Peer Support and Diabetes Technology
Contributor: Deborah Greenwood, PhD, RN, BC-ADM, CDCES, FADCES
In partnership with
So much has been written recently about disparities in diabetes technology access and use. While some of the access issues are financial, we’ve seen through research some examples of unconscious healthcare professional bias against informing and prescribing technology to individuals who may not “fit the mold” of the ideal candidate. In light of all of this discussion, I’d love to share some information about a new paper our research team just published in the Journal of Diabetes Science and Technology by M. Litchman et al. Combining CGM and an Online Peer Support Community for Hispanic Adults with T2D: A Feasibility Study.
The exciting part of this research is that all individuals identified as Hispanic, were Spanish-speaking, lived with type 2 diabetes, and were not taking insulin. Also, most were uninsured, had low income, and had low levels of formal education. Yet, given these challenges, they were all able to use a continuous glucose monitor (CGM) with minimal formal training. Why is that? We think that is because, during the study, the participants were enrolled in a study-specific online peer support group through Beyond Type 2 – En Espanol with trained, Spanish-speaking peer facilitators who also lived with diabetes and were experienced in CGM use and online peer support.
Each week, we encouraged “personal experiments” focused on healthy eating, being active, stress or sleep. The peer facilitators would encourage the participants to post their experiments to share with the group, for example, “I want to see how my glucose changes after I garden.” Then all involved would comment, provide and receive suggestions, support, share stories, and offer advice when needed. The peer facilitators would also troubleshoot issues and provide tips and tricks to help keep the person on track.
During post-study interviews, it was clear that most people wanted to continue using CGMs and felt like they learned so much about their personal journey with diabetes. While this was a small feasibility study, we did see significant improvement in self-efficacy. Increasing self-efficacy is important to help people feel confident in their ability to make behavioral changes. We all know that managing diabetes is hard work, so feeling confident in your ability to be successful and make behavior changes can be an important step in the right direction. In this small group, CGM combined with online peer support helped them feel confident as they made small changes in their diabetes treatment plan.
So if you are interested in diabetes technology but have not been offered it or have questions, reach out to your diabetes care team to ask them. The addition of a diabetes technology might be the change you need to jump-start your diabetes treatment plan. You can also visit the diabeteswise.org website to help you make decisions about diabetes technology.
Deborah Greenwood is a diabetes care and education specialist, nurse and researcher. She is a Medical Science Liaison on the Clinical Education team at Dexcom. She is a co-founder of A Fresh POV for You, a blog to guide healthcare professionals in a solution-focused approach to practice. Deborah is an Adjunct, Assistant Professor at University of Texas Health, San Antonio, School of Nursing. Deborah was the 2015 President of AADE (now the Association of Diabetes Care and Education Specialists). She is the Vice-Chair of the board of directors for DiabetesSisters.