Baksi and coworkers assessed the effectiveness and acceptability of peer advisers in diabetes in delivering a program of training on self-management. Adults with diabetes were randomly allocated to an education program delivered either by trained peer advisers or by specialist health professionals. The primary outcome measure was a change in knowledge before and at the conclusion of the four courses, each consisting of six sessions. Glycated haemoglobin and Diabetes Care Profile were assessed at baseline and at 6 months. Sessional and end-of-course evaluation responses were analyzed, as was the attendance record. Eighty-three patients were randomized into the two conditions. Of the subjects, 14 failed to attend and two were excluded. Knowledge scores improved significantly in both groups, but there was no difference between the groups for any of the knowledge domains. No difference was noted in the Diabetes Care Profiles or in glycated haemoglobin. The attendance record was similar in both groups. In the post-sessional evaluations, both groups scored highly, with the health professionals significantly more so. The post-course questionnaire exploring patients' understanding and confidence in self-management of specific aspects of diabetes care revealed no difference between the groups.

WHAT THE STUDY MAY MEAN TO YOU AS A HEALTH CARE PROVIDER: The authors concluded that trained patients were as effective in imparting knowledge to their peers as specialist health professionals. Both were also acceptable to patients as trainers. However, lay tutors require appropriate training, specific to the education program they would be expected to deliver.

WHAT THE STUDY MAY MEAN TO YOU AS A PATIENT: As both trained and lay personnel can effectively teach diabetes self-management programs, there is no excuse as to why you cannot receive training if you experience the disorder. It will permit you to establish better control over diabetes.

AK Baksi et al. Peer advisers compared with specialist health professionals in delivering a training programme on self-management to people with diabetes: a randomized controlled trial. Diabetic Medicine, 2008;25:1076-1082.