title: Effects of Providing Peer Support on Diabetes Management in People With Type 2 Diabetes.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors: Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong.
authors: Junmei
authors: J
authors: Yin
authors: Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong Diabetes and Endocrine Centre, Prince of Wales Hospital, Shatin, Hong Kong.
authors: Rebecca
authors: R
authors: Wong
authors: Ruttonjee Hospital, Hong Kong.
authors: Shimen
authors: S
authors: Au
authors: Asia Diabetes Foundation, Prince of Wales Hospital, Shatin, Hong Kong Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Shatin, Hong Kong.
authors: Harriet
authors: H
authors: Chung
authors: Alice Ho Mui Ling Nethersole Hospital, Tai Po, Hong Kong.
authors: Maggie
authors: M
authors: Lau
authors: North District Hospital, Fanling, Hong Kong.
authors: Laihar
authors: L
authors: Lin
authors: Alice Ho Mui Ling Nethersole Hospital, Tai Po, Hong Kong.
authors: Chiuchi
authors: C
authors: Tsang
authors: North District Hospital, Fanling, Hong Kong.
authors: Kampiu
authors: K
authors: Lau
authors: Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong Diabetes and Endocrine Centre, Prince of Wales Hospital, Shatin, Hong Kong.
authors: Risa
authors: R
authors: Ozaki
authors: Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong Diabetes and Endocrine Centre, Prince of Wales Hospital, Shatin, Hong Kong.
authors: Wingyee
authors: W
authors: So
authors: Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong Diabetes and Endocrine Centre, Prince of Wales Hospital, Shatin, Hong Kong Asia Diabetes Foundation, Prince of Wales Hospital, Shatin, Hong Kong.
authors: Gary
authors: G
authors: Ko
authors: Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong Diabetes and Endocrine Centre, Prince of Wales Hospital, Shatin, Hong Kong Asia Diabetes Foundation, Prince of Wales Hospital, Shatin, Hong Kong.
authors: Andrea
authors: A
authors: Luk
authors: Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong Asia Diabetes Foundation, Prince of Wales Hospital, Shatin, Hong Kong Division of Endocrinology, University of British Columbia, Canada.
authors: Roseanne
authors: R
authors: Yeung
authors: Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong Diabetes and Endocrine Centre, Prince of Wales Hospital, Shatin, Hong Kong Asia Diabetes Foundation, Prince of Wales Hospital, Shatin, Hong Kong Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Shatin, Hong Kong jchan@cuhk.edu.hk.
authors: Juliana C N
authors: JC
authors: Chan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D002681:China; D003376:Counseling / Q000193:education* / Q000379:methods; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000523:psychology / Q000628:therapy*; D004493:Education / Q000379:methods; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology; D010379:Peer Group; D012648:Self Care / Q000379:methods* / Q000523:psychology; D012944:Social Support; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
keywords: diabetes self-care; peer support; social support; type 2 diabetes mellitus