Peer Support and Diabetes

Diabetes blood test. Photo by Christiana Care

Project Team  |  Funding  |  Collaborators  |  In The News


GGG_global_projectsPeer support improves diabetes self-management and reduces hospitalizations

Effective medicines and technologies exist to diagnose and manage diabetes. However, health care systems often fail to reach the people most in need of these treatments and therapies, or are unable to help patients sustain the important behavior changes that enhance diabetes management. As a result, many patients, especially those in disadvantaged circumstances, experience disproportionate complications of diabetes, associated psychological problems and excess hospitalizations.

Through an innovative relationship with the American Academy of Family Physicians Foundation, its Peers for Progress program is coordinated through the Gillings School. Peers for Progress has promoted effective peer support networks for diabetes across the globe and showed remarkable improvements in diabetes management and reductions in hospitalization rates and associated emotional distress. Read More

Dr. Ed Fisher is a professor of health behavior at the Gillings School and global director of Peers for Progress.  Although peer support is not new, until now most of the thousands of programs around the world have been unevaluated and poorly disseminated.  Peers for Progress is curating the evidence base to show that such programs can be highly effective. The Peers for Progress network has data to demonstrate the critical role of peer support as an extension of primary care and its capacity to improve quality of life, enhance adherence, sustain behavior change and reduce costly hospitalizations.

Across North America, South America, Europe, Africa, and Asia, Peers for Progress has found a useful template for program standardization based on four key functions. Whether in groups or individually, face-to-face or over the telephone, peers provide assistance in daily management, social and emotional support, linkage to clinical care, and ongoing availability of help and encouragement.

Individual and group meetings provide practical guidance on issues such as healthy cooking, exercise, and ways to improve daily self-management.  In many countries, text messaging and telephone contacts prompt self-management and provide ongoing encouragement.  Peer supporters, many based in diabetes clinics, are trained to discuss difficult issues such as depression and fears with patients.

In China, attention to health behaviors, self-management, and patient education has been slow to develop, but leaders in diabetes and health are increasingly recognizing the importance of peer support as a sensible, scalable approach that fits with Chinese culture.  Peers for Progress is developing extensive contacts with the Chinese Diabetes Society, the Taiwan Association of Diabetes Educators, and the Western Pacific region of the International Diabetes Federation to build peer support networks.

The Peers for Progress model of peer support, coupled with the impressive demonstrations of cost-effectiveness and value, provide a useful prototype for expansion.  Gillings and the American Academy of Family Physicians Foundation have demonstrated that the chronic nature of diabetes requires lifelong integration of medical care with support for self-management in daily life.

Project Team

  • Edwin Fisher (Principal Investigator)
  • John Buse
  • Timothy Daaleman
  • Annie Green Howard
  • Laura Linnan
  • Christopher Shea


Sponsored by: American Academy of Family Physicians

Total funding: $1,125,998


In The News

Ed Fisher and John Buse Promote Peer Support for Diabetes Self-Management in China

Peers for Progress receives $5 million to provide peer counseling for Hispanics with diabetes

“Peers for Progress” awards grants to support diabetes peer support research