Offline peer support improves BMI and glucose in type 2 diabetes; hybrid support reduces HbA1c

This systematic review and meta-analysis examined the effectiveness of different peer support delivery modalities—offline, online, and hybrid—on health outcomes in adults with type 2 diabetes. The analysis synthesized data from randomized controlled trials, though the total sample size and specific follow-up duration were not reported. The comparator for the peer support interventions was not specified in the provided data.

For offline peer support, the meta-analysis found a statistically significant improvement in body-mass index (standardized mean difference [SMD] = -0.59; 95% CI: -1.12 to -0.05; p=0.033) and fasting blood glucose (SMD = -0.45; 95% CI: -0.79 to -0.12; p=0.008). Hybrid support was associated with a significant reduction in glycated haemoglobin (HbA1c) (SMD = -0.19; 95% CI: -0.35 to -0.04; p=0.016). Online peer support showed no significant effect on the outcomes measured, and no statistically significant improvement in self-efficacy was observed across modalities.

No data on adverse events, serious adverse events, discontinuations, or tolerability were reported. A key limitation is the substantial statistical heterogeneity in the meta-analysis results (I²= 88.1% for BMI, 40.2% for FBG, 48.0% for HbA1c), which complicates interpretation and suggests variability in the underlying studies. Funding sources and conflicts of interest were not reported.

In practice, these findings suggest peer support, particularly offline or hybrid models, may be a useful adjunct in managing type 2 diabetes, potentially advancing nursing practice in chronic disease management. However, clinicians should interpret the results cautiously due to the heterogeneity and the lack of safety and absolute efficacy data. The evidence indicates associations from meta-analyzed RCTs, not definitive causal proof.