Objective: Black men with type 2 diabetes (T2D) are at an increased risk for suboptimal blood glucose management, which can lead to both short- and long-term complications. This study aimed to assess the acceptability of a peer-led T2D intervention tailored to Black men and evaluate changes in primary outcomes.

Methods: In this 15-month pilot randomized clinical trial (RCT), data were collected at baseline, three (T1), nine (T2), and 15 months (T3). Participants were randomly assigned to the adapted Peer-Led Diabetes Self-Management Support (PLDSMS) group (n=24) or to the enhanced usual care (EUC) (n=24). In the first three months, participants in the PLDSMS arm received 10 hours of virtually delivered Diabetes Self-Management Education (DSME), followed by six months of virtual 90-minute sessions once a month before transitioning to six months of ongoing support. Participants in EUC only received 10 hours of virtual DSME over three months. All sessions were led by a Certified Diabetes Care and Education Specialist. A longitudinal mixed-effects linear regression model was used to compute differences in primary outcomes over time between the intervention and control groups.

Results: All participants were Black men (mean age 63.1 years, SD 9.50; mean HbA1c 6.8%, SD 1.43). No significant differences in HbA1c were observed between the intervention and control groups over time (p=0.8322). HbA1c increased by 0.08% (0.28 SE; p=0.7867), 0.05% (0.32 SE; p=0.8794), and 0.24% (0.33 SE; p=0.4682), from baseline to T1, T2, and T3, respectively, regardless of group. Significant differences in perceived diabetes self-management were observed between the intervention and control groups over time (p=0.0187). Lastly, core diabetes distress scores increased by 0.06 (0.18 SE; p=0.7362) from baseline to T1, decreased by 0.20 (0.20 SE; p=0.3279) from baseline to T2, and increased by 0.03 (0.19 SE; p=0.8657) from baseline to T3. Moderate to high retention rates were observed throughout the study. On average, 56% attended the DSME sessions and 79% attended the health assessment sessions.

Conclusion: The PLDSMS program was acceptable and resulted in changes in participant diabetes self-management efficacy. Participants in this study had optimal blood glucose levels at baseline, suggesting a reduced likelihood of observing significant changes in HbA1c levels over time.