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.

Aims: To examine the impact of a 12-month peer-led diabetes self-management support intervention delivered via telephone amongst adults with type 2 diabetes (T2D) from specialty care settings in British Columbia (BC).

Methods: One-hundred ninety-six adults with T2D were randomly assigned to either a 12-month Peer-Led, Empowerment-based, Approach, to Self-management Efforts in Diabetes (PLEASED) intervention or a usual care condition. PLEASED involved weekly telephone contacts from a peer leader (PL) in the first 3 months followed by bi-weekly telephone contacts in the last 9 months. Assessments were conducted at baseline, 3 and 12 months. The primary outcome was HbA ; secondary outcomes included diabetes distress (DD), ApoB, systolic and diastolic blood pressure (BP), body mass index, waist circumference and depressive symptoms.

Results: No within or between group changes were observed for HbA at 3 or 12 months. However, amongst participants with HbA  ≥ 69 mmol/mol (8.5%), the PLEASED group significantly lowered their HbA at 12 months [-11.7 mmol/mol (-1.07%); 95% CI: -20.7, -2.5 (-1.89, -0.23); p = 0.016] compared to usual care. Amongst secondary outcomes, within-group improvements in overall DD were found at 3 months (-0.21; 95% CI: -0.35, -0.08; p = 0.002) for the PLEASED group and at 12 months for both groups (PLEASED: -0.35; 95% CI: -0.49, -0.21; p < 0.001 and control: -0.33; 95% CI: -0.47, -0.19; p < 0.001), however, no between-group differences were observed. The PLEASED group improved systolic BP at 12 months (-5.4 mm Hg; 95% CI: -10.0, -0.8; p = 0.023) compared to usual care.

Conclusions: Participation in a peer support intervention in diabetes delivered via telephone leads to long-term improvements in HbA1c amongst high-risk adults with T2D living in BC.

Trial Registration: The study was registered on clinicaltrials.gov (NT02804620).