People with diabetes also reported that diabetes had a negative impact on their relationship with family, friends and peers (21%), leisure activities (38%), work/studies (35%) and financial situation (44%1).
DAWN2TM clearly shows that people with diabetes experience a significant burden in relation to managing their condition. More than half of people with diabetes (56%) felt very worried about the risk of hypoglycaemia and 39% of people with diabetes reported that taking medication interferes with their ability to lead a normal life1.
The DAWN2TM results reveal that about one-third of family members reported experiencing a notable burden and negative impact of diabetes. Specifically, family members reported the negative impact of living with someone who has diabetes on their emotional wellbeing (45%), financial situation (35%), leisure activities (31%) and physical health (27%)2. In addition, they reported having high levels of distress (40%) and being worried about the risk of hypoglycaemic events occurring in the person with diabetes with whom they live (61%)2. In contrast, family members also experienced some positive impacts of diabetes. For example, 35% reported a positive impact on at least one aspect of life, such as in their relationship with the person who has diabetes, family, friends and peers, and on work/studies2.
Although 37% of family members said they were frustrated that they did not know how best to help the person with diabetes they lived with, 39% indicated that they would like to be more involved in caring for their relative2. Specifically, 46% said they wanted to help the person with diabetes deal with his or her feelings regarding diabetes and living with this chronic condition2.
The importance of family support for people with diabetes is widely acknowledged for the difference it can make to self-management outcomes. However, families need psychosocial and education resources to support the person with diabetes with whom they live.
However, the DAWN2TM study highlights that healthcare professionals and people with diabetes differ considerably with regard to their perceptions about the support being given. For example, whereas 52% of healthcare professionals reported that they asked people with diabetes on a regular basis how diabetes affects their lives, only 24% of people with diabetes reported that they were being asked about this by their healthcare professionals2,3.
The vast majority of healthcare professionals who took part in the study agree that it's very helpful when people with diabetes are actively engaged, for example by preparing questions for the consultation (84%) and engaging in community activities (84%). In addition, 60% of healthcare professionals report a need for improvement in self-management by people with diabetes, in particular physical activity (93%), healthy eating (91%) and maintaining a healthy weight (90%)3.
Self-management education is a necessity for active engagement. While 61% of healthcare professionals were convinced that a better availability of diabetes self-management education would reduce the diabetes burden, only 33% reported that they had received adequate training for providing such education3. Furthermore, 50% of healthcare professionals would like to attend training programmes that would equip them with the knowledge and tools to provide better self-management education and support to people with diabetes3.
Healthcare professionals agree that self-management education is important, but the DAWN2TM results show that training for its provision is lacking. The study shows that 50% of healthcare professionals would like to attend training programmes that would equip them with the knowledge and tools to provide better self-management education and support to people with diabetes3.
The results of the DAWN2TM study have the potential to lead the way for improvements in access to diabetes education with the purpose of helping people with diabetes achieve the best quality of life possible.
Most healthcare professionals (63%) agreed that there is a major need for a better availability of resources for the provision of psychosocial support and 59% of the healthcare professionals responded that they would like to receive more training in addressing psychosocial needs of people with diabetes3. Only 20% of professionals reported that they had already received training in the management of psychological aspects of diabetes3.
DAWN2TM highlights critical gaps in relation to addressing psychosocial barriers to good self-management. The study reveals how healthcare professionals perceive a lack of resources to address emotional problems in people with diabetes and that they acknowledge a need for better training to help provide more adequate psychosocial support.
The perception of being discriminated against is associated, wherever it occurs, with a highly negative impact on relationships with family, friends or peers, work/studies, financial situation and psychological well-being4.
The DAWN2TM study shows that family members and healthcare professionals also believe that discrimination is an issue: 22% of family members believe that their loved ones with diabetes face discrimination and 33% of healthcare professionals were concerned about discrimination and said there was a "major need" for improvement in the acceptance of people with diabetes as equal members of society2,3.
The results of DAWN2TM will be used to educate decision-makers and society to make changes that are needed to reduce discrimination and improve the quality of life for people with diabetes.
1. Nicolucci A, et al. Diabetes Attitudes, Wishes and Needs: Second Study (DAWN2). Cross-national benchmarking of diabetes-related psychosocial outcomes for people with diabetes. Diabetic Medicine 2013;30:767-77.
2. Kovacs Burns K, et al. Diabetes Attitudes, Wishes and Needs second study (DAWN2): Cross-national benchmarking indicators for family members living with people with diabetes. Diabetic Medicine 2013; 30:778-88.
3. Holt RIG, et al. Diabetes Attitudes, Wishes and Needs second study (DAWN2): Cross-national comparisons on barriers and resources for optimal care: Healthcare professional perspective. Diabetic Medicine 2013; 30:789-98.
4. Wens J, Nicolucci A, Kalra S, et al. on behalf of the DAWN2 Study Group. Societal discrimination and emotional well-being in people with diabetes: results from DAWN2. Abstract 1142. EASD, 2013.