Community-based peer-led diabetes self-management: a randomized trial.
The purpose of this study is to determine the effectiveness of a community-based diabetes self-management program comparing treatment participants to a randomized usual-care control group at 6 months.



A total of 345 adults with type 2 diabetes but no criteria for high A1C were randomized to a usual-care control group or 6-week community-based, peer-led diabetes self-management program (DSMP). Randomized participants were compared at 6 months. The DSMP intervention participants were followed for an additional 6 months (12 months total). A1C and body mass index were measured at baseline, 6 months, and 12 months. All other data were collected by self-administered questionnaires.



At 6 months, DSMP participants did not demonstrate improvements in A1C as compared with controls. Baseline A1C was much lower than in similar trials. Participants did have significant improvements in depression, symptoms of hypoglycemia, communication with physicians, healthy eating, and reading food labels (P < .01). They also had significant improvements in patient activation and self-efficacy. At 12 months, DSMP intervention participants continued to demonstrate improvements in depression, communication with physicians, healthy eating, patient activation, and self-efficacy (P < .01). There were no significant changes in utilization measures.



These findings suggest that people with diabetes without elevated A1C can benefit from a community-based, peer-led diabetes program. Given the large number of people with diabetes and lack of low-cost diabetes education, the DSMP deserves consideration for implementation.
Lorig
Kate
K
Stanford University School of Medicine, USA.
Ritter
Philip L
PL
Stanford University School of Medicine, USA.
Villa
Frank J
FJ
Stanford University School of Medicine, USA.
Armas
Jean
J
Stanford University School of Medicine, USA.
D000328:Adult; D000368:Aged; D003863:Depression / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000523:psychology / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D018579:Patient Selection; D010379:Peer Group; D012648:Self Care; D011795:Surveys and Questionnaires; D055815:Young Adult
D006442:Glycated Hemoglobin