Luo Jiankun, Shu Jiyuan, Pan Weiqing, Guan Duanqin, Liang Congmin, Zheng Dongyan, Huang Kailun, Lai Yixi, Meng Bing, Lu Renjian, Cai Ziwei, Xing Lifei, Chen Jialong, Zhang He
Department of Environmental and Occupational Health, School of Public Health, Guangdong Medical University, Dongguan, China.
Dongguan Shipai Hospital, Donguan, Guangdong, China.
PeerJ. 2025 Aug 28;13:e19803. doi: 10.7717/peerj.19803. eCollection 2025.
Peer support is increasingly recognized as a valuable method for managing blood glucose levels and reducing the risk of chronic complications in patients with diabetes. This systematic review and meta-analysis specifically evaluated the effect of peer support on HbA1c levels in middle-aged and elderly patients with type 2 diabetes and explored the potential benefits of peer interactions on glycemic control.
A comprehensive search was conducted across six databases from January 2018 to July 2023, with a focus on randomized controlled trials (RCTs) that compared peer support interventions to standard diabetic care in adults. Among the 3,395 articles identified, eleven studies involving 2,187 participants were included. The quality of each study was assessed using the Cochrane risk of bias tool. A random-effects model was employed to calculate the mean difference (MD) in HbA1c changes, with additional subgroup analyses for specific contexts.
The findings revealed a modest but statistically significant improvement in HbA1c levels in groups receiving peer support (MD: -0.20; 95% CI [-0.37 to -0.02]; = 0.03). More pronounced benefits were observed in interventions conducted within formal medical settings, those involving high-frequency contact, and those in group sessions, particularly among elderly patients.
The results suggest that while peer support provides a slight improvement in HbA1c levels, other intervention strategies-such as frequent contact, group sessions, and formal medical settings-may offer greater glycemic control benefits in elderly patients with type 2 diabetes. These findings support incorporating peer support into diabetes care and underscore the need for further research with larger samples and standardized protocols.
同伴支持日益被认为是管理糖尿病患者血糖水平和降低慢性并发症风险的一种有价值的方法。本系统评价和荟萃分析专门评估了同伴支持对中老年2型糖尿病患者糖化血红蛋白（HbA1c）水平的影响，并探讨了同伴互动对血糖控制的潜在益处。
2018年1月至2023年7月期间，对六个数据库进行了全面检索，重点关注比较同伴支持干预与成人标准糖尿病护理的随机对照试验（RCT）。在识别出的3395篇文章中，纳入了11项涉及2187名参与者的研究。使用Cochrane偏倚风险工具评估每项研究的质量。采用随机效应模型计算HbA1c变化的平均差异（MD），并针对特定情况进行额外的亚组分析。
研究结果显示，接受同伴支持的组中HbA1c水平有适度但具有统计学意义的改善（MD：-0.20；95%CI[-0.37至-0.02]；P=0.03）。在正规医疗环境中进行的干预、涉及高频接触的干预以及小组会议中的干预，尤其是在老年患者中，观察到了更显著的益处。
结果表明，虽然同伴支持能使HbA1c水平略有改善，但其他干预策略，如频繁接触、小组会议和正规医疗环境，可能对老年2型糖尿病患者的血糖控制有更大益处。这些发现支持将同伴支持纳入糖尿病护理，并强调需要进行更大样本和标准化方案的进一步研究。
