Peer support : time to tap the (largely) untapped

There is growing evidence that the physical and mental health of people with, or at risk of, diabetes can benefit from support from a person with diabetes: known as diabetes peer support. Peer support involves the social and emotional help that supplements the assistance provided by health professionals and others in the life of the person with diabetes. By sharing, discussing, finding and facilitating the ways that can improve diabetes and overcome barriers to care and self-care, metabolic control and wellbeing can improve. Linking peer support to clinical care is thought to strengthen its effectiveness. Peer support complements diabetes education and facilitates implementation of the knowledge gained. There are a range of different ways in which peer support can be provided. Peer support might arise from a casual discussion with another person with diabetes or within a more structured programme. The degree of training can vary from life with diabetes in the casual encounter, to group leadership, to paraprofessional training including motivational interviewing and a range of educational and management skills. The media for delivery varies from face-to-face, telephone and online approaches. At a time of a growing diabetes epidemic, peer support could well be a key strategy in supporting those with and at risk of diabetes, reducing downstream demands on health services while improving quality of life. If this turns out to be the case, every neighbourhood, village and clinic should have one or more peer coaches to support diabetes prevention and diabetes management.