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DIABETES

“We were really struck by the number of folks reporting high levels of stress and depressive symptoms who weren’t even close to reaching major depressive disorder.”

– Lawrence Fisher, PhD Diabetes Center, UCSF 

  Success in treating diabetes depends heavily on patient self-management, but many factors can prevent a patient from sustaining an effective management program. These can range from a lack of understanding of the treatment measures, to comorbid conditions—and all of them can lead to adverse outcomes. Comorbid depression, for example, is associated with a wide variety of adverse effects among diabetes patients, including a poorer prognosis for vascular complications, increased chance of disability, and even early mortality. Less dramatic but still serious depression-related issues include reductions in quality of life, wellbeing and self-care. These effects are not limited to those with clinical depression. About one-third of diabetes patients will develop “diabetes distress” at any given time, subjecting them to increased adverse outcomes despite the often subclinical nature of their depressive symptoms. A 2010 study in Diabetes Care reported that people with higher distress levels were more likely to develop high blood glucose. Diabetes distress is at least as common among caregivers as among patients, and the weak social network that often surrounds these patients denies them the positive outcomes generally associated with higher levels of social support. Peer support has been found to offer a number of benefits to diabetes patients. One recent study found peer support to offer effective help in four specific areas: assistance in daily symptom management; emotional and social support; linkages to clinical resources; long term support. The study found improvements among many of the studied patients in:

  • Symptom management
  • Patient diet
  • Blood pressure
  • Body mass index
  • Blood sugar levels

Social connections are known to be important for successful diabetes management, but people with limited networks—such as patients with comorbidities, or the elderly—cannot gain the health benefits available to those with robust social networks. Peer support brings patients together to create a social network that can offer multiple benefits to the participants—and providing support to a peer with diabetes has been shown to lead to a reduced risk of mortality as well as improvements in health behaviors, outcomes, and functioning. Finally, one recent study at the Veterans Administration found that telemedicine was an effective component of a comprehensive, integrated treatment program that observed significant reductions in A1C levels when compared with usual care. Another study found that telemedicine-based treatment for patients with diabetes led to clinically significant reductions in depression, anxiety, and stress.   Remotely-delivered peer support groups from PSS offer all of the above advantages. Our certified peer specialists possess lived experience, we train them how to manage an online support group effectively, and we offer clinical supervision. Meeting content is tailored to the needs of the particular program, but typically contains evidence-based material to help participants better understand and manage some aspect of their condition. Participants gain the benefits of receiving help, as well as offering help to others in need, and they become part of a social network tailored to their treatment needs. Contact PSS to discuss integrating our novel online support groups with your diabetes program, and start offering better outcomes to your patients.

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