Effectiveness of peer support delivery modalities on health outcomes in adults with type 2 diabetes: A systematic review and meta-analysis.

Abstract

To expand existing evidence on the effectiveness of peer support on health outcomes in people with type 2 diabetes. Differentiate between offline, online, and hybrid forms of peer support to advance nursing practice in chronic disease management. A systematic search of five databases was executed, covering the period from their inception up to July 18, 2025. The risk of bias in the included RCTs was assessed using the Cochrane Risk of Bias tool 2.0 (RoB 2.0). A meta-analysis was performed on the included studies utilizing Stata 17.0. A narrative synthesis was conducted when the meta-analysis was deemed infeasible. Meta-analysis showed that offline peer support significantly improved body-mass index [SMD= -0.59, 95 %CI= (-1.12,-0.05), p = 0.033, I²= 88.1 %] and fasting blood glucose [SMD= -0.45, 95 %CI= (-0.79,-0.12), p = 0.008, I²= 40.2 %], whereas hybrid support significantly reduced glycated haemoglobin [SMD= -0.19, 95 %CI= (-0.35,-0.04), p = 0.016, I²= 48.0 %]. Online peer support showed no significant effect. No statistically significant improvement in self-efficacy was observed. Additionally, the presence of substantial heterogeneity warrants cautious interpretation of all conclusions. Peer support interventions help patients with type 2 diabetes regulate glycated hemoglobin, body mass index, and fasting glucose levels, strengthen disease control, and improve clinical outcomes.