Peer support and adult type 1 diabetes

Background and Aims

Insulin pump therapy is an increasingly used method of insulin replacement therapy in adults with type 1 diabetes. Having an insulin pump requires a specific diabetes regimen which can be difficult to adjust to.

Peer support is an effective method to provide emotional support and ongoing self-management [1]. However, literature on diabetes-specific peer support currently refers to a wide range of peer interactions and interventions and the quality of evidence is insufficient to determine which types of peer interactions, peer support elements and interventions are most effective and applicable in different populations of people with diabetes. Furthermore, most studies of peer support among adults with diabetes have focused on supporting people with type 2 diabetes and very few studies have explored patient preferences of peer support. 

A previous study at Steno Diabetes Center found that peer support groups facilitated by health professionals were able to reduce diabetes distress among young adults with type 1 diabetes [2]. Furthermore an explorative qualitative study highlighted the importance of peer support among adults with type 1 diabetes to relieve and legitimise a shared and burdensome feeling of diabetes loneliness [3].

The study also highlighted peer support in type 1 diabetes as a possibility to enhance the establishment and strengthening of diabetes-specific social capital. Not only creating social support between individuals (giving and having social support), but also creating space for genuine trust and a feeling of communality.

The study indicated that participatory methods, such as dialogue tools, provide a useful framework for creating diabetes-specific social capital among adults with type 1 diabetes.

The aim of the current study is:

  • to test the feasibility and effect of peer support as a method to facilitate the establishment and strengthening of diabetes-specific social capital in people with type 1 diabetes in insulin pump treatment.

  • to explore if strengthening diabetes-specific social capital results in improved psychological well-being, self-management behaviours, diabetes empowerment and glycaemic control.  

Design and Methods

Peer support was initiated in a clinical setting (Hvidovre Hospital) with a participatory based approach which allows flexibility with regards to the content of peer support meetings. By using customized participatory tools (e.g. reflection exercises based on photos) the starting point of support issues is defined by people with type 1 diabetes. We have tested the model in two support groups met four times (three hour meetings) over four months (September to December 2015). The first meeting included the participants in planning of the peer support meetings. The meetings were facilitated by a diabetes nurse.

A variety of qualitative research methods is used to evaluate the usability and effect of peer support such as observations and individual interviewing (January to March 2016). Furthermore a questionnaire including diabetes distress and social support was filled out by participants before and after their participation in peer support. HbA1c was likewise measured before and after the peer support intervention. 

Target groups

Adults with type 1 diabetes in insulin treatment

Expected outcomes

The expected outcome of this study is:
  • a flexible and relevant intervention model of peer support for persons with type 1 diabetes initiated in clinical practice 
  • knowledge of when and how peer support is effective in adults with type 1 diabetes


Kirsten Nørgaard, SDCC and Merete Meldgaard, Hvidovre Hospital

Inspirational publications

1. WHO (2008) World Health Report 2007: Peer Support Programs in Diabetes. Geneva, Switzerland.

2. Due-Christensen M, Zoffmann V, Hommel E, Lau M (2012) Can sharing experiences in groups reduce the burden of living with diabetes, regardless of glycaemic control? Diabetic Medicine 29: 251-256.

3. Joensen L (2014) Psychosocial health in type 1 diabetes - A study of bio-psycho-social interactions and the investigation of a conceptual framework for social support targeting adults with type 1 diabetes.

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