DAWN: Diabetes Attitudes, Wishes and Needs

DAWN: Diabetes Attitudes, Wishes and Needs

The results of the DAWN2 study suggest that family members
are seeking advice and support in an effort to become more
involved in the care of their loved one with diabetes.

RESEARCH IN diabetes is about more than finding a cure or better treatments. Research is also done to better understand what it’s like to live with diabetes and to learn about easier ways to manage life with diabetes. An important example of this kind of diabetes research is the DAWN2 Study. DAWN stands for Diabetes Attitudes, Wishes and Needs. The first DAWN study, done in 2001, showed that a large number of people with diabetes struggle with doing all they need to do and that almost half (43%) have had diabetes-related distress. Diabetes-related distress is the everyday anger, fear, frustration, guilt, sadness and anxiety that can occur while managing a complex and sometimes overwhelming illness.

Who took part in DAWN 2?

The DAWN2 study was done among 8,596 adults with type 1 or type 2 diabetes from 17 different countries, including the United States. Although there were some differences across countries, no single country did better or worse than others. In fact, it appears that people with diabetes the world over are very similar in how diabetes affects their lives.

What did DAWN 2 show?

Not surprisingly, DAWN2 showed that diabetes has a big impact on the lives of those who have it. These rates are similar to the 2001 DAWN study and were similar to more recent studies done in the United States alone.

What do these results mean to you?

Although this study may seem to paint a sad picture of life with diabetes, it also helps shed light on some of the important issues. In addition, the findings of this study may help you feel less alone if you know that others have had similar struggles. Also, it may give you hope to know there are things you can do to make life with diabetes better.

One proactive step is to attend a diabetes self-management education program. Slightly less than half of the people in DAWN2 attended such a program, and a large majority found it to be helpful. One of the benefits of attending an education program is that you can get the support you need from a group of similar people and learn from others with diabetes what works in their lives. Ask your healthcare provider about diabetes education and other resources for support in your area or go to www.yourdiabetesinfo.org/healthsense. Also, talk with your healthcare provider if you think you might have diabetes-related distress. There are many resources available to help you better manage and cope with diabetes.

The Family Study

The DAWN2 study indicated that a large number of people with diabetes struggle with their condition. It also assessed the diabetes attitudes, wishes and needs of family members. Although diabetes has long been described as a family disease because of its effect on the lifestyle of the person with diabetes and his or her family members, very little is known about how family members view diabetes. While other studies have shown that people with diabetes who have the support of family and friends have better outcomes, this portion of the DAWN2 study focused on a different, neglected aspect of the family impact of diabetes.

For the family study, DAWN2 surveyed 2,057 family members who lived in the same house as an adult with diabetes. The purpose of the survey was to assess the impact of diabetes on family life, family support for people with diabetes and education and community resources.

How does diabetes affect family members?

The results of the study showed that supporting a relative with diabetes was perceived as a burden by about one-third (35.3%) of the participating family members. The good news is that about half of the participants (51.4%) rated their quality of life as good or very good. However, many family members indicated a high level of distress. The biggest source of concern for about 61% was low blood glucose (hypoglycemia). Almost half of the participants reported that diabetes impacted aspects of their lives. The greatest negative effect was on emotional well-being (44.6%).

About one-third of those surveyed (37.1%) indicated that they did not know how to best help the person with diabetes and that they wanted to be more involved in their care. Another recent study showed that family members felt uncomfortable having to police the family member with diabetes and were confused about how they could best help and what their role should be.

What can family members do?

Although attendance of diabetes self-management programs was fairly low among family members (23.1%), most of those (72.1%) who went found them helpful. Almost all diabetes education programs welcome family members, so if your loved one with diabetes has never attended, ask if he or she is interested and make it clear that you would like to come along. Ask your healthcare provider for a referral to a program in your area.

The DAWN2 study also showed that family members want to know what their loved one finds helpful. An idea that others have found useful is for you and your loved one with diabetes to talk for five minutes (without interruption) about what diabetes means to each of you. This is a good way to gain insight into diabetes from both parties. Using what you learned, talk about what role the family should play, and come up with ideas so that each member of the family gets the right kind of help and support.

Results of the DAWN 2 Study

  • 12% of participants reported a poor or very poor quality of life
  • almost 14% were depressed
  • almost 45% had diabetes-related distress
  • about 20% said it had a negative impact on their relationships with family and friends
  • about 40% reported that their medicines interfered with their ability to live a normal life

The availability of person-centered chronic illness care and active support from healthcare providers were both rated as low.


By Martha Funnell, MS, RN, CDE

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