Discussion
lower diabetes, diabetes
DIABETES
This work depicts lessons learned from implementing comparable peer-leader interventions for diabetes self-care in two at-risk communities with varying health and socioeconomic conditions. We found that diabetes educational interventions, especially when accompanied by PL support, can have a greater impact on communities with lower metabolic control and more robust social cohesion, cultural identity, and functional support networks.Numerous factors contributing to the observed variations have been identified and described. These encompass both community-related environmental and behavioral factors, as well as individual characteristics. It is crucial to consider these specific features when designing future interventions that aim to enhance diabetes-related outcomes through community-based participatory approaches. By acknowledging a sectorization approach for intervention delivery, participants’ initial level of control and education, and the inherent leadership abilities of community PLs, interventions can be tailored to meet the unique needs and challenges of the community. This will ultimately lead to more effective and impactful outcomes.It is anticipated that loss-to-follow-up rates will be higher among individuals with lower diabetes control and lower levels of education. These individuals comprise the group that stands to benefit the most from receiving peer support for diabetes management. By recognizing this potential challenge and tailoring the program to address it, interventions can ensure that individuals who require support the most are effectively engaged and retained in the intervention.Furthermore, it is essential to consider the disparities in socioeconomic activities among at-risk communities when planning and implementing educational interventions to address absenteeism. As an illustrative example, our study revealed a significantly higher proportion of formal employees in the suburban area of Conkal compared to the semirural region of Komchen. It is plausible that these disparities in socioeconomic activities between the two communities may have contributed to the divergent findings observed.For example, The Mexican Institute of Social Security (IMSS) provides medical services through formal employment (Despite suburban participants from Conkal having advantages in education, income, higher affiliation to the IMSS, and better urbanization services, semirural Komchen achieved superior results in the educational intervention compared to suburban Conkal. This highlights the need for tailored strategies for each targeted population. Peer-led support could be more suitable for small, locally cohesive communities, even with language barriers.Strong community ties and interpersonal bonds outweigh challenges related to limited service access and marginalization (