THE initial results of the Diabetes Attitudes, Wishes and Needs 2 (DAWN2™) study were announced recently. It is the largest study of its kind, conducted across 17 countries and four continents, into the psychosocial aspects of diabetes management.

For the first time ever, family members were surveyed – along with diabetics, nurses, dieticians, general practitioners and specialists – to find new ways of reducing the burden of the condition.

“The DAWN2 study confirms that the physical, financial and emotional burden of diabetes across cultures and countries is carried by the entire family, not just by the person with diabetes,” says Prof Mark Peyrot, principal investigator and chair of the international scientific committee overseeing the study.

The initial results show that:

• 63% of family members are anxious about the possibility that the person they live with will develop serious complications from the condition.
• 66% of family members of insulin-treated people with diabetes fear that their loved one will become hypoglycaemic during the night.
• 34% of family members report a negative financial impact on themselves due to the diabetes of their loved one.
• 20% of family members experience that their loved one is being discriminated against because of diabetes, and that the community they live in is intolerant of diabetes.
• 35% of people with diabetes report that their family argues with them about how they manage their diabetes.
• 75% of family members have not attended an education programme about diabetes, despite at least 70% of diabetes healthcare professionals believing that involvement of family members is a vital part of good diabetes care.

“The DAWN2 study brings new and important scientific data about the hidden burden of the diabetes pandemic on the families of people with diabetes, and the gaps in current healthcare systems. The societal implications of these findings are significant, and that DAWN2 results should motivate and compel decision-makers, healthcare providers and patient organisations to act in unity to improve education and support for both people with diabetes and their loved ones,” says Sir Michael Hirst, president-elect of the International Diabetes Federation (IDF).

DAWN2 is a global Novo Nordisk initiative conducted in collaboration with the IDF, the International Alliance of Patient Organisations (IAPO), the Steno Diabetes Center, and a range of other national, regional and global partners.

“DAWN2 represents our company’s long-term commitment to work in partnership to improve the lives of people with diabetes,” explains Lars Rebien Sørensen, president and chief executive officer of Novo Nordisk. “Even with the best available medicines, people with diabetes depend on diabetes education and day-to-day motivation and support from family, friends and the wider society.”

Prof Dr Chan Siew Pheng, senior consultant endocrinologist of Sime Darby Medical Centre and visiting professor of University Malaya Medical Centre, comments: “Although Malaysia does not have data of its own, in our clinical experience, our patients with diabetes have the same issues as that noted in the important DAWN2 study. The findings of DAWN2 continues to support and affirm the need for the establishment of Integrated Diabetes Care teams – healthcare professionals such as doctors, diabetes educators, pharmacists, dieticians and psychologists, to provide a holistic approach to the successful management of the individual with diabetes.

“It is the largest survey of its kind, addressing a key unmet need for the care of people with diabetes – namely, recognising the burden this chronic illness places on the people who care for these individuals.

“In Malaysia, we have made great strides and improvements in the management of acute illnesses, such as heart attacks, strokes or infections. What is lacking is a successful chronic care model to cope with chronic illnesses like diabetes. Appropriate diabetes education and provision of psychosocial support to empower those with diabetes and their carers is important to ensure long-term motivation and ability to cope. DAWN2 is a wake-up call for all health agencies to address this vital component of diabetes management.”

DAWN2 expands on the original DAWN™ study from 2001, and involves people with diabetes, their families, carers, and a wide range of diabetes healthcare professionals, as well as patient organisations and diabetes policy experts.

The three main objectives of the DAWN2 initiative are to:

• Advance understanding and awareness of the unmet needs of people with diabetes and their families.
• Facilitate dialogue and collaboration to strengthen patient involvement and improve self-management and psychosocial support in diabetes care.
• Establish an international scientific benchmarking system for person-centred diabetes care and health policy.

The DAWN2 study was conducted during 2012, and will be followed by a comprehensive programme of activities until at least 2016.

The results of DAWN2 will be published in a series of articles starting in the spring of 2013. Additionally, partnership actions will be identified on a global and local level to address the critical needs and gaps identified by the study.

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