Purpose The purpose of this study is to report a systematic review of reviews of evidence and gaps focused on in-person and technology-mediated diabetes peer support and its impact on clinical, behavioral, and psychosocial outcomes. Methods We conducted a systematic review of reviews in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Reviews published in English from December 1978 through December 2018 examining clinical, behavioral, and psychosocial outcomes were included. The search yielded 167 reviews that were examined for inclusion/exclusion criteria. Results Nine systematic reviews and meta-analyses meeting criteria were included. Findings suggest peer support interventions can have a positive impact on clinical (A1C, blood pressure, cholesterol, weight), behavioral (diabetes knowledge, being active, healthy eating, medication management, self-management, self-efficacy, empowerment), and psychosocial (social support, health and diabetes distress, depression, quality of life) outcomes. Research gaps exist related to understanding the effects of emerging technology-mediated peer support modalities and the effects of peer support on gestational diabetes. Conclusion Many clinical, behavioral, and psychosocial benefits related to in-person and technology-mediated peer support exist. Diabetes care and education specialists should incorporate and recommend peer support resources for people with diabetes.

Purpose Increasing attention is being given to the challenges and emotional toll of managing diabetes. This Perspectives in Practice details the specialty’s guiding documents for initial and ongoing support. It also defines various types of social support, including peer support, for optimal diabetes care. Focusing on peer support, this paper provides a review of the body of evidence demonstrating the value of peer support to improve clinical and behavioral outcomes. To achieve positive outcomes, it is optimal for people with diabetes to have access to ongoing support from their health care provider, including diabetes care and education specialists. They should also be made aware of, and given referral to options and opportunities for peer support. This Perspectives in Practice concludes with a call to action for diabetes care and education specialists to deliver to integrate and promote the value of peer support in the care they provide. Conclusion Managing diabetes during the stages and ages of life is chronically challenging and complex. Various types of support offered by health care providers, including diabetes care and education specialists and others in the person’s social support milieu, can positively affect emotional well-being. Health care providers should routinely assess their client’s social supports and refer the person with diabetes and/or their caregivers to evidence-based types of peer support mutually determined to be of most value. Diabetes care and education specialists should increase their awareness of opportunities to integrate the value of and referral to peer support in their counseling and to gain greater insight into the diabetes-lived experience.

Ageism and negative attitudes towards ageing have been identified within the literature as a cause for concern. Reactions to ageing are known to be strongly positively correlated with attitudes towards older people in general. Moreover, the link between ageist practice and quality of care is also established, but implications for education and training have not been explored. The aim of this study was to investigate the reactions to ageing of clinical and fieldwork educators of undergraduate students. Clinical and field work educators are largely responsible for all the clinical education received by these students and thus have the potential to be to be highly influential in the development of their attitudes towards the elderly. Reactions to ageing were measured among clinical educators registered with a University in South East England using The Reaction to Ageing Scale, and scores were classified into typologies. Results were obtained from 62% (n=87) physiotherapy and 87% (n=81) podiatry clinical educators and 71% (n=53) of occupational therapy fieldwork educators, attending training sessions. There was a significantly greater proportion of gerophiles among the physiotherapists than among the other groups. Podiatry gerophiles were significantly older than gerophiles in the other professional groups. The results from this small study suggest that further national work is indicated to examine attitudes in a larger population.

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