DAWN2 - Another Kind of Dawn Phenomenon   (December 10, 2013)

Most of us who deal with diabetes on a daily basis are familiar with the dawn phenomenon (high blood glucose levels at dawn), but there’s another kind of dawn for us to become aware of: the DAWN and DAWN2 (Diabetes Attitudes, Wishes and Needs) studies.

The original DAWN study in 2001 had shown the need to “enhance communications between people with diabetes and healthcare providers, promote team-based diabetes care, promote active self-management, overcome emotional barriers to effective therapy, [and] enable better psychological care for people with diabetes.”

The recent DAWN2 study built on the experience gained from the original study. Researchers surveyed 15,438 participants between 2011 and 2013; participants included 8596 PWD, 2057 family members, and 4785 health care professionals (HCPs) (including 2066 PCPs and GPs, 1350 diabetes specialists, 927 nurses and 542 dietitians), from 17 countries (Algeria, Canada, China, Denmark, France, Germany, India, Italy, Japan, Mexico, The Netherlands, Poland, Russia, Spain, Turkey, UK and the USA). “Each country’s approximately 900 participants included 500 people with diabetes, 120 family members and 280 healthcare professionals.”

Results from the DAWN2 study have been trickling out this past year. Worldwide press reports focus on the results and implications.

• Global Study Finds Diabetes Education is Associated with Better Self-Management and Quality of Life – Yet More Than a Quarter of People with Diabetes in the UK Have Never Participated in Diabetes Education
• Second diabetes attitudes, wishes and needs (DAWN2) study: relevance to Pakistan
• and in India, Diabetes takes toll on family members too

But it was the latest headlines really caught my eye: Only 29% of people with diabetes report that their doctors ask them for input for their own treatment plans. And “only 33% said they were encouraged by their healthcare professional to ask questions in the consultation.”

It’s not clear from the press releases whether there were some countries where interactions between HCPs and patients were excellent and others where interactions were completely missing. Additionally, it would be interesting to see where the USA ranked. And it would be very interesting (to me, at least) to compare the results from PCPs and GPs with those of diabetes specialists or with those of nurses and dietitians. And whether it was T1DM patients or T2DM who didn’t have input (I suspect I might know the answer!).

The lead investigator from DAWN2 in Denmark is quoted as saying “People with diabetes who feel supported and capable of self-managing their condition are more likely to have a successful treatment outcome and therefore have the opportunity to live a better life with diabetes.” That’s always been my opinion, also.

The DAWN2 study shows that we’re still a long ways from universal acceptance of this idea.