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Peer Support, Education, and Mentoring

by Martha Mitchell Funnell, MS, RN, CDE

Managing one’s diabetes involves a lot of responsibility and a lot of work. There are many, many daily decisions to make, and each choice needs to be evaluated afterward to determine how well it worked and why it did or did not lead to the results you had hoped for. In addition to the challenge of carrying out daily tasks, many people with diabetes live with worries and fears about their future health and well-being or with some of the complications of diabetes. Having to face these burdens without the sustained support of others can make living as healthily as possible with diabetes difficult or even impossible.

It makes sense intuitively that having the social support you need can help you manage your diabetes, and scientific research bears this out. It is also clear that while formal diabetes education helps people learn to make changes to improve their health, these changes begin to fade in about six months without additional and ongoing support. There is even some evidence that people with diabetes who reach out to others live longer than those who do not.

Some people are able to get much of the social support they want and need from their family and friends. But unless the people around you also have diabetes, they cannot fully understand what it really means to have diabetes. They can offer empathy and support, but their experience of diabetes is different from yours. As a result, many people with diabetes report that they feel isolated, judged, and overwhelmed, even when they have a loving family and a network of supportive friends.

When facing a tough situation, it’s common to seek out someone who has faced or is facing a similar situation. It helps to talk with someone who can relate to your feelings and worries and can tell you what has worked for him in a similar circumstance. People with diabetes have long gotten support from others with diabetes through support groups in a variety of formats. But in recent years, there has been an effort to create more formal peer support programs so that people with diabetes can more easily get the help that they need from their peers.

What is a peer?
A peer is defined as “someone of equal standing.” In the context of a diabetes support program, this means a person who has diabetes or is affected by diabetes (for example, is the parent of a child with diabetes), and thus has firsthand knowledge of the daily struggles and issues this presents. Other characteristics that may be important when seeking peer support for diabetes include type of diabetes, age, cultural background, ethnicity, gender, and type of diabetes treatment used. The most important thing for the peers, however, is to be able to relate honestly and comfortably with each other about their shared experiences.

While it is possible to create peer support on your own or online, there are a growing number of formal peer-based programs in many communities. Some of these programs match individuals, while others are groups facilitated by a person with diabetes who has been trained to provide the program. Your diabetes educator or health-care provider may be able to tell you what is available in your area.

What can a peer do?
Peers can provide support, mentoring, and education and can lead self-management support groups. Research shows that people who participate in peer programs generally receive informational support through sharing experiences and seeing how others manage diabetes; emotional support, which provides encouragement and a decreased sense of isolation; and mutual support through giving and receiving help.

Peer-to-peer support (P2P) generally refers to two people working to support each other in the management of diabetes. In formal programs, both peers are trained in how to be a good listener, communicate in a nonjudgmental and supportive way, and avoid giving advice, as well as in strategies for making changes in behavior. Each person in this type of relationship can both give and receive help.

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