In 2002, the findings of DAWN (Diabetes Attitudes, Wishes and Needs), the landmark study of the psychosocial aspects of diabetes financed by Novo Nordisk, played a pivotal role in placing the social and psychological needs of people with diabetes squarely on the agenda.

As the largest global psychosocial diabetes survey of its kind, DAWN addressed the perceptions and attitudes of more than 5,000 people with diabetes and nearly 4,000 healthcare professionals in a total of 13 countries. It made clear that healthcare providers should focus at least as much on patient attitudes and environment as on medicine when
trying to improve a patient’s health. In 2002 the findings were presented through a
range of activities, not only to medical professionals, but also to government leaders, and institutions and organisations active in diabetes. In meetings, publications, programmes and other initiatives we invited a discussion aimed at bringing about solutions to the problems made evident by DAWN. One-third of the patients in the study reported a  feeling of “poor well-being”, and only 10% reported a feeling of “good well-being”.  Approximately 50% of patients were very anxious about their weight and were constantly afraid that their disease would get worse. Almost 40% felt stressed by their diabetes and worried about being able to carry out their family responsibilities and felt more tense than other people they knew. Less than 50% of the healthcare professionals interviewed felt able to identify and evaluate patients’ psychological needs. The findings showed that social support and emotional well-being are central to achieving effective self-management, and that  psychosocial support should be combined with appropriate medical care.

Now that DAWN has made clear the challenges, a number of initiatives are going forward to find solutions. Those efforts begin at home, with our own employees, all of whom need to understand the key messages of DAWN in order to better deliver on our promise of ‘being there’ for people with diabetes. Thus, in 2002, we succeeded in meeting our target that at least 80% of all employees were to have a dialogue with people with diabetes.

The first Oxford International Diabetes Summit in April 2002, convened by the Oxford Centre for Diabetes, Endocrinology and Metabolism in Oxford, UK, and Novo Nordisk, shared the findings with doctors, nurses, patients and policymakers. Delegates called for a new framework for psychosocial education and a global campaign to raise diabetes awareness. A second Oxford International Diabetes Summit will be held in May 2003.

We also held a symposium during the European Association for the Study of Diabetes (EASD) Congress in Budapest, where DAWN was the focus. In addition, a EUR 1.6 million research grant given by Novo Nordisk in 2002 to the European Foundation for the Study of Diabetes, the research arm of the EASD, will encourage projects with a psychosocial focus. Findings from DAWN were also part of the discussion for inclusion of diabetes in the 6th framework programme of the European Union. DAWN has been presented and discussed with the International Diabetes Federation, leading to  collaboration on a project to improve diabetes educational programmes.

“DAWN pointed out many pressing problems, among which: How do you manage psychological support when there is not enough support to go around?” says Professor David Matthews, chairman, Oxford Centre for Diabetes, Endocrinology and Metabolism. “It means gradually moving away from the old doctor-patient model and recognising that doctors need the help of other professionals to treat diabetes – nurses, podiatrists,
psychologists, and so on. But educating doctors alone about the psychosocial aspects of
diabetes will not be enough. We need to move towards a scheme that is more group-oriented, not only among health professionals but also among patients, so that they can support one another in a group setting.”

Improving the communication and understanding between doctor and patient is at the heart of the Communicating Care programme, a patient communication tool for healthcare professionals developed by Novo Nordisk as one response to the issues raised by DAWN. Successful pilot programmes in Sweden and the UK with 70 healthcare professionals during 2001–2002 now pave the way for the programme to be conducted through Novo Nordisk affiliates in a number of countries over the next two years, including the US and Australia.