Community-based peer support significantly improves metabolic control in people with Type 2 diabetes in Yaoundé, Cameroon

• Published in: Diabetic medicine Vol. 32; no. 7; pp. 886 - 889
• Main Authors: Assah, F. K., Atanga, E. N., Enoru, S., Sobngwi, E., Mbanya, J. C.
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01-07-2015; Wiley Subscription Services, Inc
• Subjects: Aged; Cameroon; Combined Modality Therapy; Developing Countries; Diabetes; Diabetes Complications - prevention & control; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - therapy; Female; Follow-Up Studies; Glycated Hemoglobin A - analysis; Group Processes; Humans; Hyperglycemia - prevention & control; Hyperlipidemias - complications; Hyperlipidemias - prevention & control; Hypertension - complications; Hypertension - prevention & control; Male; Medically Underserved Area; Middle Aged; Patient Compliance; Peer Group; Self Care; Social Support; Cameroon
• ISSN: 0742-3071; 1464-5491
• DOI: 10.1111/dme.12720

Aims
To examine the effectiveness of a community‐based multilevel peer support intervention in addition to usual diabetes care on improving glycaemic levels, blood pressure and lipids in patients with Type 2 diabetes in Yaoundé, Cameroon.
Methods
A total of 96 subjects with poorly controlled Type 2 diabetes (intervention group) and 96 age‐ and sex‐matched controls were recruited and followed up over 6 months. The intervention subjects underwent a peer support intervention through peer‐led group meetings, personal encounters and telephone calls. Both intervention subjects and controls continued their usual clinical care. HbA1c, blood pressure, blood lipids and self‐care behaviours were measured at 0 and 6 months.
Results
There was significant reduction in HbA1c in the intervention group [–33 mmol/mol (–3.0%)] compared with controls [–14 mmol/mol (–1.3%)]; P < 0.001. Peer support also led to significant reductions in fasting blood sugar (–0.83 g/l P < 0.001), cholesterol (–0.54 g/l P < 0.001), HDL (–0.09 g/l, P < 0.001), BMI (–2.71 kg/m² P < 0.001) and diastolic pressure (–6.77 mmHg, P < 0.001) over the 6‐month period. Also, diabetes self‐care behaviours in the intervention group improved significantly over the 6 months of peer support.
Conclusion
Community‐based peer support, in addition to usual care, significantly improved metabolic control in patients with uncontrolled Type 2 diabetes in Yaoundé, Cameroon. This could provide a model for optimizing diabetes care and control in other settings with limited healthcare and financial resources.