Raising awareness at the grassroots level –

community and workplace

This slideset was developed in 2007 with support from GlaxoSmithKline

The need for improved global awareness

Healthy diet and exercise could prevent up to 80% of type 2 diabetes

7 million new cases of diabetes each year

At least 50% of people with diabetes do not know they are affected

Every 10 seconds, a person diesfrom diabetes-related causes

International Diabetes Federation. Did You Know?http://www.idf.org/home/index.cfm?unode=3B96906B-C026-2FD3-87B73F80BC22682A

Diabetes has serious implications

Blindness

Leading causeof blindnessin working ageadults1

Kidney failure

Leading cause of end-stage kidney disease2

Heart Disease

Stroke

2 to 4 fold increase in cardiovascular mortality and stroke3

Amputations

Leading cause of non-traumatic lower extremity amputations5

8/10 diabetic patients die from cardiovascular events4

1 Fong DS et al. Diabetes Care 2003; 26 (Suppl. 1):S99–S102. 2Molitch ME et al. Diabetes Care 2003; 26 (Suppl. 1):S94–S98. 3 Kannel WB et al. Am Heart J 1990; 120:672–676. 4Gray RP & Yudkin JS. In Textbook of Diabetes 1997 Chapter 57.

5Mayfield JA et al. Diabetes Care 2003; 26 (Suppl. 1):S78–S79.

Unite for Diabetes: World Diabetes Day

United Nations Resolution on DiabetesGeneral Assembly of the UN

• Designated 14 November, the current World Diabetes Day, as a United Nations Day, to be observed every year from 2007

• Invited all member states to observe World Diabetes Day in order to raise public awareness on diabetes care and prevention

United Nations. Resolution on Diabetes. http://www.unitefordiabetes.org/assets/files/UN_Resolution.pdf.

What can communities do?

Raise public awareness

Create a sense of urgency

Communicate the magnitude of the problem

Get people involved in improving their health

Recognise those who are most at risk

Reduce risk to families, friends and wider communities

What examples do we have of successful campaigns?

Increasing awareness of diabetes, its risk factors and complications

Chennai Urban Rural Epidemiology Study, India

Chennai Urban Rural Epidemiology Study

• Study in Chennai, largest city in Southern India

• Questionnaire completed by ~26,000 individuals

• Five questions about diabetes; data collected on:– education

– medical history

Do you know what diabetes is?

Do you think more people are affected

by diabetes nowadays?

What factors do you think

contribute to diabetes?

Do you know that diabetes can cause

complications in other organs?

Can diabetes be prevented?

Mohan D et al. J Assoc Physicians India 2005; 53:283287.

Diabetes as

a conditionIncreasing prevalenceof diabetes

Complications:

Adpated from Mohan D et al. J Assoc Physicians India 2005; 53:283287.

The need for improved awareness: Chennai Urban Rural Epidemiology Study

Diabetes ispreventable

Risk factors:– Family history– Lack of physical activity– Obesity

– Foot problems– Kidney disease– Eye disease– Heart attack– Stroke

Individuals (%)

0 100Aware of:

10 20 30 40 50 60 70 80 90

Increase awareness, promote change: Chennai Urban Rural Epidemiology Study

• Complementary programme of initiatives including:– Counselling of people with/at risk of

diabetes– Public lectures on benefits of regular

exercise, tailored to age, gender and cultural background

– Educational materials distributed to every household

– Short video sequences highlighting serious nature of diabetes and importance of physical activity

+313%

People exercisingmore than 3 times/week

Mohan V et al. J Assoc Physicians India 2006; 54:858862.

Raising awareness among high risk groups

Measure Up Campaign,Diabetes UK

Measure Up Campaign, Diabetes UK

Objective• 25% in awareness of diabetes and

Diabetes UK services in people with undiagnosed type 2 diabetes

Strategy• Campaign targeting information to high

risk groups, including:– the overweight– people with a family history of

diabetes– black and minority ethnic groups– people aged over 40

Diabetes UK. Measure Up – Are You At Risk of Diabetes. http://www.diabetes.org.uk/Measure_Up_-_are_you_at_risk_of_diabetes/.

