Peer Support: An Untapped Resource in Diabetes Care
For many individuals, living with diabetes can feel isolating.
While healthcare professionals provide essential clinical expertise, education, and guidance, they may not always be able to offer something equally valuable—the perspective of lived experience. Sometimes the most powerful words a person with diabetes can hear are, "I've been there too."
As healthcare systems continue to address rising rates of diabetes, workforce shortages, increasing demands on educators, and persistent health disparities, peer support is emerging as a powerful yet underutilized tool for improving outcomes and expanding access to care.
The Growing Evidence Behind Peer Support
Peer support is not a new concept. For decades, peer-led programs have been successfully used in behavioral health, substance use recovery, chronic disease management, and rural healthcare settings. These programs leverage individuals with shared experiences to provide encouragement, practical problem-solving, emotional support, and social connection.
In diabetes care, research continues to demonstrate that peer support can positively impact:
- Self-management behaviors
- Diabetes self-efficacy and confidence
- Emotional well-being
- Diabetes distress
- Medication adherence
- Healthy eating and physical activity habits
- Healthcare engagement
A landmark review by Fisher et al. identified four key functions of diabetes peer support:
- Assistance in daily disease management
- Social and emotional support
- Linkage to clinical care and community resources
- Ongoing support that extends beyond traditional healthcare encounters
These functions align closely with many of the goals of Diabetes Self-Management Education and Support (DSMES), making peer support a natural complement to professional diabetes education.
Why Peer Support Matters
Diabetes is a condition managed primarily outside the healthcare setting.
Patients spend only a few hours each year interacting with healthcare professionals, while managing diabetes every day. The daily decisions surrounding food, physical activity, medications, glucose monitoring, sleep, stress management, and problem-solving can be overwhelming.
Many individuals experience diabetes distress, feelings of burnout, frustration, guilt, or discouragement related to the demands of self-management. Research suggests that diabetes distress affects a significant proportion of people living with diabetes and is associated with poorer self-care behaviors and higher A1C levels.
Peer support helps address these challenges by creating opportunities for connection and normalization.
When individuals hear from others who have faced similar struggles, they often feel less alone, more hopeful, and more motivated to continue making healthy changes.
Peer Support and Adult Learning Principles
The effectiveness of peer support may also be explained through established adult learning theories.
Adult learners tend to learn best when education is:
- Relevant to their daily lives
- Problem-centered rather than content-centered
- Based on real-world experiences
- Collaborative and interactive
- Respectful of individual autonomy
Rather than relying solely on information transfer, peer support creates environments where individuals can learn from one another's successes, challenges, and practical solutions.
Hearing how another person managed medication side effects, navigated a family gathering, incorporated physical activity into a busy schedule, or advocated for diabetes technology can make educational concepts more relatable and actionable.
In many ways, peer support transforms education from simply acquiring knowledge to building confidence and applying skills.
The Importance of Community
Humans are inherently social beings.
Research across healthcare disciplines consistently demonstrates that social connection influences health outcomes. Individuals who feel connected to others often experience greater resilience, improved mental health, and increased engagement in health-promoting behaviors.
This can be especially important in rural communities.
Many rural residents face challenges including:
- Geographic isolation
- Transportation barriers
- Limited access to specialists
- Fewer healthcare resources
- Increased rates of chronic disease
Peer support programs can help bridge these gaps by fostering local networks of encouragement and shared learning.
For individuals who may not have access to frequent healthcare visits, peer relationships can provide ongoing reinforcement between clinical encounters.
Opportunities for Diabetes Programs
Across Washington and throughout the country, diabetes educators are exploring innovative ways to incorporate peer support into existing services.
Examples include:
Support Groups
In-person or virtual support groups provide opportunities for individuals to share experiences, discuss challenges, and celebrate successes in a supportive environment.
Peer Mentors
Individuals successfully managing their diabetes can be trained to support others who are newly diagnosed or facing similar challenges.
Community Partnerships
Faith communities, senior centers, community organizations, and local health coalitions may offer opportunities to develop peer-based programs outside traditional healthcare settings.
Lifestyle Change Programs
Programs such as the National Diabetes Prevention Program have long utilized group-based learning and peer interaction to support behavior change.
Community Health Workers
Community health workers often serve as trusted connectors between healthcare systems and the communities they serve, helping individuals navigate resources and overcome barriers to care.
Digital Communities
Online support groups, moderated social media communities, and virtual peer programs can extend support to individuals who may not be able to attend in-person programs.
Extending the Reach of DSMES
The demand for diabetes education continues to exceed available resources in many communities.
Peer support should not replace DSMES or the expertise of Certified Diabetes Care and Education Specialists (CDCESs). Rather, it can serve as an extension of professional care, reinforcing education, increasing engagement, and providing ongoing encouragement between visits.
The ADCES National Standards for DSMES emphasize the importance of ongoing support following initial education. Peer support may be one of the most scalable and sustainable ways to provide that ongoing connection.
As healthcare continues to move toward person-centered care, community partnerships, and population health approaches, peer support offers an opportunity to expand the reach and impact of diabetes education.
Looking Forward
The future of diabetes care will likely involve more than traditional classroom education and one-on-one visits. Successful programs will increasingly combine professional expertise, technology, community resources, and peer connection.
People living with diabetes need evidence-based clinical guidance. They also need support, understanding, encouragement, and a sense of belonging.
Peer support offers all of these.
By creating opportunities for individuals to learn from one another, share their experiences, and build meaningful connections, we can strengthen diabetes care, reduce isolation, and empower people to live well with diabetes.
Sometimes the most effective intervention is not a new medication, device, or technology.
Sometimes it is simply knowing that someone else understands the journey.
References
American Diabetes Association. Standards of Care in Diabetes—2026. Diabetes Care.
Fisher EB, Boothroyd RI, Elstad EA, et al. Peer support of complex health behaviors in prevention and disease management with special reference to diabetes. Current Diabetes Reports. 2017.
Powers MA, Bardsley J, Cypress M, et al. Diabetes Self-Management Education and Support in Adults With Type 2 Diabetes: A Consensus Report. Diabetes Care.
Heisler M. Different models to mobilize peer support to improve diabetes self-management and clinical outcomes: Evidence, logistics, evaluation considerations, and needs for future research. Family Practice.
World Health Organization. Community Health Workers: Evidence and Guidelines for Policy and Practice.