title: [Education of people with type 2 diabetes through peers with diabetes: is it cost effective?].
abstract: BACKGROUND
  Inadequate quality of care provided to people with type 2 diabetes mellitus, generates a significant socioeconomic burden and a serious public health problem. Diabetes education through peers with diabetes is an alternative to that provided by professional educators (traditional education) which achieves non-inferior results. However, there is little evidence of cost-effectiveness of education trough peers over traditional education.
  
  
  OBJECTIVE
  To evaluate cost-effectiveness of education of people with type 2 diabetes mellitus, during a year, by a team of professional educators (traditional education) versus education and support delivered by trained peers with diabetes.
  
  
  METHODS
  Cost-effectiveness analysis based on a randomized prospective clinical study conducted in the city of La Plata, including 199 people with type 2 diabetes mellitus, divided in two groups:, one receiving traditional education and another receiving the same education but delivered by peer educators with type 2 diabetes mellitus. Change in glycosylated hemoglobin (HbA1c) was considered as a primary indicator of effectiveness and secondary indicators were others, such as body mass index, systolic blood pressure, diastolic blood pressure, fasting blood glucose, total cholesterol and triglyceride levels. The direct cost of each strategy was estimated based on resources used in the trial, evaluating three cost scenarios for peer education. The strength of the results was assessed by univariate sensitivity analysis.
  
  
  RESULTS
  Cost per unit decrease (%) in HbA1c: traditional education: $2 621; peer education: $1 508, $1 779 y $2 071 for each of the three scenarios considered (scenario 1, scenario 2, scenario 3), respectively. For each $100 invested a decrease of 0.04% in the HbA1c with traditional education was achieved; and 0.07% in scenario 1; 0.06% in scenario 2 and 0.05% in scenario 3, with education delivered by peer educators. Sensitivity analysis showed the strength of the results.
  
  
  CONCLUSIONS
  Education of type 2 diabetes mellitus patients through peers as a complement to control and treatment of the disease, is cost-effective compared to traditional education.
authors.affiliation: Centro de Endocrinología Experimental y Aplicada, Facultad de Ciencias Médicas Universidad Nacional de La Plata, La Plata, Argentina. Address: Facultad de Ciencias Médicas, Universidad Nacional de La Plata, Avenida 60 Sin Número, La Plata, Argentina. Email: lgonzalez@cenexa.org.
authors.forename: Lorena
authors.initials: L
authors.lastname: González
authors.affiliation: Centro de Endocrinología Experimental y Aplicada, Facultad de Ciencias Médicas Universidad Nacional de La Plata, La Plata, Argentina.
authors.forename: Jorge Federico
authors.initials: JF
authors.lastname: Elgart
authors.affiliation: Centro de Endocrinología Experimental y Aplicada, Facultad de Ciencias Médicas Universidad Nacional de La Plata, La Plata, Argentina.
authors.forename: Juan José
authors.initials: JJ
authors.lastname: Gagliardino
mesh_terms: D001118:Argentina; D003362:Cost-Benefit Analysis; D003924:Diabetes Mellitus, Type 2 / Q000191:economics / Q000628:therapy*; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D010353:Patient Education as Topic / Q000191:economics* / Q000379:methods; D010379:Peer Group; D011446:Prospective Studies
chemical_list: D006442:Glycated Hemoglobin
keywords: cost-effectiveness analysis; diabetes mellitus type 2; education