The effect of peer support in adults with insulin pump-treated type 1 diabetes: a pilot study of a flexible and participatory intervention

Abstract

AimThe aim of this study was to explore the effects of a flexible and participatory peer support intervention in a clinical setting for adults with type 1 diabetes treated with an insulin pump, focusing on enhancing diabetes-specific social capital. The key questions were as follows: 1) what effects are appropriate to expect, according to participants? and 2) to what extent did these effects occur?MethodsTwo peer support intervention programs were conducted in a diabetes specialist clinic (N=30). A participatory and adaptable approach allowed flexibility in the content of peer support meetings, which were facilitated by a diabetes nurse. Individual interviews explored participants’ perception of effects of the intervention. Interview data were analyzed qualitatively. Participants (n=27) completed a baseline and postintervention questionnaire that included items assessing diabetes empowerment, diabetes distress, diabetes-specific social support, and diabetes loneliness. HbA1c levels were compared before and after the intervention.ResultsParticipants experienced enhanced diabetes-specific social capital, diabetes motivation, awareness of personal diabetes practices, and serenity and openness in life with diabetes. They also became more aware of treatment and support possibilities. Negative effects included feeling sad or upset after the meetings or feeling different than and not as well-controlled as other participants. Quantitative analyses showed enhanced social support, decreased eating distress and trends toward enhanced diabetes empowerment, decreased diabetes loneliness, and decreased diabetes distress (powerlessness). We found fewer positive and/or negative outcomes among participants who felt no need for peer support or felt that the group was not a unit or that important issues were not addressed.ConclusionThe study indicated that flexible and participatory peer support can strengthen diabetes-specific social capital and improve participants’ well-being and diabetes empowerment. Awareness of participants’ incentives for attending peer support, as well as the risk of people feeling isolated within peer support groups, is essential to creating effective diabetes-specific social support.

Diabetes and COVID‐19: psychosocial consequences of the COVID‐19 pandemic in people with diabetes in Denmark—what characterizes people with high levels of COVID‐19‐related worries?

“…and 'often', providing a total score from 0 to 9. Diabetes-related loneliness was measured with two questions developed for a previous qualitative pilot study [15] and took the same format as the UCLA Loneliness Scale. The questions measured: (1) if the respondents missed someone to talk to about diabetes; and (2) whether they felt alone with diabetes.…”

Twenty‐five years of diabetes distress research

“…People with type 1 diabetes may especially benefit from meeting in groups with peers, as they often do not meet others with the disease. Studies have shown that peer support among adults with type 1 diabetes both legitimizes and relieves a shared and burdensome feeling of diabetes loneliness . Also, peer support is a way of enhancing the establishment and strength of diabetes‐specific social capital, i.e.…”

“…Also, peer support is a way of enhancing the establishment and strength of diabetes‐specific social capital, i.e. peer support fosters social support between individuals (giving and receiving social support) and creates space for genuine trust and a feeling of communality . Meeting in groups can provide emotional support and reduce distress both by sharing emotions and feeling normalcy, and also through sharing diabetes experiences and tips and tricks .…”

“…peer support fosters social support between individuals (giving and receiving social support) and creates space for genuine trust and a feeling of communality . Meeting in groups can provide emotional support and reduce distress both by sharing emotions and feeling normalcy, and also through sharing diabetes experiences and tips and tricks . Other features of interventions that can be used in group support and have been shown to reduce diabetes distress are goal‐setting, problem‐solving, reflection, motivational focus, supportive listening, addressing emotional challenges, improving emotion regulation skills, and mindfulness‐based stress reduction/cognitive therapy .…”

Playing with peers: Exploring peer support mechanisms of a type 2 diabetes-specific board game

“…The copyright holder for this preprint this version posted September 9, 2020. ; https://doi.org/10.1101/2020.09.07.20177733 doi: medRxiv preprint themselves in others' experiences and realising that they are not as different as they believed (Joensen, Filges, et al, 2016). Recognisability and normalization may replace feelings of isolation with the sense of belonging and being in a "safe space" (Joensen, Filges, et al, 2016;Joensen et al, 2017). The reciprocal exchange of diabetes experiences and management tips among group members may also engender empathy and a sense of group cohesiveness (Christoffersen et al, 2018;Heisler, 2010).…”