Feasibility and preliminary outcomes of a peer-led diabetes self-management support program for black men: the michigan men’s diabetes project (MenD II)

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Abstract
Background: Black men face disproportionately high rates of type 2 diabetes (T2D), yet are underrepresented in diabetes self-management support (DSMS) interventions. Peer-led DSMS (PLDSMS) shows promise for minoritized populations, but few programs target Black men specifically. Objective: This pilot study examined feasibility and preliminary effectiveness of a culturally adapted, PLDSMS intervention for Black men with T2D in Metro Detroit. Methods: We conducted a 15-month randomized pilot trial (N = 48) comparing PLDSMS plus DSMES to DSMES alone (enhanced usual care). PLDSMS included monthly peer-led virtual sessions for six months post-DSME, plus six months of optional support. Primary outcomes included HbA1c and perceived diabetes self-management (PDSMS). Secondary outcomes included diabetes distress and social support at baseline, 3, 9, and 15 months. Results: Participants (mean age=63 years) demonstrated successful recruitment (N = 60) and high retention (>80% at 15 months). No between-group differences in HbA1c emerged (p=0.32). Perceived self-management showed significant group-by-time interaction (p=0.03); the control group scored 5.36 points higher at 3 months (p=0.02), but differences were not sustained at 9 months (p=0.67). Diabetes distress and social support did not differ between groups, though provider-related distress declined significantly across both arms (B=-0.54, p=0.001). Conclusion: This pilot demonstrates feasibility of a PLDSMS program for Black men. Glycemic control remained stable, and although between-group differences in perceived self-management were not sustained over time, findings are consistent with the hypothesis that peer-led support may help sustain self-management gains as the initial benefits of DSME alone begin to wane. Future fully powered trials are needed to test this hypothesis.

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