Effectiveness of Diabetes Education by Health Professionals Versus Peers on Improving Diabetes Care: A Quasi-Experimental Study

Abstract

Background: Studies on education with peer support for improving diabetes care among diabetes patients are relatively rare in developing countries, including Bangladesh. Objectives: The purpose of the present study was to compare the effectiveness of diabetes education by health professionals versus peers for achieving targeted diabetes care among people with type 2 diabetes. Methods: With a quasi-experimental design, 133 type 2 diabetes patients [hemoglobin A1c (HbA1c) > 8%] were screened conveniently from the Outpatient Department of BIRDEM (the Tertiary Hospital of Diabetic Association of Bangladesh). Sixty-seven participants were guided by four professionals and 66 by eight peer educators. Following a predesigned curriculum, four professionals and eight peers provided two-hour diabetes education, once to the participants at the time of their enrollment. The changes observed in fasting blood glucose (FBG), HbA1c, weight, systolic blood pressure (SBP), diastolic blood pressure (DBP), knowledge, and lifestyles were compared after 12 weeks of the intervention and psychological support among 124 (59 for professionals and 65 for peers) participants. The mean age was (53.4 ± 10.4) years. Results: In the peer-educated group, after the intervention, levels of FBG (3.9 ± 3.1 versus 6.7 ± 0.7), HbA1c (8.04 ± 1.1 versus 9.1 ± 1.5), and DBP (81.86 ± 13.1 versus 87.29 ± 8.2) decreased significantly (P < 0.05) compared to the health professional-educated group. After receiving education, levels of HbA1c, FBG, and SBP decreased significantly (P < 0.05) in both groups. The mean knowledge improved significantly (P = 0.0001) among the peer-guided participants. Approximately 6%, 65%, and 25% had good, average, and poor (GAP) knowledge about diabetes respectively before the intervention, whereas 15%, 63%, and 20% had GAP knowledge after the intervention. Conclusions: The findings suggest that it is feasible to train peer educators with the necessary knowledge and skills to facilitate diabetes self-management.