Women face varied challenges in diabetes management. These call for examination of women’s responses to diabetes management and support programs. A community-based peer support program was implemented in 12 Intervention Communities (ICs) with 4 Comparison Communities (CCs) in Shanghai, China from 2019-2021.
Women constituted 56.8% of the sample in ICs but 46.4% in CCs (p = 0.003), indicating advantages of the program in recruiting women. Accordingly, all analyses controlled for variables associated with gender differences: age, diabetes duration, baseline BMI.
Analyses of clinical/quality of life changes controlled for corresponding baseline measures.At baseline, women had lower HbA1c (7.44% vs 7.63%) and FPG (7.74 vs 8.12 mmol/L), but slightly higher SBP (138.25 vs 136.12 mmHg). Women scored slightly higher on a four item measure of diabetes distress, (1.17 vs 1.15, range = 1-3) and on the PHQ8 measure of depressed mood (1.96 vs 1.33).
Among all participants (all ps ≤ 0.04), ICs exceeded CCs on beneficial changes in HbA1c (-0.06% vs. 0.22%) including among those with HbA1c ≥ 8% at baseline (-0.76% vs. -0.41%), FPG (-0.04 vs. 0.76 mmol/L), among those with FPG > 7 mmol/L at baseline (-0.54 vs. -0.06 mmol/L), and both diabetes distress (-0.07 vs. 0.06) and PHQ8 (-0.49 vs. 0.54).
Among women, ICs exceeded CCs for change in HbA1c (-0.12% vs. 0.15%), FPG (-0.15 vs. 1.12 mmol/L) and among those ≥ FPG 7 mmol/L at baseline (-0.74 vs. 0.39 mmol/L), and both diabetes distress (-0.06 vs. 0.11) and PHQ8 (-0.55 vs. 0.93) (all ps≤0.008). For men, ICs differed significantly from CCs for only two variables, less worsening for both HbA1c (0.02 vs. 0.28) and FPG (0.10 vs. 0.46) (ps ≤ 0.028).
Summarizing, women showed beneficial changes, including HbA1c, FPG, diabetes distress, and PHQ8. Community based peer support for diabetes management may offer both clinical and quality-of-life benefits for women, in spite of other biological and social challenges to diabetes and its management that women face.
Y. Liu: None. C. Cai: None. X. Wu: None. P.Y. Tang: None. M.M. Coufal: None. L. Shen: None. E.B. Fisher: None. W. Jia: None.
Shanghai Key Discipline of Public Health Grants Award No. GWVI-11.1-20, and Shanghai Municipal Grants Award No. GWIV-3.1 to Professor Weiping Jia as principal investigator, Shanghai Municipal Health Commission “Health Promotion Talent” grant No. JKKPYC-2022-12 to Dr. Yuexing Liu as principal investigator, and by grants from The Merck Foundation and from Sanofi China, both to Professor Edwin Fisher as principal investigator, and by the UNC-Michigan Community, Family, and Peer Support Core of the Michigan Center for Diabetes Translational Research, P30 DK092926.
