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BMJ 2010; 341 doi: (Published 27 October 2010) Cite this as: BMJ 2010;341:c6002

A diabetes buddy helps improve glycaemic control

People need help to manage their own chronic diseases, and in health systems with overstretched primary care, asking patients to help each other looks like an attractive option. In one trial (n=244), men with poorly controlled diabetes improved when they were put into pairs and asked to telephone each other once a week. Each partner supported the other, without the teacher and pupil hierarchy common to other forms of peer support. Men with partners reduced their glycated haemoglobin (HbA1c) concentrations by a mean of 0.29% over six months (from 8.02% to 7.73%). Controls without partners got worse (increased from 7.93% to 8.22%; mean difference between groups 0.58%; P=0.004). Both groups were seen by nurse care managers. The men who were paired up had one compulsory group session followed by three voluntary sessions. Controls had one (shorter) compulsory session followed by a contact telephone number.

This is an encouraging start for a new kind of peer support, says an editorial (p 544). Now we need to know if it can work for women, or for anyone outside the well organised system of primary care run by the US department of Veterans Affairs. We also need to explore just how the intervention improved outcomes. One clue is that men were more likely to agree to insulin treatment when they had someone to talk to, even though they didn’t talk as much as the researchers planned. After six months, partners were calling each other less than once a month and speaking for less than seven minutes. Peer support had no effect on blood pressure or adherence to drugs.

Cardiovascular risks increase after invasive dental treatment

An analysis of claims on a large US database suggests that invasive dental treatment is followed by a small but significant increase in the risk of heart attacks and strokes. The authors …

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