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The median age of diabetes diagnosis was 35 years, which is older than in other studies,26 27 but is consistent with the age at which diabetes-specific care was provided to these participants at the time of study. It is possible that younger people are more likely to have diagnosed diabetes and to access diabetes-specific care. A significant number of participants had previously had diabetes-specific counselling and/or support, with only 3 of the DPMs reporting no previous counselling or support. At baseline, a significantly higher proportion of participants with a family history of diabetes had received diabetes-specific counselling and support (p=0.037). A further limitation of this study is that we did not have access to data on the referral source of participants and were unable to identify whether the DPMs were self-referrals or referrals from a health care professional. This is a limitation as there may be other factors influencing referral to an established DPM, such as access to family support, family history of diabetes and level of confidence in diabetes self-management. The current study was not designed to investigate the factors which influence referrals to DPMs. As mentioned previously, the DPMs completed an extensive baseline questionnaire which included questions relating to how often they received counseling and support.
There is evidence of significant benefit from peer support in diabetes management, and peer support is an important element of diabetes care that needs to be considered when addressing the health and economic burden of diabetes.12 24 In this study, we found a high retention rate and positive program outcomes by 6 months, as well as a high level of DPM satisfaction. This is consistent with other peer support studies, such as the Diabetes Prevention Program, where the retention rate was 63% after 1 year and attrition was highest among those with higher education and income, and those with higher baseline hemoglobin A1c levels.13 27 The present study found that volunteer retention was improved by having a single point of contact (N.J.G.) who was available to support volunteers and answer questions. Our results suggest that there is a need to establish further more extensive peer support programs with a focus on diabetes in Australia, and that peer support is an effective model of diabetes care for people with diabetes.
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