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The Diabetes Attitudes, Wishes, and Needs (DAWN) Program: A New Approach to Improving Outcomes of Diabetes Care

The first 300 words of the full text of this article appear below.

	Introduction

 
The Diabetes Attitudes, Wishes, and Needs (DAWN) program is an international partnership effort to improve outcomes of diabetes care by increasing the focus on the person behind the disease, especially the psychosocial and behavioral barriers to effective diabetes management. DAWN was initiated by an international survey of > 5,000 people with diabetes and almost 4,000 diabetes care providers. The DAWN program has facilitated a number of concrete initiatives to address the gaps in diabetes care identified by the DAWN study.

	Why Do We Need DAWN?

 
Diabetes is one of the major world health problems. Recent estimates from the World Health Organization predict that if current trends continue, the number of people with diabetes will more than double, from 176 to 370 million people by 2030.¹ Diabetes is already the single most costly health care problem in Westernized countries. Among those diagnosed with the disease, at least half still do not achieve satisfactory glycemic control, despite the availability of effective treatments.² As a consequence, millions of people with diabetes are at elevated risk of suffering needlessly from serious complications of the disease. With the growing number of people with diabetes, there is an urgent need to find better ways of curbing the human and economic burden of this chronic progressive disease, through prevention, detection, and treatment. A review of the literature suggests several important areas that have the potential to address these problems.

Suboptimal diabetes self-management has been identified by several studies as one of the possible causes of poor outcomes of diabetes care in general practice.^3,4 A multitude of research studies, mainly in the Western world and with relatively small patient samples, has indicated the potential importance of a multitude of psychological, social, and behavioral factors for patient self-management.^5,6 Access to patient-centered self-management support and education has been shown in several studies to improve outcomes . . . [Full Text of this Article]

	What Is DAWN?

 

	The DAWN Study

 

	What DAWN Taught Us

 
Adherence
Distress
Patient-Provider Relationships
Provider Collaboration
Barriers to Use of Effective Medication Therapy
Summary

	Implications of the DAWN Study

 

	Translating Goals Into Action

 
Strategy 1. Raise awareness and advocacy.
Strategy 2. Educate and mobilize people with diabetes and those at risk.
Strategy 3. Train health care providers and enhance their competencies.
Strategy 4. Provide practical tools and systems.
Strategy 5. Drive policy and health care systems change.
Strategy 6. Develop psychosocial research in diabetes.

	Next Steps

 

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