Psychological outcomes also differed by ethnicity. African Americans had the best scores and non-Hispanic whites had the worst scores for well-being, quality of life, diabetes empowerment, and diabetes impact. Hispanics had the worst scores for quality of life and diabetes distress.
The DAWN2 data for U.S. survey respondents also indicated a substantial level of distress among people with diabetes and their family members. Having a large social support network for diabetes was related to better psychosocial outcomes, but few people with diabetes let others know how they can best provide support.
Also, U.S. respondents were pleased with the level of involvement of their family in diabetes care, and they feel that family members help a great deal by listening to them when they talk about difficulties associated with living with diabetes.
Diabetes is a burden from a management and psychological perspective. Patients need to be encouraged to ask for support when it is needed, and clinicians need to recognize that family members are untapped resources for patient support as well as a group in need of support as they deal with the burdens of caring for a family member with diabetes, Ms. Funnell added.
"Finally, we absolutely have to involve the person with diabetes and their family members as equal partners when developing care solutions," she said. Family members need to be taught how to help, and patients need to be asked how diabetes is affecting their life to identify problems and set appropriate goals for solving them.
"We need to truly focus on patient-centered care. ... We really need to surround the patient with their family and their friends, their health care, their communities, their workplaces, and the larger society if they are going to be successful in their self-management. It takes a village to manage diabetes, and every one of us has a role to play to make person-centered diabetes care and patient-centered diabetes education and ongoing support the reality that it needs to be," she said.
Ms. Funnell reported serving as a board or advisory panel member for Novo Nordisk, the sponsor of DAWN2, as well as several other drug companies involved in diabetes care, and receiving grant funding from BMS Foundation.