outcome, English language, published in last 10 years, and available in free full text. Seven studies met the inclusion criteria and included in the further analysis. Five studies reported peer support intervention found statistically significant to improve glycemic control through decreasing HbA1c level. Short term peer support intervention provide potential benefit on glycemic control.

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Effect of coaching on glycemic control among type 2 diabetes mellitus patients: A literature review

Enfermería Clínica ◽

10.1016/j.enfcli.2019.07.068 ◽

2020 ◽

Vol 30 ◽

pp. 158-162

Author(s):

Sri Marnianti Irnawan ◽

Syahrul Syahrul

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Glycemic Control ◽

Literature Review

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A peer support intervention in improving glycemic control in patients with type 2 diabetes

Patient Education and Counseling ◽

10.1016/j.pec.2017.10.007 ◽

2018 ◽

Vol 101 (3) ◽

pp. 460-466 ◽

Cited By ~ 15

Author(s):

Maryam Peimani ◽

Fateme Monjazebi ◽

Robabeh Ghodssi-Ghassemabadi ◽

Ensieh Nasli-Esfahani

Keyword(s):

Type 2 Diabetes ◽

Glycemic Control ◽

Peer Support ◽

Support Intervention ◽

Peer Support Intervention

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Diabetes Distress and Glycemic Control in Type 2 Diabetes: Mediator and Moderator Analysis of a Peer Support Intervention (Preprint)

10.2196/preprints.21400 ◽

2020 ◽

Author(s):

Kara Mizokami-Stout ◽

Hwajung Choi ◽

Caroline R Richardson ◽

Gretchen Piatt ◽

Michele Heisler

Keyword(s):

Type 2 Diabetes ◽

Glycemic Control ◽

Peer Support ◽

Goal Setting ◽

Perceived Competence ◽

Diabetes Distress ◽

Support Intervention ◽

Insulin Use ◽

Peer Support Intervention

BACKGROUND High levels of psychosocial distress are correlated with worse glycemic control as measured by glycosylated hemoglobin levels (HbA1c). Some interventions specifically targeting diabetes distress have been shown to lead to lower HbA1c values, but the underlying mechanisms mediating this improvement are unknown. In addition, while type 2 diabetes mellitus (T2D) disproportionately affects low-income racial and ethnic minority populations, it is unclear whether interventions targeting distress are differentially effective depending on participants’ baseline characteristics. OBJECTIVE Our objective was to evaluate the mediators and moderators that would inform interventions for improvements in both glycemic control and diabetes distress. METHODS Our target population included 290 Veterans Affairs patients with T2D enrolled in a comparative effectiveness trial of peer support alone versus technology-enhanced peer support with primary and secondary outcomes including HbA1c and diabetes distress at 6 months. Participants in both arms had significant improvements in both HbA1c and diabetes distress at 6 months, so the arms were pooled for all analyses. Goal setting, perceived competence, intrinsic motivation, and decisional conflict were evaluated as possible mediators of improvements in both diabetes distress and HbA1c. Baseline patient characteristics evaluated as potential moderators included age, race, highest level of education attained, employment status, income, health literacy, duration of diabetes, insulin use, baseline HbA1c, diabetes-specific social support, and depression. RESULTS Among the primarily African American male veterans with T2D, the median age was 63 (SD 10.2) years with a baseline mean HbA1c of 9.1% (SD 1.7%). Improvements in diabetes distress were correlated with improvements in HbA1c in both bivariate and multivariable models adjusted for age, race, health literacy, duration of diabetes, and baseline HbA1c. Improved goal setting and perceived competence were found to mediate both the improvements in diabetes distress and in HbA1c, together accounting for 20% of the effect of diabetes distress on change in HbA1c. Race and insulin use were found to be significant moderators of improvements in diabetes distress and improved HbA1c. CONCLUSIONS Prior studies have demonstrated that some but not all interventions that improve diabetes distress can lead to improved glycemic control. This study found that both improved goal setting and perceived competence over the course of the peer support intervention mediated both improved diabetes distress and improved HbA1c. This suggests that future interventions targeting diabetes distress should also incorporate elements to increase goal setting and perceived competence. The intervention effect of improvements in diabetes distress on glycemic control in peer support may be more pronounced among White and insulin-dependent veterans. Additional research is needed to understand how to better target diabetes distress and glycemic control in other vulnerable populations.

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