DAWN2™ Study © 2013 Novo Nordisk A/S. All rights reserved DIABETES CARE – WHAT PATIENTS WANT Roz Rosenblatt London Regional Manager

DAWN2™ Study © 2013 Novo Nordisk A/S. All rights reserved UK/DA/0214/0005aUK/DA/0214/0005a. Date of preparation Feb 2014

DAWN2™ Study © 2013 Novo Nordisk A/S. All rights reserved Presentation title Slide No 3 Date DAWN2™ Study © 2013 Novo Nordisk A/S. All rights reserved

17 countries International Diabetes Federation (IDF) Steno Diabetes Center International Alliance of Patient Organizations (IAPO) DAWN2™: A global 360° perspective on diabetes The UK study included approximately 900 participants: 500 people with diabetes, 120 family members and 280 healthcare professionals 15,438 respondents 8,596 people with diabetes 2,057 family members 4,785 diabetes care professionals Patient organisations and policy makers

DAWN2™ Study © 2013 Novo Nordisk A/S. All rights reserved DAWN2™ is the first study of its kind to use a 360 o approach to reducing the burden of diabetes, interviewing not only people with diabetes, but also their family members, nurses, dieticians, general practitioners and specialists.

DAWN2™ Study © 2013 Novo Nordisk A/S. All rights reserved Presentation title Slide No 6 Date DAWN2™ Study © 2013 Novo Nordisk A/S. All rights reserved

Diabetes can have a negative impact on emotional and physical well-being On average, each person with diabetes experiences around two episodes of severe hypoglycaemia per year. DAWN2 TM Country Report, United Kingdom – data on file

DAWN2™ Study © 2013 Novo Nordisk A/S. All rights reserved Data: Adjusted for clustering, and weighted on age, gender, region and education to allow generalization from the sample to larger populations Nicolucci A, et al. Diabet Med 2013;30:767–77 Diabetes-related emotional distress around the world Across 17 countries 44.6% of people with diabetes had emotional distress due to their diabetes

DAWN2™ Study © 2013 Novo Nordisk A/S. All rights reserved 1. DAWN2 TM Country Report, United Kingdom – data on file 2. Kovacs K et al. Diabet Med 2013;30, 778–788 Diabetes has a significant impact on the lives of family members

DAWN2™ Study © 2013 Novo Nordisk A/S. All rights reserved DAWN2 TM Country Report, United Kingdom – data on file Family members provide valuable support and want to play a role in diabetes care

DAWN2™ Study © 2013 Novo Nordisk A/S. All rights reserved Data: Adjusted for clustering Kovacs Burns K, et al. Diabet Med 2013;30:778–88 Hypoglycaemia can be a particular worry for family members Across 17 countries 61.3% of family members worried about the risk of hypoglycaemic events in their loved ones

DAWN2™ Study © 2013 Novo Nordisk A/S. All rights reserved People with diabetes (%) Family members (%) Reduced physical health5821 Reduced emotional well-being4735 Finances2625 Impacted on leisure activities4531 Work studies2219 Relationship with family/friends/peers2316 DAWN2 TM Country Report, United Kingdom – data on file Diabetes can negatively impact several aspects of people’s lives

DAWN2™ Study © 2013 Novo Nordisk A/S. All rights reserved DAWN2 TM Country Report, United Kingdom – data on file HCPs agree that self management needs improving but provision of structured education is lacking

DAWN2™ Study © 2013 Novo Nordisk A/S. All rights reserved There can be a disconnect in perceptions of care between HCPs and people with diabetes DAWN2 TM Country Report, United Kingdom – data on file

DAWN2™ Study © 2013 Novo Nordisk A/S. All rights reserved Data show numbers of healthcare professionals indicating that major improvement in the area is required Access to quality diabetes care – several areas need major improvement, including prevention and psychological support DAWN2 TM Country Report, United Kingdom – data on file

DAWN2™ Study © 2013 Novo Nordisk A/S. All rights reserved DAWN2 TM Country Report, United Kingdom – data on file People with diabetes can feel discriminated against

DAWN2™ Study © 2013 Novo Nordisk A/S. All rights reserved

DAWN2™ UK Action Plan Improve communication between healthcare professionals and people with diabetes regarding treatment targets, measures and options Increase commissioning of structured education and involvement in care planning for people with diabetes Increase access to and uptake of education resources for people with diabetes and family members Raise awareness of the need for psychological and psychosocial care among people with diabetes and healthcare professionals Improve provision of information on management of hypoglycaemia for patients, pharmacists, family members and healthcare professionals UK/DA/0214/0005aUK/DA/0214/0005a. Date of preparation Feb 2014

DAWN2™ Study © 2013 Novo Nordisk A/S. All rights reserved WHAT’S HAPPENING IN LONDON?

Psychological support is One of the 15 Health Care Essentials One of the NICE Quality Standards BUT Few areas have provision for psychological care that is only for those with diabetes ‘Projects’ not mainstream NHSE - London CSN for mental health

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