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October 18th, 2010
06:14 PM ET

Study shows peer support benefits diabetes patients

Peer-support improves blood sugar control in patients with diabetes, according to a study published Monday in the Annals of Internal Medicine. Findings confirmed phone calls to peers facing similar disease-management issues offered an alternative and rather beneficial approach to traditional nurse-care for patients with diabetes.

Traditional nurse-care management programs are not useful for all patients with diabetes. Lack of face-to-face meeting time and financial barriers set hurdles in creating quality management programs. One of the costliest diseases, diabetes is an expensive disease to treat. Even more so, the cost of taking a pill to control blood sugar levels is on the rise.

“We know that many, many people with diabetes know what they are supposed to be doing – taking medications, starting insulin if oral medications alone no longer work well enough, following diet plans, maintaining physical activity, monitoring disease status and symptoms – but [patients] find it too difficult to do well. They also may know what they are supposed to do but not how to do it,” noted Michele Heisler, the study’s lead researcher and an associate professor of Medicine and Health Behavior and Health Education at University of Michigan. “Many people need more self-management support than over-extended health care systems can provide.”

Researchers assigned 244 male veterans with uncontrolled diabetes to either peer-support or a traditional nurse-care management program. Patients with uncontrolled diabetes had high blood sugar levels during the three months prior to the study’s onset as measured by hemoglobin A1c levels, according to Heisler, a primary care physician at VA Ann Arbor Healthcare System.

Patients assigned to the traditional nurse-care program attended an educational session and received assignment to a nurse-case manager. In the peer-support set-up, researchers matched patients with diabetes similar in age. Before the intervention, the peers underwent basic training on peer communication. Patients initially met in a group setting to define their individual self-management goals and outlined steps to reach their disease management goals. From there on out, the peers made phone calls to each other at least once per week. The phone calls aimed to touch base about the progress of the peers’ efforts of disease management and to provide mutual encouragement.

The assignments in the peer-to-peer support model allowed patients to act not only as learners, but teachers, as well.

“We explicitly wanted to test whether patients who were having self-management challenges and did not have good control of their diabetes might be better motivated themselves if given the opportunity to both help and receive help from another participant facing similar self-management challenges and who also had poor control,” according to Heisler. “Patients know a lot about living with their condition and strategies they have developed so have a lot to share with others also struggling.”

Researchers assessed the results of the peer intervention and nurse-care program by measuring changes in the patients’ hemoglobin A1c levels. Furthermore, researchers monitored patients’ blood pressure, changes in insulin therapy, and adherence to oral therapy regimens. The findings showed patients receiving peer support managed their conditions better. Lower hemoglobin A1c levels indicated higher control of blood sugars in patients receiving peer intervention.

Peer-support programs can improve the quality of self-management care and improve health outcomes in patients with diabetes.

“Diabetes management requires much more than regular visits to health care offices,” added Heisler. “We need to develop a menu tailored to people’s different needs of both face-to-face extension services, as well as use of technology whether the telephone as we used with the assistance of an interactive platform so people could maintain their privacy.”


soundoff (20 Responses)
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    October 19, 2010 at 11:04 | Report abuse | Reply
    • PasoParent

      A Type 1 inslulin-dependent diabetes patient would DIE if they took your advice. They NEED insulin–a natural hormone found in our pancreas, not a drug–to survive. They inject themselves w/insulin at mealtimes because their pancreas isn't working properly.

      October 19, 2010 at 13:54 | Report abuse |
  2. PasoParent

    This article needs to clarify that it's referring to TYPE 2 diabetes, not Type 1. My child was recently diagnosed w/Type 1, also known as juvenile diabetes or insulin-dependent diabetes. When I saw the headline, I clicked on the article only to find info that applies only to Type 2 patients. My son is not obese. He does not take oral meds. Poor diet and lack of exercise does not cause Type 1. This article says "diabetes" many times but it should make it clear to readers that it's referring to Type 2 diabetes.

    October 19, 2010 at 13:49 | Report abuse | Reply
  3. Elizabeth Workman

    My granddaughter, diagnosed with Type 1 Diabetes at the age of three years, is one of countless children who are ignored
    in every study that addresses "Diabetes", when in fact only Type 2 Diabeties research is mentioned. Type 1 Diabetes, and autoimmune attack on the child's own body, makes the day-in-and-day-out injection of insulin for the rest of their lives a necessary form of life support. All articles should clearly represent which form of Diabetes are being presented.

    October 20, 2010 at 09:16 | Report abuse | Reply
  4. John

    This article is very well written. I appreciate the writer making us aware of this study.

    October 21, 2010 at 10:36 | Report abuse | Reply
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    It is really great to read the article.

    October 22, 2010 at 01:16 | Report abuse | Reply
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    It is really great to read the article. The article is very helpful for diabetes sufferers. Along with proper diabetes education, you should undergo regular diabetes screening for proper management of your disease. Diabetes education Hemet

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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.