Effectiveness of family and peer support intervention on glycemic control, self-management, and quality of life in type 2 diabetes in rural Indonesia: A randomized controlled trial

BACKGROUND: Type 2 diabetes mellitus (T2DM) is a major global health burden, with many patients failing to achieve optimal glycemic targets. Family and peer support are recognized as important determinants of effective diabetes self-management. However, there is little evidence of the combined impact. Therefore, this study aimed to evaluate the effectiveness of a structured family and peer support intervention, delivered alongside standard diabetes care, to improve glycemic control. MATERIALS AND METHODS: A randomized controlled trial was conducted on 120 patients with T2DM, allocated into two equal intervention and control groups. The intervention consisted of eight weekly group-based educational sessions followed by four structured weekly telephone follow-ups, during which emphasis was placed on family and peer support in diabetes education, self-management, and problem-solving strategies. The primary outcome was glycemic control measured with Glycated hemoglobin (HbA1c), while the secondary outcomes included self-management, knowledge, and diabetes-related quality of life (DQoL). Data were analyzed using SPSS. Chi-square test and independent t-test were used to compare baseline data between groups. Mann Whitney U test or t-test, as appropriate, assessed the changes from baseline to 12 weeks. RESULTS: A total of 110 subjects completed 12 week follow-up. Majority (75%) were females, and were aged 46-65 years (>70.0%). At the 3-month follow-up, the intervention group demonstrated significantly greater reductions in HbA1c compared to the control (6.7% ± 0.8% vs. 7.2% ± 0.8%, P = 0.002). Significant improvements were also observed in self-management scores (56.1 ± 2.7 vs. 46.1 ± 3.4, P < 0.001), DQoL (46.3 ± 7.9 vs. 37.1 ± 8.4, P < 0.001), and knowledge of diabetes (4.31 ± 0.61 vs. 3.91 ± 0.72, P < 0.001). CONCLUSION: Family and peer support intervention significantly improved glycemic control, self-management behaviors, diabetes knowledge, and the quality of life of patients with T2DM. Therefore, healthcare providers should consider making family members and peers an essential part of the diabetes management routine.