Psychosocial problems and barriers to improved diabetes management: results of the Cross‐National Diabetes Attitudes, Wishes and Needs (DAWN) Study
Open accessAbstract
Aims To examine patient‐ and provider‐reported psychosocial problems and barriers to effective self‐care and resources for dealing with those barriers. Methods Cross‐sectional study using face‐to‐face or telephone interviews with diabetic patients and health‐care providers in 13 countries in Asia, Australia, Europe and North America. Participants were randomly selected adults ( n = 5104) with Type 1 or Type 2 diabetes, and providers ( n = 3827), including primary care physicians, diabetes specialist physicians and nurses. Results Regimen adherence was poor, especially for diet and exercise; provider estimates of patient self‐care were lower than patient reports for all behaviours. Diabetes‐related worries were common among patients, and providers generally recognized these worries. Many patients (41%) had poor psychological well‐being. Providers reported that most patients had psychological problems that affected diabetes self‐care, yet providers often reported they did not have the resources to manage these problems, and few patients (10%) reported receiving psychological treatment. Conclusions Psychosocial problems appear to be common among diabetic patients worldwide. Addressing these problems may improve diabetes outcomes, but providers often lack critical resources for doing so, particularly skill, time and adequate referral sources.
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Daily self-management imposes a significant burden on patients with T2DM, often leading to increased emotional distress and feelings of being overwhelmed.
“However, the demanding character of daily self-management imposes a significant burden on patients with T2DM. Adopting new healthier habits, along with the need for constant blood glucose monitoring and medication adherence, often leads to increased emotional distress and feelings of being overwhelmed [6,11-13].”
From Evaluation of the Impact of Mobile Health App Vitadio in Patients With Type 2 Diabetes: Randomized Controlled Trial (2025) · cites this paper as [12]
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- Authors
- Peyrot, M., Rubin, R. R., Lauritzen, T., Snoek, F. J., Matthews, D. R., & Skovlund, S. E.
- Affiliations
- Johns Hopkins University (US)
- Aarhus University (DK)
- Vrije Universiteit Amsterdam (NL)
- University of Oxford (GB)
- Novo Nordisk (Denmark) (DK)
- Corresponding author
- Peyrot, M.
- Venue
- Diabetic Medicine
- Publisher
- Wiley
- Published
- 2005-09-13
- Volume
- 22
- Issue
- 10
- Pages
- 1379-1385
- ISSN
- 0742-3071 (ISSN-L)
- 1464-5491
- OpenAlex
- W2104616957
- Cited by
- 931
- References
- 23
- Citations by year
- 2026: 28 · 2025: 27 · 2024: 25 · 2023: 39 · 2022: 51 · 2021: 54 · 2020: 41 · 2019: 42 · 2018: 41 · 2017: 55 · 2016: 57 · 2015: 82 · 2014: 54 · 2013: 66 · 2012: 49
- FWCI
- 16.43
- Type
- journal article
- Language
- en
- Open access
- green
- www.scopus.com
- Licence
- Locations
- Diabetic Medicine (publishedVersion)
- PubMed (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Digital Academic REpository of VU University Amsterdam (Vrije Universiteit Amsterdam) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Funders
- Novo Nordisk
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Keywords
- psychosocial problems, diabetes self-care, barriers to self-care, type 1 diabetes, type 2 diabetes, medication adherence, dietary adherence, exercise adherence, psychological well-being, psychological intervention, patient and provider perspectives
- MeSH terms
- Adult, Cross-Sectional Studies, Cross-Cultural Comparison, Diabetes Mellitus, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Family Practice, Female, Humans, Male, Mental Health, Middle Aged, Nurse Practitioners, Patient Compliance, Self Care, Stress, Psychological
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