Peer Mentoring Leads to Large A1C Reductions

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One of the main goals of diabetes management is to maintain blood glucose at a healthy level. Now, a recent study published in the Annals of Internal Medicine shows that peer mentoring can help people with diabetes lower their A1C — a marker of blood glucose control — by up to a full point. Each percentage point decrease in A1C lowers the risk of long-term diabetes complications by 37%.

Diabetes is more common and often more severe in African Americans. To determine if people in this population could lower their A1C levels by talking regularly with others who had successfully controlled their blood glucose levels, researchers recruited 118 African Americans at the Philadelphia Veterans Affairs Medical Center who hadn’t been successful at lowering their A1C. The participants were assigned to one of three groups: usual care, financial incentive, or peer mentoring.

Those in the usual care group were provided with specific goals for A1C. Participants in the financial incentive group were given $100 for lowering their A1C by one point (for example, from 7.9% to 6.9%) and $200 for lowering their A1C by two points or for hitting an A1C level of 6.5% or lower. Those in the peer-mentoring group were connected with someone with diabetes who had once had poor blood glucose control but who had brought it to target levels (an average of 6.7%). The mentors were paid $20 and told to meet with their “mentees” at least once per week for the duration of the six-month study.

Mentors and mentees spoke an average of four times during the first month of the study and twice a month thereafter. The researchers were not sure whether this decrease in contact was due to reduced motivation or to a perceived lack of need for more frequent communication.

At the end of the study, the researchers found that those in the peer-mentoring group had achieved the greatest reduction in A1C levels: Among those in the usual care group, A1C was reduced, on average, from 9.9% to 9.8%; among those in the financial incentive group, A1C was reduced from 9.5% to 9.1%; and among those in the peer-mentoring group, A1C was reduced from 9.8% to 8.7%.

“Perhaps the most obvious attraction of this type of peer mentoring is that it is virtually free, almost certainly enhancing its cost-effectiveness relative to more expensive interventions, such as nurse care management, telemedicine, and group medical appointments,” state the study authors.

The researchers note that all participants in the study were veterans, so the sense of camaraderie among them may not translate to other groups of people with diabetes, and they call for future studies that look into whether the blood glucose effects seen in this trial are sustainable.

For more information, read the article “Peer Mentoring Helps Reduce A1C a Full Point” or see the study summary in the journal Annals of Internal Medicine. And for more on how to find a diabetes mentor, check out the article “Peer Support, Education, and Mentoring,” by certified diabetes educator Martha Mitchell Funnell.

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