Living with diabetes? Your peers can help!

The Bottom Line

  • Peers with diabetes can provide important emotional, social and practical support that encourages good health and lowers blood sugar.
  • Peer support works best when it occurs more frequently (at least 1-2 times per month) and one-on-one. 
  • Peer support appears to have the greatest impact among those with high or uncontrolled glucose levels.

You may be familiar with the old saying “You can’t understand someone until you’ve walked a mile in their shoes”. Diabetes can be a challenging disease. No one knows better about a diabetic’s experience than another diabetic.

The number of people with diabetes is on the rise in Canada. It is estimated that 4.9 million Canadians will be living with diabetes by 2026 (1). Diabetes becomes more prevalent with advancing age – in Canada, 1 in 6 older adults report having the disease (2). Type 2 diabetes is the most common, accounting for 90-95% of all cases (3).

Type 2 diabetes is not just about monitoring blood sugar – although this is an important aspect of diabetes care. Diabetes management also requires lifestyle modifications like diet, exercise and taking medications (4). If it is not managed properly, diabetes increases the risk of health complications like heart disease and nerve, kidney, eye and foot damage (5).

Chronic diseases like diabetes are often “self-managed” – a model of care that empowers patients to be in control of their own treatments (6). But managing diabetes involves a lot of responsibility and work. This can leave some patients feeling overwhelmed and alone.

This is where peer support may help. Peer support is based on the idea that people with diabetes understand what it is like to live with the disease day-to-day. Therefore, they are in a good position to provide support, encouragement and advice based on their own experiences. Peer support can complement other health care services by creating the emotional, social and practical help necessary for managing the disease (7).

But can peer support really help people with diabetes stay healthy?

Research sought to answer this question. In most of the studies in this research, diabetes education sessions were provided by a trained peer supporter or community health worker in a group setting. Peer support participants met weekly or every other week for a total of 6-8 sessions of 2-2.5 hours each. Other studies explored peer support given to individuals rather than groups. Numerous topics were discussed, including the basics of diabetes, blood sugar monitoring, medication adherence, self-management skills, diabetes complications, and lifestyle changes. Peer support sessions also provided a place for social and emotional support (8).


What the research tells us

Research shows that peer support may help lower blood sugar levels in people with type 2 diabetes, compared with people who receive standard diabetes care (8;9). More frequent peer support sessions (at least 1-2 times per month) and the inclusion of one-on-one support (vs. group support or a combination of the two) are the most effective in lowering blood sugar (8). People who have higher blood sugar levels or poor blood sugar control to begin with may benefit the most (8;9). More research is needed to determine if peer support is effective in low-income populations (8).

If you struggle with managing your diabetes, peer support can improve your ability to self-manage your disease, leading to better health.


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References

  1. Canadian Diabetes Association. Diabetes in Canada. [Internet] 2016. [cited December 2017]. Available from https://www.diabetes.ca/getmedia/513a0f6c-b1c9-4e56-a77c-6a492bf7350f/diabetes-charter-backgrounder-national-english.pdf.aspx
  2. National Center for Chronic Disease Prevention and Health Promotion. National diabetes statistics report, 2017. United States: CDC; 2017, 20 p. Available from https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf
  3. Statistics Canada. Diabetes. [Internet] 2016. [cited December 2017]. Available from https://www.statcan.gc.ca/pub/82-229-x/2009001/status/dia-eng.htm
  4. Glasgow RE, Funnell MM, Bonomi AE, et al. Self-management aspects of the improving chronic illness care breakthrough series: Implementation with diabetes and heart failure teams. Ann Behav Med. 2002; 24(2):80-87. 
  5. Mayo Clinic. Type 2 diabetes. [Internet] 2017. [cited December 2017]. Available from https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/symptoms-causes/syc-20351193 
  6. Drab S. The evolving role of the diabetes educator. Am J Med Sci. 2013; 345(4):307-313. doi: 10.1097/MAJ.0b013e31828c68cc.
  7. Dennis CL. Peer support within a health care context: A concept analysis. Int J Nurs Stud. 2003; 40(3):321-332.
  8. Qi L, Liu A, Qi W, et al. Effectiveness of peer support for improving glycaemic control in patients with type 2 diabetes: A meta-analysis of randomized controlled trials. BMC Public Health. 2015; 15:471. doi: 10.1186/s12889-015-1798-y.
  9. Tay JHT, Jiang Y, Hong J, et al. (2020). Effectiveness of lay-led, group-based self-management interventions to improve glycated hemoglobin (hba1c), self-efficacy, and emergency visit rates among adults with type 2 diabetes: A systematic review and meta-analysis. Int J Nurs Stud. 2021; 113:103779. doi: 10.1016/j.ijnurstu.2020.103779. 

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