Behavioral science in diabetes - Contributions and opportunities

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.