Blood pressure dropped slightly (although not significantly) in both groups, and no adverse effects were noted in either. Eight patients in the peer group also started on insulin during the trial, as opposed to just one in the control group, indicating that peer support may also be instrumental in convincing often-resistant patients to initiate insulin therapy, the authors stated.
Further study is needed to tease out which parts of a peer group intervention are most successful, concluded the authors, who noted that their research was limited in that it involved only men, lasted just six months, and was not a double-blind study.
In addition to the weekly telephone calls, patients in the peer group met about four-and-a-half hours more than those in the control group, which probably accounted for at least some of the improvement, said Dr. Joel Zonszein, director of the Clinical Diabetes Center at Montefiore Medical Center in New York City.
"In diabetes, every time we spend more time with the patient - it could be a [nurse], a physician, or a Johnny-do-gooder, it reminds the patient to do something or to be more engaged," he said. "The outcomes short-term tend to be better."
Zonszein pointed out that almost 1,000 veterans contacted declined to participate, a fact which he said may not bode well for the success of this type of system in the real world.
However, he said, such programs may "play a role, especially in minority populations where either language or ethnicity is very different from our traditional American population. They really help the bridging between health-care providers."
Peer educators may "almost be better suited for [certain] important ingredients of diabetes self-management," added Sharon Movsas, a certified diabetes educator who, like Zo
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