In the Journals

Peer mentoring may improve diabetes management among adolescents

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January 27, 2015

Sharing important diabetes management skills and experiences through peer mentoring may help adolescents and young adults with type 1 diabetes control their disease, according to study findings published in The Diabetes Educator.

“Many adolescents and young adults with type 1 diabetes are interested in peer mentoring as an approach to help improve patient adherence and glycemic control,” Yang Lu, PhD, MPP, assistant professor at the UCLA David Geffen School of Medicine and investigator at the Los Angeles Biomedical Research Institute, told Endocrine Today. “Clinicians play a critical role in identifying and connecting youth with diabetes who seek peer support.”

Yang Lu

Yang Lu

Lu and colleagues evaluated 54 adolescents aged 13 to 18 years and 46 young adults aged 19 to 25 years to determine attitudes and topics relevant to peer monitoring for type 1 diabetes intervention. Young adults were seen as prospective mentors, whereas the adolescents would be mentees in the program.

According to the self-care diabetes score, both groups reported medium adherence to various diabetes management tasks; higher scores were reported by adolescents (P<.004). Lower adherence was reported by young adults compared with adolescents for blood glucose testing (P<.01) and recording (P<.004), eating on time (P<.007), taking medication or insulin at the right time (P<.04) and checking ketones (P<.001).

High scores on the Diabetes Empowerment Scale were reported by both groups.

Eighty-seven percent of adolescents and 80% of young adults were able to report their most recent HbA1c levels, but the age-specific HbA1c targets recommended by the American Diabetes Association were not reached by 78% of adolescents and 89% of young adults. Glucose was moderately controlled in 46% of adolescents and 41% of young adults who did not reach ADA-recommended HbA1c targets.

Current social barriers to diabetes control were reported by one-third of adolescents and young adults. Embarrassment about blood glucose monitoring or insulin injection in social situations was greater among adolescents compared with young adults (P=.054). Adolescents also more often reported feeling they could not act spontaneously in social situations (57%) compared with young adults (15%; P=.024).

Eighty-seven percent of young adults and 57% of adolescents reported interest in participating in a peer mentoring program (P<.001). Interest in having a peer mentor was associated with adolescents having supportive friends who know about their condition (P=.02) and living in a large household (P=.02). However, glycemic control measured by self-reported or laboratory HbA1c levels, age at diabetes diagnosis, extent of diabetes self-care, level of depressive symptoms and barriers to adherence did not predict interest.

Twenty-three adolescents reported they were not interested in peer mentoring; 60% said they did not need help, 22% did not feel comfortable sharing personal experiences and 26% had no time. Six young adults reported they did not want to be a mentor, with 66% reporting lack of time as the reason.

Phone (55%), text messaging (58%) and social media (58%) were preferred over email (42%) among adolescents, whereas phone (88%), email (83%) and text messaging (88%) were preferred over social media (65%) among young adults.

“Adolescents who lack positive experiences communicating about their diabetes with friends may not have a frame of reference for understanding how a peer mentoring program could be beneficial,” the researchers wrote. “However, they may benefit as much, or more, from a peer mentoring program. Innovative incentives may be needed to reach prospective mentees who are less willing to share their diabetes experiences. Alternatively, other interventions not involving direct social interactions may be more suitable to improve adherence in these individuals.” – by Amber Cox

Disclosure: The study was funded in part by NIH.