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19 October 2010, Vol 153, No. 8>
Summaries for Patients | 19 October 2010

Can Patients With Diabetes Help Each Other Get Better? FREE

[+] Article and Author Information

The summary below is from the full report titled “Diabetes Control With Reciprocal Peer Support Versus Nurse Care Management. A Randomized Trial.” It is in the 19 October 2010 issue of Annals of Internal Medicine (volume 153, pages 507-515). The authors are M. Heisler, S. Vijan, F. Makki, and J.D. Piette.


Ann Intern Med. 2010;153(8):I-54. doi:10.7326/0003-4819-153-8-201010190-00003
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What is the problem and what is known about it so far?

Many diabetic patients have elevated blood sugar levels, despite being in standard treatment programs.

Why did the researchers do this particular study?

Because standard treatment programs are not effective for everyone, experimental studies have examined whether diabetic patients can help each other take their medications, follow diets, and make other changes that lower blood sugar levels. These studies have involved face-to-face meetings between patients or group meetings led by a clinician. Such efforts have been only partly successful, perhaps because patients found it difficult to attend meetings. This study examined a program to extend support between patients beyond face-to-face meetings.

Who was studied?

224 diabetic patients who had levels of hemoglobin A1c (HbA1c), a measure of average blood sugar level during the past several weeks, that were greater than or equal to 7.5%. The target HbA1c level for diabetic patients is less than 7.0%.

How was the study done?

The researchers randomly assigned patients to either a control group or to an intervention group. Patients in the control group continued receiving their usual care with nurse care manager support. In the intervention group, the researchers matched each patient with another patient of about the same age, provided them some initial training in peer communication skills, encouraged matched patients to call each other weekly, and offered periodic optional patient-driven group sessions.

What did the researchers find?

After 6 months, HbA1c levels in the control group increased by 0.3%, whereas the HbA1c levels in the intervention group decreased by the same amount. That difference of 0.6% is about the same size as the average decrease that occurs when patients start receiving an oral drug that lowers blood sugar level.

What were the limitations of the study?

The patients were male veterans at 2 Veterans Affairs hospitals, so it is uncertain how these results apply to other diabetic patients. The study lasted 6 months, so it is uncertain whether the intervention is effective for longer than 6 months.

What are the implications of the study?

Pairing diabetic patients who have poor diabetes control with similar patients and encouraging them to talk weekly on the telephone to provide mutual support might improve patient outcomes.

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NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Compression-Only CPR: Pushing the Science Forward
Cone
AAM 2010;304:1493-1495.
All you need to read in the other general jounals
BMJ 2010;341:c5893-c1494.

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