Division of Endocrinology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Department of Family Medicine, University of British Columbia, West Vancouver, British Columbia, Canada.
Diabet Med. 2022 Nov;39(11):e14931. doi: 10.1111/dme.14931. Epub 2022 Sep 2.
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).
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.
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.
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.
The study was registered on clinicaltrials.gov (NT02804620).
在不列颠哥伦比亚省（BC）的专科医疗机构中，研究通过电话对 2 型糖尿病（T2D）成年人进行为期 12 个月的同伴主导的糖尿病自我管理支持干预对他们的影响。
196 名 T2D 成年人被随机分配到 12 个月的同伴主导、以赋权为基础、自我管理努力的方法（PLEASED）干预组或常规护理组。PLEASED 包括在最初的 3 个月中每周与一名同伴领导（PL）进行电话联系，然后在接下来的 9 个月中每两周进行一次电话联系。在基线、3 个月和 12 个月时进行评估。主要结局是 HbA1c；次要结局包括糖尿病困扰（DD）、ApoB、收缩压和舒张压（BP）、体重指数、腰围和抑郁症状。
在 3 个月或 12 个月时，HbA1c 未观察到组内或组间变化。然而，对于 HbA1c≥69mmol/mol（8.5%）的参与者，PLEASED 组在 12 个月时显著降低了他们的 HbA1c[-11.7mmol/mol（-1.07%）；95%CI：-20.7，-2.5（-1.89，-0.23）；p=0.016]，与常规护理相比。在次要结局中，在 3 个月时，PLEASED 组的整体 DD 得到了改善（-0.21；95%CI：-0.35，-0.08；p=0.002），而两组在 12 个月时都得到了改善（PLEASED：-0.35；95%CI：-0.49，-0.21；p<0.001 和对照组：-0.33；95%CI：-0.47，-0.19；p<0.001），然而，组间没有差异。与常规护理相比，PLEASED 组在 12 个月时收缩压得到了改善（-5.4mmHg；95%CI：-10.0，-0.8；p=0.023）。
在不列颠哥伦比亚省生活的 2 型糖尿病高危成年人中，通过电话进行同伴支持干预可长期改善 HbA1c。
该研究在 clinicaltrials.gov 上注册（NT02804620）。