Measure Up: Tactics

• Roadshows ~20 UK towns/year– Simple 2-minute test to assess

risk of diabetes– Advice about diabetes

• Advertising– Posters at strategic locations

throughout the UK– Adverts in national newspapers

and consumer magazines– Online targeting of at risk groups

• Lobbying– Extended poster campaign and

awareness day at UK Houses of Parliament

– Campaigning at conferences of UK political parties

Diabetes UK. Measure Up – Are You At Risk of Diabetes. http://www.diabetes.org.uk/Measure_Up_-_are_you_at_risk_of_diabetes/.

Measure Up: Results

Print media campaign reaches

> 33 million people4,000 posters at strategic locations

870,000 people

reached online

200,000 visitors to Diabetes UK website in first 2 months

> 3 million people

recall campaign

> 150,000 tested for diabetesby family doctor

> 93,000 orders for campaign materials

by healthcare professions

Diabetes UK. Measure Up – Are You At Risk of Diabetes. http://www.diabetes.org.uk/Measure_Up_-_are_you_at_risk_of_diabetes/.

Simple steps to prevent diabetes

Small Steps, Big RewardsUS National Diabetes Education Program

Diabetes can be prevented or delayed:Small steps, Big rewards

Diabetes can be prevented through small steps:Lose a modest amount of weight (5–7%)…

… by building up to 30 mins of physical activity/day…

… and following a low-calorie, low-fat eating plan

For big rewards:– Healthier and longer life– Avoid serious complications such as heart

disease, stroke, blindness, kidney failure and amputations

– Peace of mind

Campaign run by the US National Diabetes Education Programme

National Diabetes Education Program. Small steps. Big Rewards. Prevent Type 2 Diabetes. http://ndep.nih.gov/campaigns/SmallSteps/SmallSteps_index.htm.

Small steps, Big rewardsCampaign components

• Public service advertising– Television, radio and print

• Publicity campaign– Events in cities across the US to

promote community-based weight loss and lifestyle change

• “GAME PLAN” toolkit for health professionals

– Latest research on diabetes prevention

– Practical tips for counselling patients about weight loss

– Educational materials

• “GAME PLAN” consumer materials– Provide at-risk individuals with everything needed to start and maintain weight loss

– Practical tips tailored for specific audiences, e.g. elderly, ethnic groups

National Diabetes Education Program. Small steps. Big Rewards. Prevent Type 2 Diabetes. http://ndep.nih.gov/campaigns/SmallSteps/SmallSteps_index.htm.

Regular physical activity can make a huge difference

Walk Missouri&

Tour de Cure

Community-based initiatives:Walk Missouri

• Community-wide media campaign in St. Joseph, Missouri

• Billboard, newspaper and radio advertisements

• Promoted benefits of walking and moderate physical exercise in reducing:– diabetes

– other diseases including heart disease and stroke

Wray RJ et al. Prev Chronic Dis 2005: 2:117.

Encouraging regular physical activity:Walk Missouri – the results

Participated insponsored walk

Participated in worksite wellness activities

Participated in health fairsponsored by local HCP

Walked ≥ 10 min at a timeduring usual week

Days/week walked ≥ 10 min at a time

Total minutes walkedon scale of 1–6

Wray RJ et al. Prev Chronic Dis 2005: 2:117.

+760%*

*P < 0.05

+100%*

+30%

–1%

+15%*

+3%

American Diabetes Association:Tour de Cure

• Series of fund raising cycling events in support of the ADA

• In the 2006 series: 32,000 cyclists…

took part in 78 events…

raising nearly $13 million

• Riders champion the search for a cure for diabetes and many have diabetes themselves

American Diabetes Association. Tour de Cure.http://tour.diabetes.org/.

Helping doctor/patient communication

Designs on Diabetes

Designs on Diabetes:Highlighting the emotional impact of diabetes

• Art competitions across the Asia-Pacific region

• Doctors submit their artwork expressing what they think living with diabetes is like

• Intended to build empathy and improve communication between patients and doctors

• Artwork will also be used in a number of ways to raise awareness of diabetes

Making a difference

What can you do?

You can make a difference! (1)

Recognise risk factors– Family history– Waist circumference– Ethnic groups– Age

Recognise that increasing public awareness through simple campaigns can change attitudes and produce resultsGet involved – organise events to increase exercise levels

You can make a difference! (2)

Understand the need for regular weight and eye tests

Encourage communication between patients and healthcare providers

Educate on the need for urgency in attaining good glycaemic control

Talk to each other and share success stories