New directions for diabetes prevention and management in behavioral medicine

Abstract

Accelerating diabetes rates have resulted in a global public health epidemic. Lifestyle change is a cornerstone of care, yet regimen demands may result in adherence difficulties. Distress, depression, and other psychosocial concerns are higher in those with diabetes. While interventions, such as the Diabetes Prevention Program appear to be effective, further research is needed to support the translation of interventions to prevent diabetes. Studies assessing optimal approaches to promoting effective decision making, coping and adherence are needed. More information is needed to evaluate the influence and potential of emerging technologies on intervention delivery and quality of life in children and adults with diabetes. Theoretically informed, interdisciplinary studies that consider ecological models are needed to develop a roadmap for policies and diabetes management recommendations. Reduction of diabetes-related health disparities is a critical area for future studies. Behavioral medicine scientists and practitioners are poised to address these and other proposed future research directions to advance diabetes prevention and management.

Biopsychosocial Aspects of Weight Management in Type 1 Diabetes: a Review and Next Steps

“…Moreover, it may be that multilevel approaches that involve family members, peers, school personnel, and modification of the home environment, in addition to individual-level approaches (e.g., individual therapy to address depression, low self-esteem, body image dissatisfaction, pharmacotherapy), are needed for overweight/obesity prevention and/or intervention programs [108]. Thus, interventions that focus solely on food consumption or physical activity are not likely to be effective.…”

Motivating future directions of behavioral medicine

“…While there is a large evidence base demonstrating that lifestyle interventions can aid in prevention of chronic disease, not enough people are benefiting from these programs (Stetson et al, 2016). What we need are low-cost, high-impact approaches to disseminating this knowledge on a larger scale.…”

“…The life course perspective asks that researchers and health practitioners take a broad holistic social ecological approach to intervening for health promotion, and consider risk and protective factors across the domains of influence. Similarly, transitions associated with emerging adulthood present unique challenges, risks, and needs for intervention and prevention, particularly with regard to chronic diseases such as diabetes (Stetson et al, 2016). The health of the millions of military service members and veterans in the US is of great concern, especially given the fact that military service members tend to be healthier than the general population upon entry but have equivalent or worse health than civilians long term.…”

“…Stetson et al (2016) describe the need for ecological models of diabetes that include an understanding of policy and place, and research designs that have adequate minority representation. Buscemi et al (2016) also underscore the importance of place and environment on health outcomes.…”

“…Also, to appropriately use these tools we must understand their benefits alongside potential drawbacks, and we must explore the psychological and behavioral implications of these innovations on individuals who use them (Stetson et al, 2016). Technology may not be the right tool for everyone, and while it holds promise its effects may not be unilaterally positive.…”