OBJECTIVE - To summarize the current status of behavioral research and prac
tice in diabetes and to identify promising future directions.
RESEARCH DESIGN AND METHODS - We review behavioral science contributions to
diabetes in self-management and patient empowerment, interventions with ch
ildren and adolescents, and special problems including blood glucose awaren
ess training and complications such as depression. We also identify emergin
g areas in which behavioral science stands to make significant contribution
s, including quality of life, worksite and community programs, intervention
s using new information technologies, and translation research evaluating p
ractical programs in representative settings. We then discuss the gap betwe
en the generally encouraging research on behavioral contributions to diabet
es and the infrequent incorporation of such contributions in practice. Sugg
estions are made for how to close this gap, including ways to increase unde
rstanding of behavioral issues, opportunities for funding of key research a
nd implementation questions, and how behavioral science principles can beco
me more integrated into diabetes organizations and care.
CONCLUSIONS - Changes are required on the part of behavioral scientists in
how they organize and present their research and on the part of potential u
sers of this knowledge, including other health professions, organizations,
and funding agencies. Integrating behavioral science advances with other pr
omising genetic, medical, nutritional, technology health care, and policy o
pportunities promises not only to broaden our understanding of diabetes but
also to improve patient care, quality of life, and public health for perso
ns with diabetes.