title: Type 2 diabetes patients educated by other patients perform at least as well as patients trained by professionals.
abstract: BACKGROUND
  Diabetes education can improve the quality of care of people with diabetes, but many organizations are not equipped to manage its implementation. Involving people with diabetes in the education process can overcome the problem. Thus, we compared clinical, metabolic and psychological outcomes in people with type 2 diabetes 1 year after attending a structured diabetes education programme implemented by professional educators versus the same programme implemented by trained peers with diabetes that also provided ongoing peer support.
  
  
  METHODS
  People with type 2 diabetes (25-75 years) were randomly assigned to attend a 4-week structured diabetes education course delivered by professional educators (control) or previously trained peers (peer). Peers also received continuing psychological support, including examples on how to apply diabetes knowledge in daily life via weekly peer cellular phone calls and bimonthly face-to-face interviews in small groups (ten patients), using a structured questionnaire related to the patient's clinical, metabolic and psychological progress. Identical outcome data from both groups were used for follow-up.
  
  
  RESULTS
  Both groups had a comparable positive effect on clinical, metabolic and psychological indicators immediately following the programme. Over the following year, peer-educated subjects had lower A(1C) and systolic blood pressure and showed higher adherence to physical activity and better control of hypoglycaemic episodes.
  
  
  CONCLUSIONS
  The non-inferiority of the peer outcomes and the mentioned improvements in this group suggest that volunteer trained peer educators and ongoing support can be successful. This approach provides an effective alternative method of education, especially in areas with limited availability of professionals and economic resources.
authors.affiliation: CENEXA - Centro de Endocrinología Experimental y Aplicada (UNLPCONICET La Plata, Centro Colaborador de la OPS/OMS en Diabetes), Facultad de Ciencias Médicas, UNLP, La Plata, Argentina. cenexa@speedy.com.ar
authors.forename: Juan José
authors.initials: JJ
authors.lastname: Gagliardino
authors.forename: Viviana
authors.initials: V
authors.lastname: Arrechea
authors.forename: Daniel
authors.initials: D
authors.lastname: Assad
authors.forename: Gabriel G
authors.initials: GG
authors.lastname: Gagliardino
authors.forename: Lorena
authors.initials: L
authors.lastname: González
authors.forename: Soledad
authors.initials: S
authors.lastname: Lucero
authors.forename: Liliana
authors.initials: L
authors.lastname: Rizzuti
authors.forename: Zulma
authors.initials: Z
authors.lastname: Zufriategui
authors.forename: Charles
authors.initials: C
authors.lastname: Clark
mesh_terms: D000328:Adult; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000628:therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D010379:Peer Group; D012648:Self Care / Q000523:psychology*
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human