Phone calls with a peer facing the same self-management challenges helped diabetes patients manage their conditions and improved their blood sugar levels better than those who used traditional nurse care management services alone, according to research from the U-M Health System.

The findings, published Oct. 19 in the Annals of Internal Medicine, showed the peer partner program resulted in lower glycated hemoglobin (HbA1c) levels after six months among men with uncontrolled diabetes.

The research was based on a peer partnership program established by the Veterans Affairs Ann Arbor Health System and the Medical School. Each peer pair received initial brief training in peer communication skills and was expected to communicate by telephone at least once a week about their mutual efforts to improve diabetes control. Program participants also were offered optional periodic nurse-facilitated group sessions to exchange experiences with fellow patients.

“Our model was testing the hypothesis that a good way to activate patients was to give them some skills and encouragement to both help and be helped. Just as in education they say that the best way to learn something is to try to teach it,” says study lead author Dr. Michele Heisler, who is a research scientist for the Center for Clinical Management Research at the VA Ann Arbor’s Health Services Research & Development Center of Excellence and associate professor of internal medicine at the Medical School. Heisler also is associate professor of health behavior and health education at the School of Public Health.

“We are trying to tap into the underappreciated expertise of patients,” Heisler says. “Our program hoped to mobilize patients themselves to realize how much they themselves had to offer another person with diabetes and enjoy the sense of meaning and pleasure that being needed and helping another can provide. That’s why I think people did well — they were very motivated when they felt they were helping someone else.”

More patients in the peer support group also started insulin therapy at much higher rates than those in the nurse care management group, a step that many patients resist.

“The higher rate of insulin therapy initiation in the peer support group suggests that patents’ concerns about insulin may be best addressed by another person who also is coping with insulin management,” Heisler says.

Heisler says this is the first randomized controlled trial to examine reciprocal peer support in chronic disease management. This can be a low-cost, easy-to-implement system that allows patients to get more one-on-one support in managing a chronic illness, Heisler says.

Additional authors are Dr. Sandeep Vijan, of U-M and VA Ann Arbor; Fatima Makki of VA Ann Arbor; and John Piette, of U-M and VA Ann Arbor.