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Epidemiol Health > Accepted Articles
Epidemiology and Health 2021;e2021090.
DOI: https://doi.org/10.4178/epih.e2021090    [Accepted] Published online Oct 22, 2021.
The Effect of Peer Support in Diabetes Self-Management Education on Glycemic Control in Patients with Type 2 Diabetes: A Meta-Analysis
Akhmad Azmiardi1  , Bhisma Murti2  , Ratih Puspita Febrinasari3  , Didik Gunawan Tamtomo2 
1Doctoral Program on Public Health, Universitas Sebelas Maret, Surakarta, Indonesia, Surakarta, Indonesia
2Doctor of Public Health Program, Universitas Sebelas Maret, Surakarta, Indonesia, Surakarta, Indonesia
3Department of Pharmacology, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia, Surakarta, Indonesia
Correspondence  Akhmad Azmiardi ,Email: aazmiardi@gmail.com
Received: Sep 30, 2021  Accepted after revision: Oct 22, 2021
Abstract
Objectives:
The diabetes self-management education (DSME) program is one of the strategies to maintain healthy behaviors. Nevertheless, limited evidence has been systematically evaluated about DSME integrated with peer support’s effect on glycemic control. This study aimed to review the effectiveness of DSME interventions integrated with peer support on glycemic control in patients with type 2 diabetes.
Method:
Systematically searching was carried out on electronic databases, including PubMed, Cochrane Library, ProQuest, Springer link, Science direct, Scopus, and Google scholar for English language articles published from 2005 until 2020. The effect size was estimated as standard mean difference (SMD). The Cochrane Collaboration’s tool were employed to assess the risk of bias.
Results:
Twelve studies were included in this study. DSME integrated with peer support effectively reduced HbA1c, and it was statistically significant (SMD= -0.41 95%CI= -0.69 to -0.13; p<0.001). Program with sample size <100 (SMD= -0.45; 95%CI= -0.79 to -0.11; p= 0.009), dura¬tion of intervention ≤6 month (SMD= -0.52; 95%CI= -0.96 to -0.07; p=0.020), baseline at HbA1c <8.5% (SMD= -0.42; 95%CI= -0.77 to -0.07; p=0.020), delivery by group (SMD= -0.28; 95%CI=-0.51 to -0.06; p=0.010), and high frequency of contact (SMD= -0.29; 95%CI= -0.48 to -0.10; p=0.003) were effective and statistically significant to reduce HbA1c level in patients with type 2 diabetes.
Conclusions:
DSME integrated with peer support effectively enhances glycemic control in patients with type 2 diabetes. Program with smaller study sizes, shorter duration of intervention, weekly meetings and closer group sessions are improving glycemic control in patients with type 2 diabetes.
Keywords: peer support; randomized controlled trial; type 2 diabetes; meta-analysis


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