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The effect of peer support in diabetes self-management education on glycemic control in patients with type 2 diabetes: a systematic review and meta-analysis
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Akhmad Azmiardi
 , Bhisma Murti, Ratih Puspita Febrinasari, Didik Gunawan Tamtomo
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Epidemiol Health. 2021;43:e2021090. Published online October 22, 2021
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DOI: https://doi.org/10.4178/epih.e2021090
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Abstract
OBJECTIVES
Diabetes self-management education (DSME) programs are a strategy to maintain healthy behaviors. Nevertheless, limited evidence has been reported from systematic evaluations of the effects of DSME integrated with peer support on glycemic control. This study aimed to review the effectiveness of DSME interventions integrated with peer support on glycemic control in patients with type 2 diabetes.
METHODS A systematic search was carried out in electronic databases, including PubMed, Cochrane Library, ProQuest, SpringerLink, ScienceDirect, Scopus, and Google Scholar, for English-language articles published from 2005 until 2020. The effect size was estimated as the standard mean difference (SMD). The Cochrane Collaboration’s Risk of Bias tool was employed to assess the risk of bias.
RESULTS Twelve studies were included in this study. DSME integrated with peer support effectively reduced glycated hemoglobin A1c (HbA1c) levels, with a statistically significant effect (SMD, -0.41; 95% confidence interval [CI], -0.69 to -0.13; p<0.001). Programs with a sample size <100 (SMD, -0.45; 95% CI, -0.79 to -0.11; p=0.009), duration of intervention ≤6 months (SMD, -0.52; 95% CI, -0.96 to -0.07; p=0.020), baseline HbA1c <8.5% (SMD, -0.42; 95% CI, -0.77 to -0.07; p=0.020), delivery by group (SMD, -0.28; 95% CI, -0.51 to -0.06; p=0.010), and high frequency of contact (SMD, -0.29; 95% CI, -0.48 to -0.10; p=0.003) had statistically significant effects on reducing HbA1c levels in patients with type 2 diabetes.
CONCLUSIONS DSME integrated with peer support effectively enhances glycemic control in patients with type 2 diabetes. Programs with smaller participants groups, shorter interventions, weekly meetings, and closer group sessions improved glycemic control in patients with type 2 diabetes.
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Summary
Korean summary
Key Message
We reviewed and assessed the quality of the twelve articles included in this systematic review and meta-analysis. The findings of this review show that peer support integrated with diabetes self-management education programs can significantly enhance glycemic control in type 2 diabetes patients. Peer support is a critical component of a successful diabetes self-management programme in patients with type 2 diabetes. interventions programme with smaller groups, shorter durations, lower HbA1c baseline levels, group sessions, and high frequencies of sessions significantly enhanced glycemic control.
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Citations
Citations to this article as recorded by  - The current diabetes education experience: Findings of a cross-sectional survey of adults with type 2 diabetes
Kelley M. Baker, Carine M. Nassar, Neelam Baral, Michelle F. Magee
Patient Education and Counseling.2023; 108: 107615. CrossRef - 2023 update on Italian guidelines for the treatment of type 2 diabetes
Edoardo Mannucci, Riccardo Candido, Lina delle Monache, Marco Gallo, Andrea Giaccari, Maria Luisa Masini, Angela Mazzone, Gerardo Medea, Basilio Pintaudi, Giovanni Targher, Marina Trento, Giuseppe Turchetti, Valentina Lorenzoni, Matteo Monami
Acta Diabetologica.2023;[Epub] CrossRef - Family doctors’ attitudes toward peer support programs for type 2 diabetes and/or coronary artery disease: an exploratory survey among German practitioners
K. Majjouti, L. Küppers, A. Thielmann, M. Redaélli, F. Vitinius, C. Funke, I. van der Arend, L. Pilic, M. Hessbrügge, S. Stock, B. Weltermann, D. Wild
BMC Primary Care.2022;[Epub] CrossRef - From clinic to community: A randomized controlled trial of a peer support model for adults with type 2 diabetes from specialty care settings in British Columbia
Tricia S. Tang, Rowshanak Afshar, Thomas Elliott, Jason Kong, Sabrina Gill
Diabetic Medicine.2022;[Epub] CrossRef
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