Peer-led Diabetes Self-Management Education and Support Enhances Cardiometabolic Markers in Adults With Type 2...

Optimal diabetes mellitus (DM) control is associated with improved cardiometabolic markers. Interventions such as peer-led education and support offer a community-driven approach to enhance self-management and mitigate cardiometabolic risks associated with diabetes, even though they are not well understood in Kenya. This study sought to determine the effectiveness of a 12-months peer-led diabetes education and support on cardiometabolic markers among adults with type 2 DM. A total of 132 participants with type 2 DM were allocated to intervention (n = 66) and control (n = 66) groups. The intervention group was subjected to a structured peer-led diabetes self-management education and support (DSMES) twice a month for 12 months. The control group was provided with standard care. Outcomes, including glycated hemoglobin (HbA1c), random blood glucose (RBG), blood pressure (BP), and anthropometrics, were monitored at baseline and at the end of the study, and compared across the study groups. Peer-led DSMES achieved significant improvements in glycemic outcomes in the intervention group with the RBG being lower (M = 7.56 vs 9.22 mmol/L; P = .008; d = 0.48), and HbA1c being substantially reduced (M = 7.36% vs 8.95%; P < .001; d = 0.78). Blood pressure showed small but non-significant reductions in the intervention group (systolic: d = 0.30, P = .090; diastolic: d = 0.27, P = .117). There were however no significant differences observed in weight, Body Mass Index and waist hip ratio (all P > .60; Cohen's d < 0.10). This is one of the novel peer-led DSMES evaluation demonstrating the feasibility and effectiveness of a peer support system in enhancing self-management, and thus control of DM-related cardiometabolic risks in low-resource settings. However, longer follow-ups, larger populations and multiple study sites are recommended to realize the broader effect of peer-led interventions on cardiometabolic health and universal health coverage.