THIRUVANANTHAPURAM: Kerala, long regarded as the diabetic capital of India, has seen a sharp rise in cases over the past decade with nearly one in four adults affected. The surge has placed significant strain on the state’s healthcare system.
However, a new nine-year study published in The Lancet Global Health points to a promising, low-cost solution rooted in community. According to the Kerala Diabetes Prevention Program (K-DPP), “peer support”, where trained community members guide others, can significantly reduce the risk of type 2 diabetes.
The study focused on persons at high risk of diabetes, a group that also constitutes roughly one in four adults in the state. Researchers tracked more than 1,000 such individuals, a population representative sample, across 60 polling areas. Half of them joined peer-led lifestyle groups, while the rest received only an educational booklet.
Unlike traditional medical models that rely on doctors and nurses, the K-DPP trained “peer leaders” to guide neighbours through 12 months of lifestyle changes. They led group sessions on practical, culturally tailored habits: healthier diets, increased physical activity and tobacco cessation.
“Two peer leaders were selected from each group and trained. This was before WhatsApp became popular, so they stayed connected directly, monitoring each other’s progress,” explained Dr Jeemon Panniyammakal, lead author of the study and additional professor at Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST).
After nine years, the results were striking. More than one-third of the control group developed diabetes, while the intervention group showed a 28% reduction in incidence when measured by fasting plasma glucose.The benefits were consistent across age groups, gender and varying levels of risk, highlighting the model’s wide applicability. The study also recorded a high follow-up rate, with 86% of participants remaining engaged over the nine-year period, an uncommon achievement in long-term community research.
Jeemon emphasised the wider significance: “Global studies have shown that peer group intervention is effective in controlling chronic diseases. We have proved that such interventions are effective in diabetes incidence prevention in our context, in a cost-effective manner. It creates a platform for discussing issues and overcoming challenges such as facilitating physical activities.”
The study underscores the potential of community-driven healthcare models, particularly in resource-limited settings. Unlike large-scale clinical trials conducted in countries such as the US, Finland, or China, Kerala’s approach relied on local volunteers.
Already, the programme has influenced policy. “All health and wellness centres in Kerala now have structured lifestyle intervention programmes to manage diabetes and hypertension. Peer groups have been formed in 4,500 centres and the approach has been integrated into government programmes over the past year,” Jeemon said.