Abstract
BackgroundPeer support by persons affected with diabetes improves peer supporter’s diabetes self-management skills. Peer support interventions by individuals who have diabetes or are affected by diabetes have been shown to improve glycemic control; however, its effects on other cardiovascular disease risk factors in adults with diabetes are unknown. We aimed to estimate the effect of peer support interventions on cardiovascular disease risk factors other than glycemic control in adults with diabetes.MethodsWe conducted a systematic review and meta-analysis of randomized controlled trials comparing peer support interventions to a control condition in adults affected by diabetes that measured any cardiovascular disease risk factors [Body Mass Index, smoking, diet, physical activity, cholesterol level, glucose control and blood pressure]. Quality was assessed by Cochrane’s risk of bias tool. We calculated standardized mean difference effect sizes using random effects models.ResultsWe retrieved 438 citations from multiple databases including OVID MEDLINE, Cochrane database and Scopus, and author searches. Of 233 abstracts reviewed, 16 articles met inclusion criteria. A random effects model in a total of 3243 participants showed a positive effect of peer support interventions on systolic BP with a pooled effect size of 2.07 mmHg (CI 0.35 mmHg to 3.79 mmHg, p = 0.02); baseline pooled systolic blood pressure was 137 mmHg. There was a non-significant effect of peer support interventions on diastolic blood pressure, cholesterol, body mass index, diet and physical activity. Cardiovascular disease risk factors other than glycemic control outcomes were secondary outcomes in most studies and baseline values were normal or mildly elevated. Only one study reported smoking outcomes.ConclusionsWe found a small (2 mmHg) positive effect of peer support interventions on systolic blood pressure in adults with diabetes whose baseline blood pressure was on average minimally elevated. Additional studies need to be conducted to further understand the effect of peer support interventions on high-risk cardiovascular disease risk factors in adults with diabetes.
Highlights
Peer support by persons affected with diabetes improves peer supporter’s diabetes self-management skills
In the last decade, several trials have looked at the effects of peer support interventions in adults with diabetes; several of these have looked at changes in cardiovascular disease risk factors
The American Heart Association (AHA) introduced the concept of cardiovascular health characterized by seven ideal metrics namely Body Mass Index (BMI), smoking, diet, physical activity, cholesterol level, blood pressure and glucose levels, to improve the cardiovascular health of all Americans while reducing deaths from cardiovascular disease (CVD) and strokes [3, 4]
Summary
Peer support by persons affected with diabetes improves peer supporter’s diabetes self-management skills. The American Heart Association (AHA) introduced the concept of cardiovascular health characterized by seven ideal metrics namely Body Mass Index (BMI), smoking, diet, physical activity, cholesterol level, blood pressure and glucose levels, to improve the cardiovascular health of all Americans while reducing deaths from CVD and strokes [3, 4]. These metrics are known as Life’s Simple 7 [3]. Peer support interventions could be a sustainable community-based intervention for behavioral counseling in people with CVD risk factors
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